Treatment for the casualty with a suspected head injury/TBI should be initiated as soon as possible following acute injury with the goal of preventing secondary brain injury caused by hypoxia and hypotension.

Treatment should include the following:

- Control hemorrhage from head and other injuries
- Administer tranexamic acid as indicated per TCCC guidelines
- Secure airway as indicated
- Provide supplemental oxygen if available (monitor with pulse oximetry and maintain oxygen saturation >90%)
- Resuscitate as indicated (monitor and maintain normal radial pulse or, if blood pressure monitoring is available, systolic blood pressure 100-110 mm Hg)
- Treat other immediately life-threatening injuries to prevent hypoxia and hypotension (secondary brain injury)
- Prevent/treat hypothermia
- Administer antibiotics for all open wounds per TCCC guidelines
- Manage pain per TCCC guidelines; TBI does NOT preclude use of ketamine or fentanyl, but caution should be used when administering in casualties suspected of TBI as it may make it difficult to assess mental status, perform a neurologic exam, or determine if casualty is decompensating

More advanced treatments and interventions for head injury/TBI are addressed in the Tactical Evacuation (TACEVAC) phase of TCCC.