Jurnal Internasional Afrika vol.10 issue.3 2020
African Journal of Emergency Medicine
Emergency department management of traumatic brain injuries: A resource tiered review
Dublin Core
Title
Jurnal Internasional Afrika vol.10 issue.3 2020
African Journal of Emergency Medicine
Emergency department management of traumatic brain injuries: A resource tiered review
African Journal of Emergency Medicine
Emergency department management of traumatic brain injuries: A resource tiered review
Subject
Traumatic brain injury
trauma
Emergency management
Head injury
TBI
trauma
Emergency management
Head injury
TBI
Description
Introduction: Traumatic brain injury is a leading cause of death and disability globally with an estimated African
incidence of approximately 8 million cases annually. A person suffering from a TBI is often aged 20–30, con-
tributing to sustained disability and large negative economic impacts of TBI. Effective emergency care has the
potential to decrease morbidity from this multisystem trauma.
Objectives: Identify and summarize key recommendations for emergency care of patients with traumatic brain
injuries using a resource tiered framework.
Methods: A literature review was conducted on clinical care of brain-injured patients in resource-limited set-
tings, with a focus on the first 48 h of injury. Using the AfJEM resource tiered review and PRISMA guidelines,
articles were identified and used to describe best practice care and management of the brain-injured patient in
resource-limited settings.
Key recommendations: Optimal management of the brain-injured patient begins with early and appropriate
triage. A complete history and physical can identify high-risk patients who present with mild or moderate TBI.
Clinical decision rules can aid in the identification of low-risk patients who require no neuroimaging or only a
brief period of observation. The management of the severely brain-injured patient requires a systematic ap-
proach focused on the avoidance of secondary injury, including hypotension, hypoxia, and hypoglycaemia. Most
interventions to prevent secondary injury can be implemented at all facility levels. Urgent neuroimaging is
recommended for patients with severe TBI followed by consultation with a neurosurgeon and transfer to an
intensive care unit. The high incidence and poor outcomes of traumatic brain injury in Africa make this subject
an important focus for future research and intervention to further guide optimal clinical care.
incidence of approximately 8 million cases annually. A person suffering from a TBI is often aged 20–30, con-
tributing to sustained disability and large negative economic impacts of TBI. Effective emergency care has the
potential to decrease morbidity from this multisystem trauma.
Objectives: Identify and summarize key recommendations for emergency care of patients with traumatic brain
injuries using a resource tiered framework.
Methods: A literature review was conducted on clinical care of brain-injured patients in resource-limited set-
tings, with a focus on the first 48 h of injury. Using the AfJEM resource tiered review and PRISMA guidelines,
articles were identified and used to describe best practice care and management of the brain-injured patient in
resource-limited settings.
Key recommendations: Optimal management of the brain-injured patient begins with early and appropriate
triage. A complete history and physical can identify high-risk patients who present with mild or moderate TBI.
Clinical decision rules can aid in the identification of low-risk patients who require no neuroimaging or only a
brief period of observation. The management of the severely brain-injured patient requires a systematic ap-
proach focused on the avoidance of secondary injury, including hypotension, hypoxia, and hypoglycaemia. Most
interventions to prevent secondary injury can be implemented at all facility levels. Urgent neuroimaging is
recommended for patients with severe TBI followed by consultation with a neurosurgeon and transfer to an
intensive care unit. The high incidence and poor outcomes of traumatic brain injury in Africa make this subject
an important focus for future research and intervention to further guide optimal clinical care.
Creator
Julia Dixon, Grant Comstock, Jennifer Whitfield, David Richards, Taylor W. Burkholder, Noel Leifer, Nee-Kofi Mould-Millman, Emilie J. Calvello Hynes
Source
https://doi.org/10.1016/j.afjem.2020.05.006
Date
20 May 2020
Contributor
peri irawan
Format
pdf
Language
english
Type
text
Files
Citation
Julia Dixon, Grant Comstock, Jennifer Whitfield, David Richards, Taylor W. Burkholder, Noel Leifer, Nee-Kofi Mould-Millman, Emilie J. Calvello Hynes, “Jurnal Internasional Afrika vol.10 issue.3 2020
African Journal of Emergency Medicine
Emergency department management of traumatic brain injuries: A resource tiered review,” Repository Horizon University Indonesia, accessed February 4, 2025, https://repository.horizon.ac.id/items/show/1816.
African Journal of Emergency Medicine
Emergency department management of traumatic brain injuries: A resource tiered review,” Repository Horizon University Indonesia, accessed February 4, 2025, https://repository.horizon.ac.id/items/show/1816.