Smacc

William Knight presents the considerations in the management of extra-cranial injuries in patients with traumatic brain injuries (TBI). Patients with TBI often have concomitant systemic injuries that complicate the management of the TBI. In this talk William presents his five top areas to think about – prognostication, suitability for the operating room, use of ventilators, pressure considerations and monitoring. Prognostication becomes difficult when a brain injury is added to other injuries due to the long-term nature of neurological damage. This means that other clinicians can be unsure when managing extra-cranial injuries in such patients. Adding a brain injury on top of other injuries tends to make people unsure, and enhances nihilism. Intensivists in the neurological ICU tend to be very protective of their TBI patients. However, some simple measures and tests can go a long way to reassuring the treating team of a patient’s suitability for the operating room. William describes the ‘lay flat test’, which