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.

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.