Pre-hospitaal management van ernstig hersenletsel

Hammell CL, Henning JD. Prehospital management of severe traumatic brain injury. BMJ 2009;338:b1683.

Management of severe traumatic brain injury is focused on rapid transfer to secondary care while preventing secondary brain injury
Airway compromise and inadequate ventilation are common and should be addressed immediately
Prehospital endotracheal intubation should be undertaken with the assistance of anaesthetic drugs by appropriately trained physicians
Hypotension is an independent risk factor for mortality; small boluses of isotonic crystalloid fluids should be given if it occurs
Patients may be best managed in a neurosurgical centre where they should receive definitive neurosurgical treatment within 4 hours of injury
There is no role for the routine use of corticosteroids in patients with head injury

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