====== Traumatic brain injury transfer ======


It is sometimes necessary for a neurosurgeon to accept a trauma patient in transfer from another institution that is not equipped to handle major neurologic injuries, or to transfer patients to other facilities for a variety of reasons.

===== Factors to assess in head injured patients =====

[[Hypoxia]] or [[hypoventilation]] ABG, respiratory rate intubate any patient who has [[hypercarbia]], [[hypoxemia]],
or is not localizing

[[Hypotension]] or [[hypertension]] BP, Hgb/Hct transfuse patients with significant loss of blood
volume

[[Anemia]] Hgb/Hct transfuse patients with significant anemia

Seizures electrolytes, AED levels correct [[hyponatremia]] or [[hypoglycemia]]; administer
AEDs when appropriate

[[Infection]] or hyperthermia WBC, temperature LP if meningitis is possible and no contraindications

Spinal stability spine x-rays spine immobilization (spine board, cervical collar & sandbags…); patients with locked facets should be reduced if possible before transfer.