Head Injuries - Revision history

Treloars at 14:05, 24 September 2024

2024-09-24T14:05:21Z

← Older revision		Revision as of 14:05, 24 September 2024
Line 22:		Line 22:
	*** Skull deformity		*** Skull deformity
	''ADULT''		''ADULT''
	* 3% Saline bolus, 250 ml IV or IO		* [[Hypertonic Saline\|3% Saline]] bolus, 250 ml IV or IO
	* Keppra 1 gram IV or IO		* [[Keppra]] 1 gram IV or IO
	''PEDIATRIC''		''PEDIATRIC''
	* 3% Saline bolus at 5 ml/kg (max of 250 ml) IV/IO drip utilizing 10ggts drip set		* [[Hypertonic Saline\|3% Saline]] bolus at 5 ml/kg (max of 250 ml) IV/IO drip utilizing 10ggts drip set
	* Keppra 20mg/kg (not to exceed 1g) IV/IO (may be repeated once at 40mg/kg if seizure continues)		* [[Keppra]] 20mg/kg (not to exceed 1g) IV/IO (may be repeated once at 40mg/kg if seizure continues)
	* Transport patient to nearest Pediatric Trauma Center via appropriate method		* Transport patient to nearest Pediatric Trauma Center via appropriate method

Treloars at 15:06, 23 September 2024

2024-09-23T15:06:38Z

← Older revision		Revision as of 15:06, 23 September 2024
Line 10:		Line 10:
	::'''AND / OR'''		::'''AND / OR'''
	* [[Ketamine\|KETAMINE (KETALAR)]] Titrate to effect, starting dose of 0.5 mg/kg slow IVP or 1 mg/kg IM.		* [[Ketamine\|KETAMINE (KETALAR)]] Titrate to effect, starting dose of 0.5 mg/kg slow IVP or 1 mg/kg IM.
			* Maintain ETCO2 between 30-35 mmHg and Oxygen saturation >95%

	'''~~PEDIATRIC~~ TRAUMATIC BRAIN INJURY MANAGEMENT'''		'''TRAUMATIC BRAIN INJURY MANAGEMENT'''
	* If the following criteria have been met:		* If the following criteria have been met:
	** GCS < 8 (Consider airway management with an i-gel if no gag reflex)		** GCS < 8 (Consider airway management with an i-gel if no gag reflex)
Line 20:		Line 21:
	*** Seizure after injury		*** Seizure after injury
	*** Skull deformity		*** Skull deformity
			''ADULT''
			* 3% Saline bolus, 250 ml IV or IO
			* Keppra 1 gram IV or IO
			''PEDIATRIC''
	* 3% Saline bolus at 5 ml/kg (max of 250 ml) IV/IO drip utilizing 10ggts drip set		* 3% Saline bolus at 5 ml/kg (max of 250 ml) IV/IO drip utilizing 10ggts drip set
	* Keppra 20mg/kg (not to exceed 1g) IV/IO (may be repeated once at 40mg/kg if seizure continues)		* Keppra 20mg/kg (not to exceed 1g) IV/IO (may be repeated once at 40mg/kg if seizure continues)
	* Maintain ETCO2 between 30-35 mmHg and Oxygen saturation >95%
	* Transport patient to nearest Pediatric Trauma Center via appropriate method		* Transport patient to nearest Pediatric Trauma Center via appropriate method

	<BR>		<BR>
	'''OTHER OPTIONS'''		'''OTHER OPTIONS'''

Treloars at 16:29, 20 November 2023

2023-11-20T16:29:13Z

← Older revision		Revision as of 16:29, 20 November 2023
Line 13:		Line 13:
	'''PEDIATRIC TRAUMATIC BRAIN INJURY MANAGEMENT'''		'''PEDIATRIC TRAUMATIC BRAIN INJURY MANAGEMENT'''
	* If the following criteria have been met:		* If the following criteria have been met:
	** GCS < 8 (Consider airway management with an i-gel)		** GCS < 8 (Consider airway management with an i-gel if no gag reflex)
	** AND Any one of the following:		** AND Any one of the following:
	*** Unilateral fixed or dilated pupil		*** Unilateral fixed or dilated pupil

