Severe Traumatic Brain Injury with Dr. Dana Klavansky

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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