In this episode, Sam Ashoo, MD and Dr. Dana Klavansky, MD discuss the March 2026 Emergency Medicine Practice article, Emergency Department Evaluation and Management of Severe Traumatic Brain Injury

  • Introduction & Welcome (0:15)
  • Guest Introduction (0:55)
  • Epidemiology of Severe TBI (2:37)
  • Pathophysiology: Primary vs. Secondary TBI (4:24)
  • Types of Hemorrhage and Hematomas (5:25)
  • Classification (7:31)
  • Mild vs. Moderate vs. Severe TBI
  • Impact Loading vs. Inertial Loading
  • Differential Diagnosis (9:22)
  • Prehospital Care (9:42)
  • Emergency Department History (13:33)
  • Diagnostics (15:13)
  • CT Scan and the A-B-B-B-C Approach
  • Repeat CT Timing
  • Bedside Ultrasound for Optic Nerve Sheath Diameter
  • Pupillometry
  • Biomarkers
  • Treatment (24:52)
  • Airway Management
  • Ventilation and CO2 Targets
  • Hyperosmolar Therapy: Hypertonic Saline and Mannitol
  • Cerebral Perfusion Pressure
  • Blood Pressure Goals
  • Temperature Management
  • Coagulopathy Management
  • Seizure Prophylaxis and EEG Monitoring
  • Tiered ICP Management (35:29)
  • Surgical Indications (38:40)
  • Prognosis (40:33)
  • Special Topics (41:30)
  • Sports Injuries and CTE
  • Tranexamic Acid (CRASH-3 Trial)
  • Wrap-Up (43:46)

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