Box 92 Summary of basic management to prevent secondary brain injury A

• Secure airway

• Avoid and treat hypoxaemia

Maintain normal PaCO2

Avoid and treat hypotension (colloids give less interstitial volume increases)

Maintain MAP at around 90 mmHg

• Treat pyrexia

• Ensure adequate sedation and analgesia in intubated patients

• Avoid placing patient head down

• Mannitol/steroids for oedema or surgery for evacuation of haematomas

• CSF shunt if indicated

Full examination once the above secured

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