Head Injuries

Section 6 - TRAUMA

6.07 HEAD INJURIES

INITIAL TRAUMA CARE, (2.02) OXYGEN @ 100% via NRB mask or hyperventilate with BVM.

• Elevate head and shoulders 15 - 30 degrees if systolic BP > 90 mm Hg.
• Refer to ALTERED MENTAL STATUS PRACTICE PARAMETER (5.03).
• If Combative refer to ANALGESIA / SEDATION PRACTICE PARAMETER (2.04)
  • Note: Morphine is the first choice of Combative Head Injury
• MORPHINE - Initial dose 2-5 mg IVP or IN followed by 2 mg doses. (Max 15 mg)
  • Physician’s orders if time permits
• MIDAZOLAM (Versed) - Initial dose 2-5mg IV or IN then 2 mg every 30 seconds to 1 minute.
  • (Max dose 15 mg) in the intubated patient. IM .07-.08 mg/kg with onset in approximately 15 minutes. IM injection requires immediate IV access upon sedation.
• These drugs may be given in combination for maximum effectiveness.
• Ensure that Pulse Oximeter is in place.
• Ensure that BVM and ROMAZICON and/or NARCAN are readily available.
• SCALP WOUNDS
  • Consider iTClamp if available