Provider Practice Essentials registered nurse continuing education

Neuroimaging and decision making in TBI (2008)

  • Inclusion:
    • Non-penetrating trauma to the head
    • Presentation to ED within 24 hours of injury
    • GCS 14 or 15 on initial evaluation in ED
    • Age ≥ 16
  • Exclusion:
    • Penetrating trauma
    • Patients with multi-system trauma
    • GCS < 14 on initial evaluation in the ED
    • Age < 16
  • Level A:
    • A noncontrast head CT indicate in head trauma patients with LOC or post-traumatic amnesia only if ≥ 1 of following is present:
      • Headache
      • Vomiting
      • Age> 60
      • Drug or alcohol intoxication
      • Deficits in short-term memory
      • Physical evidence of trauma above the clavicle
      • Post-traumatic seizure
      • GCS < 15
      • Focal neurological deficit
      • Coagulopathy
  • Level B:
    • A noncontrast head CT should be considered in head trauma patients with no LOC or post-traumatic amnesia if there is:
      • Focal neurological deficit
      • Vomiting
      • Severe headache
      • Age ≥ 65
      • Physical signs of basilar skull fracture
      • GCS < 15
      • Coagulopathy
      • Dangerous mechanism of injury
    • Patients with an isolated TBI who have a negative head CT scan result are at a minimal risk for developing an intracranial lesion and therefore may be safely discharged from the ED.
  • Level C:
    • In mild TBI patient with significant extracranial injuries and a serum S-100B level ≤ 0.5ℳg/L measured w/in 4 hours if injury, consideration can be given to not performing a CT.
    • Mild TBI patients discharged from the E should be informed abut post-concussive symptoms.
  • No specific recommendation for use of head MRI in patient with mild TBI

Clinical policy: Neuroimaging and decisionmaking in adult mild traumatic brain injury in the acute setting. Ann Emerg Med. 2008;52:714-748.

1 thought on “Neuroimaging and decision making in TBI (2008)”

Leave a Comment

Item added to cart.
0 items - $0.00

Member Log-in

Not a Member? Become one today!

  • Membership discounts on live and online programs
  • Continuing education with additional credits
  • Concise references on the most common clinical questions in primary care, urgent care, and emergency medicine

Register here for all of our live workshops

Registration for our programs INCLUDES THE FOLLOWING:

  • Tuition for live education (8am until 5pm)
  • High quality lectures and clinical skills program
  • Hands-on procedure and suture workshop
  • Opportunity to receive certification and a written letter of reference from our faculty
  • Lunch on all course days
  • A practice suture kit, tote bag, course companion guide, and additional course-related materials prior to the course ($99 value)
  • 22 CME credits from the AAPA and 22.25 CME credits from the AANP.
error: Alert: Content is protected !!