If the casualty does not have any of the risk factors described above, the provider should care for the casualty as described in the MACE2. If worsening symptoms develop more than 24 hours after the initial injury, the provider should contact the designated TBI Biomarker Consultant.

Research suggests that some casualties without MACE2 red flags undergo evacuation for head CT despite the MACE2 recommendations. If a provider wishes to obtain a head CT in individuals without the high or moderate risk signs or symptoms described above, a TBI whole blood biomarker test should be performed before referral for a head CT if the casualty is evaluated within 24 hours of injury.

Consultation with the designated TBI Biomarker Consultant is strongly recommended to help determine the urgency of referral and evacuation.