Pre-Quiz: TBI

A two-year-old male is brought to the emergency department (ED) by his mother after she noticed him fall off the couch and onto the floor. She speculates that he fell approximately 2 feet. The fall was unwitnessed as she was in the other room when the incident occurred. The child seems to be behaving normally and exhibits no evident bruising or redness around the head or face. The ED physician employs an algorithm to determine whether a CT scan necessary. According to this criteria, this patient does not require a CT scan. What is the mentioned algorithm?

A 35-year-old male presents to the emergency department following a high-speed motor vehicle accident. He is unconscious, has a suspected spinal cord injury, and his vital signs are within normal limits except for a blood pressure of 165/95 mmHg. His past medical history is significant for hypertension and hyperlipidemia. A CT scan reveals a cervical spine fracture at the C5 level. According to the American Association of Neurological Surgeons and Congress of Neurological Surgeon, which one of the following is the recommended course of treatment for this patient’s spinal cord injury?

A 53-year-old man with a history of hypertension and smoking, presents to the Emergency Department (ED) with shortness of breath, central chest pain and lightheadedness over the past few hours. He appears anxious and distressed on examination and his vitals show a blood pressure of 90/60 mmHg, heart rate of 110 bpm, and respiratory rate of 22 breaths per minute. Notable physical findings include jugular venous distension, distant or muffled heart sounds, and a decrease in systolic blood pressure of >10mm Hg during inspiration (pulsus paradoxus). An immediate echocardiogram demonstrates a large pericardial effusion and concerning signs of cardiac tamponade.

Which of the following is the most appropriate next step in the management of this patient?

A 25-year-old male presents to the emergency department with a head injury after a car accident. He has a past medical history of hypertension. Physical examination reveals a Glasgow Coma Scale score of 8, and a CT scan shows a traumatic brain injury. The patient’s vital signs are stable. Which one of the following medication regimens would be indicated for the patient for the prevention of early-onset post-traumatic seizures?

A 22-year-old food delivery rider is transported to the emergency room 30 minutes after a traffic accident. His BP is 65/42, his HR is 124, and he is maintaining a spo2 of 99% on 1 L of oxygen. You admit the patient and immediately begin fluid resuscitation. Your supervisor requests that you provide intravenous Tranexamic acid (TXA) to reduce coagulopathy risk. What TXA dosage do you propose for this patient?