![]() ![]() Administer antibiotics for all open wounds per TCCC guidelines.Treat other immediately life-threatening injuries to prevent hypoxia and hypotension (secondary brain injury).Resuscitate as indicated (monitor and maintain normal radial pulse or, if blood pressure monitoring is available, systolic blood pressure 100-110 mm Hg).Provide supplemental oxygen if available (monitor with pulse oximetry and maintain oxygen saturation >90%).Administer tranexamic acid as indicated per TCCC guidelines.Control hemorrhage from head and other injuries.Treatment for the casualty with a suspected head injury/TBI should be initiated as soon as possible following acute injury with the goal of preventing secondary brain injury caused by hypoxia and hypotension. Keep in mind that in the combat or trauma setting, altered mental status may be secondary to hypovolemia and/or hypoxia in the presence of other injuries resulting in massive hemorrhage or altered respiratory status. This technique involves assessing for the level of responsiveness by validating whether the casualty is alert (the “ A”), responds to your verbal commands appropriately (the “ V”), responds to painful stimulation (the “ P”), or is unresponsive (the “ U”). Mental status can be further assessed using the AVPU technique. If the casualty is not responding appropriately (noted by observing their verbal and nonverbal responses), this may be a sign of altered mental status. ![]() The initial rapid assessment of a casualty’s mental status comes from communicating with the casualty by asking them to follow commands and to answer questions during the trauma assessment. Exposure to blasts and significant impacts from a fall or vehicle crash can lead to head injuries that are not always accompanied by obvious external signs.Īltered mental status may be your first indication of a possible head injury.
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