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Brain Injury, Traumatic, Pediatric

Mark E. Halstead, MD and Jose A. Pineda, MD, MSCI Reviewed 10/2018
 


BASICS

DESCRIPTION

Traumatic brain injury (TBI): damage to the brain from accidental or nonaccidental trauma 
  • Children >1 year: Glasgow Coma Scale (GCS) <14, amnesia >15 minutes for event, pene...

DIAGNOSIS

HISTORY

  • Eyewitness accounts are invaluable.

  • Details of who was caring for the child

  • Falls: Did LOC precede fall? Height of fall, surface of impact

  • History of epilepsy, cardiac problems

  • History of...

TREATMENT

  • Airway, breathing, circulation

  • Cervical spine stabilization in unconscious patient

  • Prehospital stabilization: Avoid hypoxemia, hyperventilation, and hypotension (strong, possibly modifiable, i...

ONGOING CARE

PROGNOSIS

  • Majority of mild TBI patients recovery without significant sequelae

  • Presence of both hypoxemia and hypotension or traumatic cardiac arrest on arrival to ER bode poorly

  • 24-hour GCS ...

ADDITIONAL READING

  • Badjatia N, Carney N, Crocco TJ, et al. Guidelines for prehospital management of traumatic brain injury 2nd edition. Prehosp Emerg Care.  2008;12(Suppl 1):S1–S52. [View Abstrac...

CODES

ICD9

  • 854.00 Intracranial injury of other and unspecified nature without mention of open intracranial wound, unspecified state of consciousness

  • 854.06 Intracranial injury of other and unspecified n...

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