# Answers

### What external forces can cause a head injury?

- Involvement in a vehicle blast event, collision, or rollover
- The presence within 50 METERS of a blast (inside or outside)
- A direct blow to the head or a fall
- Gunshot or shrapnel wound to the head, open skull fracture, or witnessed loss of consciousness
- Exposure to more than one blast event (the Service member’s commander will direct a medical evaluation)

### What are the critical observations or red flags that may prompt urgent evacuation to a higher level of medical care for trauma casualties with a suspected head injury, in accordance with the Military Acute Concussive Evaluation 2 (MACE 2)?

- Deteriorating level of consciousness
- Double vision
- Increased restlessness; combative or agitated behavior
- Repeat vomiting
- Results from a structural brain injury detection device (if available)
- Seizures
- Weakness or tingling in arms or legs
- Severe or worsening headache

### What is the goal of management for casualties with suspected head injuries/TBI in TFC?

Prevention of secondary brain injury from hypotension and hypoxia.