Head Injuries

From Protocopedia
Jump to navigation Jump to search

Section 6 - TRAUMA

6.07 HEAD INJURIES

INITIAL TRAUMA CARE, (2.02) OXYGEN @ 100% via NRB mask or hyperventilate with BVM.

AND / OR

PEDIATRIC TRAUMATIC BRAIN INJURY MANAGEMENT

  • If the following criteria have been met:
    • GCS < 8 (Consider airway management with an i-gel if no gag reflex)
    • AND Any one of the following:
      • Unilateral fixed or dilated pupil
      • Unilateral paralysis
      • Posturing
      • Seizure after injury
      • Skull deformity
  • 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)
  • Maintain ETCO2 between 30-35 mmHg and Oxygen saturation >95%
  • Transport patient to nearest Pediatric Trauma Center via appropriate method


OTHER OPTIONS

  • 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.
  • DIAZEPAM (VALIUM) 2 - 20 mg SLOW IVP or IM to desired effect.
  • These drugs may be given in combination for maximum effectiveness.
  • Ensure that Pulse Oximeter is in place.
  • Ensure that BVM and ROMAZICON and/or NARCAN are readily available.