There is limited data on TBI in animals. Anticipate TBI in MWDs after trauma in 25-40% of cases.2-6 TBI carries an extremely high mortality; assume a prehospital mortality of >40% in severe TBI cases. Management of MWDs is largely based on recommendations for treating people. Care by HCPs should be directed at efforts to mitigate secondary injury from hypotension, hyperthermia, hyper- and hypoglycemia, hypoxia, hyper-and hypocapnia, acid-base imbalances, electrolyte imbalances, SIRS, MODS, and ARDS. Thus, HCP care should be directed at maintenance of blood pressure, normoxemia, normal ventilation, and normal body temperature.

 

Clinical Signs Suggesting TBI

Brain injury should be suspected in any trauma patient with altered mentation (coma, stupor, depression, lethargy, inappropriate behavior or responses) or with physical evidence of head trauma (e.g., lacerations, abrasions, bruising, swelling, pain, bleeding from the nose or ears).

 

Figure 47.  Characteristic Neurologic Postures on Presentation