Hypotension and hypoxaemia in blunt traumatic brain injury.
Each year, ~89 000 (180/100 000) new cases of head injury are reported in SA. Most patients are in the economically active population.
Hypotension and hypoxaemia significantly increase morbidity and mortality after traumatic brain injury (TBI). Cerebral tissue is particularly vulnerable to these secondary insults immediately after a TBI, emphasising the importance of prehospital care.
Most TBIs are followed by an epsiode of apnoea, even if just for a brief period. Hypoxaemia was associated with a near-doubling in mortality from 27% to 50%.
The prevalence of hypotension and hypoxaemia associated with TBI in the greater Johannesburg area reported by Stassen and Welzel  is comparable with that observed in international studies. Hypotension was associated with midazolam dosage and the presence of injuries that could result in significant haemorrhage. Similarly, hypoxaemia was associated with injuries to the chest. This study highlights the need for the development of a national TBI protocol for prehospital care providers that is based on sound clinical evidence and can guide decision-making on the most appropriate interventions in the prehospital setting to optimise outcome.
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|Title Annotation:||EDITOR'S CHOICE|
|Publication:||South African Medical Journal|
|Date:||Jun 1, 2014|
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