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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