Treloars at 13:11, 20 November 2023

2023-11-20T13:11:03Z

← Older revision		Revision as of 13:11, 20 November 2023
Line 13:		Line 13:
	'''PEDIATRIC TRAUMATIC BRAIN INJURY MANAGEMENT'''		'''PEDIATRIC TRAUMATIC BRAIN INJURY MANAGEMENT'''
	* If the following criteria have been met:		* If the following criteria have been met:
	** GCS < 8 ~~and~~ an ~~advanced airway in place~~		** GCS < 8 (Consider airway management with an i-gel)
	** AND Any one of the following:		** AND Any one of the following:
	*** Unilateral fixed or dilated pupil		*** Unilateral fixed or dilated pupil

Treloars at 19:35, 15 November 2023

2023-11-15T19:35:10Z

← Older revision		Revision as of 19:35, 15 November 2023
Line 21:		Line 21:
	*** Skull deformity		*** Skull deformity
	* 3% Saline bolus at 5 ml/kg (max of 250 ml) IV/IO drip utilizing 10ggts drip set		* 3% Saline bolus at 5 ml/kg (max of 250 ml) IV/IO drip utilizing 10ggts drip set
	* Keppra 20mg/kg (not to exceed 1g) IV/IO (may be repeated once at 40mg/kg is seizure continues)		* Keppra 20mg/kg (not to exceed 1g) IV/IO (may be repeated once at 40mg/kg if seizure continues)
	* Maintain ETCO2 between 30-35 mmHg and Oxygen saturation >95%		* Maintain ETCO2 between 30-35 mmHg and Oxygen saturation >95%
	* Transport patient to nearest Pediatric Trauma Center via appropriate method		* Transport patient to nearest Pediatric Trauma Center via appropriate method

Treloars at 18:22, 15 November 2023

2023-11-15T18:22:07Z

@@ Line 11: / Line 11: @@
 * [[Ketamine|KETAMINE (KETALAR)]] Titrate to effect, starting dose of 0.5 mg/kg slow IVP or 1 mg/kg IM.
 <BR>
 '''OTHER OPTIONS'''

Treloars at 14:57, 8 November 2021

2021-11-08T14:57:03Z

← Older revision		Revision as of 14:57, 8 November 2021
Line 7:		Line 7:
	* Refer to [[Altered Mental Status (AMS)\|ALTERED MENTAL STATUS PRACTICE PARAMETER]] (5.03).		* Refer to [[Altered Mental Status (AMS)\|ALTERED MENTAL STATUS PRACTICE PARAMETER]] (5.03).
	* If '''Combative''' refer to [[Dissociative Anesthetic\|DISSOCIATIVE ANESTHETIC]] (2.05)		* If '''Combative''' refer to [[Dissociative Anesthetic\|DISSOCIATIVE ANESTHETIC]] (2.05)
			* [[Morphine_Sulfate\|MORPHINE]] - Initial dose 2-5 mg IVP, IM or IN followed by 2 mg doses. (Max 15 mg)
			::'''AND / OR'''
	* [[Ketamine\|KETAMINE (KETALAR)]] Titrate to effect, starting dose of 0.5 mg/kg slow IVP or 1 mg/kg IM.		* [[Ketamine\|KETAMINE (KETALAR)]] Titrate to effect, starting dose of 0.5 mg/kg slow IVP or 1 mg/kg IM.
	~~::'''AND / OR'''~~
	* [[Morphine_Sulfate\|MORPHINE]] - Initial dose 2-5 mg IVP, IM or IN followed by 2 mg doses. (Max 15 mg)
	<BR>		<BR>
	'''OTHER OPTIONS'''		'''OTHER OPTIONS'''

