TBI (Adult)

Question 1

Recite the high risk TBI CPG (Adult)

Answer 1

Question 2

Recite the medium risk TBI CPG (Adult)

Answer 2

Question 3

Recite the low risk TBI CPG (Adult)

Answer 3

Question 4

What criteria categorise a patient as ‘High Risk – Trauma Time Critical’ following head trauma?

Answer 4

Any of the following:
* Moderate to severe TBI (GCS < 13)
* Penetrating head injury
* High-risk features:
* LOC > 5 minutes
* Skull fracture
* Vomiting more than once
* Neurological deficit
* Seizure
* Worsening signs and symptoms

GCS stands for Glasgow Coma Scale, a scale used to assess consciousness in a person.

Question 5

How should high-risk TBI patients be managed?

Answer 5

As per CPG A0810 Major Trauma:
* Airway: manage
* Breathing: provide oxygenation/ventilation
* Circulation: avoid hypotension
* Supportive care
* Transport as per CPG A0105 Trauma Triage

CPG stands for Clinical Practice Guidelines.

Question 6

What findings indicate moderate risk in head trauma?

Answer 6

Altered mental status
Dangerous mechanism of injury:
* Motor/cyclist impact > 30 km/h
* High speed MCA > 60 km/h
* Pedestrian impact
* Ejection from vehicle
* Prolonged extrication
* Fall from height > 3 m
* Hit by falling object > 3 m
* Explosion
* Amnesia ≥ 30 mins
* Intoxication
* Age ≥ 65
* Coagulopathy / anticoagulant / antiplatelet use (not aspirin)

MCA refers to motor vehicle accident.

Question 7

How are moderate-risk patients managed?

Answer 7

Transport: CT scan or observation required
Consider VWED: if age/coagulopathy are only risk factors with no other concerning features

VWED stands for Vulnerable and Weak Elderly Demographic.

Question 8

What defines a ‘low-risk’ head injury?

Answer 8

No high or moderate risk criteria
Competent adult available to monitor the patient for 4 hours

Monitoring is crucial for ensuring patient safety.

Question 9

What is the advice for patients with concussion symptoms at low risk?

Answer 9

Self-care
Safety netting
Provide health information sheet
GP follow-up within 2–3 days

Safety netting refers to providing patients with information on what to do if their condition worsens.

Question 10

What about low-risk patients with no symptoms?

Answer 10

Provide health information sheet
Safety netting

Even asymptomatic patients should be informed about potential risks and signs to monitor.