How do physicians on the critical care team treat a traumatic brain injury?

Dr. Darria Long Gillespie, MD
Emergency Medicine
Traumatic Brain Injury (TBI) is an extremely dangerous condition that requries the coordinated efforts of many physicians--ranging from the ER physician to the trauma surgeon to neurosurgeons.  
The first steps are to address the basics--to make sure someone is breathing and protecting their spinal cord.  If there's any danger to either of these, then the physicians often have to intervene immediately.  In the ER, this will be checked again, as well as vital signs, and detailed neurologic exams.  The ER doctors and trauma surgeons will also check the person for other signs of trauma, since someone with a TBI often has other associated injuries.
A patient will then have a string of images taken of their brain--CTs and MRIs, among others.  They may have to have surgery, if there is a hemorrhage inside their brain or any large depressed skull fracture.  
Patients with TBI are usually first placed in the intensive care unit (ICU), where the specialists mentioned above, plus an intensive care physician can monitor them carefully.  They may measure the pressure inside the brain, monitor the patient's vital signs, help care for any other injuries, and give medications if the patient has a dangerously high intracranial pressure.  

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