Treloars at 14:54, 8 November 2021

2021-11-08T14:54:43Z

← Older revision		Revision as of 14:54, 8 November 2021
Line 7:		Line 7:
	* Refer to [[Altered Mental Status (AMS)\|ALTERED MENTAL STATUS PRACTICE PARAMETER]] (5.03).		* Refer to [[Altered Mental Status (AMS)\|ALTERED MENTAL STATUS PRACTICE PARAMETER]] (5.03).
	* If '''Combative''' refer to [[Dissociative Anesthetic\|DISSOCIATIVE ANESTHETIC]] (2.05)		* If '''Combative''' refer to [[Dissociative Anesthetic\|DISSOCIATIVE ANESTHETIC]] (2.05)
	* [[Ketamine\|KETAMINE (KETALAR)]] 2 mg/kg IVP or ~~IN OR 4~~ mg/kg IM ~~x 1 dose~~		* [[Ketamine\|KETAMINE (KETALAR)]] Titrate to effect, starting dose of 0.5 mg/kg slow IVP or 1 mg/kg IM.
	::'''AND / OR'''		::'''AND / OR'''
	* [[Morphine_Sulfate\|MORPHINE]] - Initial dose 2-5 mg IVP, IM or IN followed by 2 mg doses. (Max 15 mg)		* [[Morphine_Sulfate\|MORPHINE]] - Initial dose 2-5 mg IVP, IM or IN followed by 2 mg doses. (Max 15 mg)

Treloars at 14:30, 24 April 2020

2020-04-24T14:30:20Z

← Older revision		Revision as of 14:30, 24 April 2020
Line 3:		Line 3:


	[[Initial Trauma Assessment and Care\|INITIAL TRAUMA CARE]], (2.02) [[~~Medical Gases~~\|OXYGEN]] @ 100% via NRB mask or hyperventilate with BVM.		[[Initial Trauma Assessment and Care\|INITIAL TRAUMA CARE]], (2.02) [[Oxygen\|OXYGEN]] @ 100% via NRB mask or hyperventilate with BVM.
	* Elevate head and shoulders 15 - 30 degrees if systolic BP > 90 mm Hg.		* Elevate head and shoulders 15 - 30 degrees if systolic BP > 90 mm Hg.
	* Refer to [[Altered Mental Status (AMS)\|ALTERED MENTAL STATUS PRACTICE PARAMETER]] (5.03).		* Refer to [[Altered Mental Status (AMS)\|ALTERED MENTAL STATUS PRACTICE PARAMETER]] (5.03).

Treloars at 13:56, 24 April 2020

2020-04-24T13:56:30Z

← Older revision		Revision as of 13:56, 24 April 2020
Line 12:		Line 12:
	<BR>		<BR>
	'''OTHER OPTIONS'''		'''OTHER OPTIONS'''
	* [[~~Sedative Hypnotics~~\|MIDAZOLAM (Versed)]] - Initial dose 2-5mg IV or IN then 2 mg every 30 seconds to 1 minute.		* [[Versed\|MIDAZOLAM (Versed)]] - Initial dose 2-5mg IV or IN then 2 mg every 30 seconds to 1 minute.
	** (Max dose 15 mg) in the intubated patient. IM .07-.08 mg/kg with onset in approximately 15 minutes. IM injection requires immediate IV access upon sedation.		** (Max dose 15 mg) in the intubated patient. IM .07-.08 mg/kg with onset in approximately 15 minutes. IM injection requires immediate IV access upon sedation.
	* [[~~Sedative Hypnotics~~\|DIAZEPAM (VALIUM)]] 2 - 20 mg SLOW IVP or IM to desired effect.		* [[Valium\|DIAZEPAM (VALIUM)]] 2 - 20 mg SLOW IVP or IM to desired effect.
	* These drugs may be given in combination for maximum effectiveness.		* These drugs may be given in combination for maximum effectiveness.
	* Ensure that Pulse Oximeter is in place.		* Ensure that Pulse Oximeter is in place.