Initial Management of Traumatic Brain Injury : To Reduce Preventable Trauma Death

DOI Web Site 10 References Open Access
  • Yokobori Shoji
    Department of Emergency and Critical Care, Nippon Medical School Hospital Department of Emergency and Critical Care Medicine, Nippon Medical School
  • Sasaki Kazuma
    Department of Emergency and Critical Care, Nippon Medical School Hospital Department of Emergency and Critical Care Medicine, Nippon Medical School
  • Shibata Ami
    Department of Emergency and Critical Care, Nippon Medical School Hospital Department of Emergency and Critical Care Medicine, Nippon Medical School
  • Kanaya Takahiro
    Department of Emergency and Critical Care, Nippon Medical School Hospital Department of Emergency and Critical Care Medicine, Nippon Medical School
  • Fujiki Yu
    Department of Emergency and Critical Care, Nippon Medical School Hospital Department of Emergency and Critical Care Medicine, Nippon Medical School
  • Yamaguchi Masahiro
    Department of Emergency and Critical Care, Nippon Medical School Hospital Department of Emergency and Critical Care Medicine, Nippon Medical School
  • Sato Shin
    Department of Emergency and Critical Care, Nippon Medical School Hospital Department of Emergency and Critical Care Medicine, Nippon Medical School
  • Watanabe Akihiro
    Department of Emergency and Critical Care, Nippon Medical School Hospital Department of Emergency and Critical Care Medicine, Nippon Medical School
  • Igarashi Yutaka
    Department of Emergency and Critical Care, Nippon Medical School Hospital Department of Emergency and Critical Care Medicine, Nippon Medical School
  • Suzuki Go
    Department of Emergency and Critical Care, Nippon Medical School Hospital Department of Emergency and Critical Care Medicine, Nippon Medical School
  • Kaneko Junya
    Department of Emergency and Critical Care, Nippon Medical School Hospital Department of Emergency and Critical Care Medicine, Nippon Medical School
  • Nakae Ryuta
    Department of Emergency and Critical Care, Nippon Medical School Hospital Department of Emergency and Critical Care Medicine, Nippon Medical School
  • Onda Hidetaka
    Department of Emergency and Critical Care, Nippon Medical School Hospital Department of Emergency and Critical Care Medicine, Nippon Medical School
  • Kitahashi Akiko
    Department of Emergency and Critical Care, Nippon Medical School Hospital Department of Emergency and Critical Care Medicine, Nippon Medical School
  • Kudo Saori
    Department of Emergency and Critical Care, Nippon Medical School Hospital Department of Emergency and Critical Care Medicine, Nippon Medical School
  • Takayama Yasuhiro
    Department of Emergency and Critical Care, Nippon Medical School Hospital Department of Emergency and Critical Care Medicine, Nippon Medical School
  • Naoe Yasutaka
    Department of Emergency and Critical Care, Nippon Medical School Hospital Department of Emergency and Critical Care Medicine, Nippon Medical School
  • Sato Hidetaka
    Department of Emergency and Critical Care, Nippon Medical School Hospital Department of Emergency and Critical Care Medicine, Nippon Medical School
  • Unemoto Kyoko
    Department of Emergency and Critical Care, Nippon Medical School Hospital Department of Emergency and Critical Care Medicine, Nippon Medical School
  • Fuse Akira
    Department of Emergency and Critical Care, Nippon Medical School Hospital Department of Emergency and Critical Care Medicine, Nippon Medical School
  • Morita Akio
    Department of Neurosurgery, Nippon Medical School
  • Yokota Hiroyuki
    Department of Emergency and Critical Care Medicine, Nippon Medical School Graduate School of Medical and Health Science, Nippon Sport Science University

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Other Title
  • 頭部外傷の初期診療
  • ―Preventable Trauma Deathを回避するために―

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<p>  To avoid preventable trauma death (PTD), initial management, including resuscitation, is crucial in traumatic brain injury care. PTD is defined as a case in which the probability of survival exceeds 50% but unfortunately death occurs unless appropriate treatments are available. To diminish the cases of PTD, a standardized approach has been established with several training courses and guidelines. However, 20% of all traumatic brain injury (TBI) patients still suffer from PTD. Our research clarified that the cases of so-called “talk and deterioration” accounted for 26.2% of the PTD cases. In addition, 26.8% of PTD cases were anti-coagulant/anti-platelet drug users. Therefore, to eliminate PTD, measures against anticoagulation are important. Moreover, quick decision making regarding treatments preceding the rapid-changing pathophysiology is also essential in TBI care. In addition to securing airway, breathing support, stabilization of circulation, timely administration of neutralizers for anti-coagulative drugs, and the use of tranexamic acid, a drug for anti-fibrinolysis, is also significant.</p><p>  In this chapter, the pearls of initial TBI management are mentioned, with focus on the “first one hour” of treatment.</p>

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