Further management of the patient depends on neuro exam, nature of injury and age of the patient. Younger patients, especially < 1 y/o, and high-risk types of injuries (e.g. falls from height) are more likely to get a CT and to be admitted. Categorizing risk according to GCS and neuro exam can also be helpful in determining treatment. The high-risk patient with a GCS < 9 should be intubated immediately. An emergency CT is next, followed by Neurosurgery consult and treatment according to the severe TBI protocol. The low risk patient can be managed as in the section on minor TBI. The intermediate risk patient needs an urgent CT and repeated assessment of the GCS. CT has largely replaced skull xray in trauma management, although an xray tangential to an area suspicious for depressed skull fracture may be useful. Indications for hospital admission include: GCS < 15 early posttraumatic seizure (not a contact seizure) compound or depressed skull fracture basilar skull fracture persistent vomiting, dizziness or abnormal neurologic findings in the ER "Clinical" Pages: Previous 1 2 3 4 Next