In this episode, Sam Ashoo, MD and Dr. Dana Klavansky, MD discuss the March 2026 Emergency Medicine Practice article, Emergency Department Evaluation and Management of Severe Traumatic Brain Injury

• Introduction & Welcome (0:15)
• Guest Introduction (0:55)
• Epidemiology of Severe TBI (2:37)
• Pathophysiology: Primary vs. Secondary TBI (4:24)
• Types of Hemorrhage and Hematomas (5:25)
• Classification (7:31)
• Mild vs. Moderate vs. Severe TBI
• Impact Loading vs. Inertial Loading
• Differential Diagnosis (9:22)
• Prehospital Care (9:42)
• Emergency Department History (13:33)
• Diagnostics (15:13)
• CT Scan and the A-B-B-B-C Approach
• Repeat CT Timing
• Bedside Ultrasound for Optic Nerve Sheath Diameter
• Pupillometry
• Biomarkers
• Treatment (24:52)
• Airway Management
• Ventilation and CO2 Targets
• Hyperosmolar Therapy: Hypertonic Saline and Mannitol
• Cerebral Perfusion Pressure
• Blood Pressure Goals
• Temperature Management
• Coagulopathy Management
• Seizure Prophylaxis and EEG Monitoring
• Tiered ICP Management (35:29)
• Surgical Indications (38:40)
• Prognosis (40:33)
• Special Topics (41:30)
• Sports Injuries and CTE
• Tranexamic Acid (CRASH-3 Trial)
• Wrap-Up (43:46)

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