Traumatismo craneoencefálico grave. Actualización al manejo inicial en urgencias. Revisión sistemática

Abstract

Antecedents: Severe traumatic brain injury (TBI) is the leading cause of disability and mortality worldwide. It is estimated that there are approximately 50,000 deaths/year; its incidence varies according to geographic areas, and it is seen that out of every 100,000 people, 200 experience a TBI. The most frequent causes are car accidents, falls from heights, and violent acts. A TBI is scored at less than 8; in addition, imaging examinations and timely, effective and correct interventions in the treatment are performed. Objective: To identify emergency management for patients with TBI. Methodology: Qualitative research about managing patients with TBI was conducted with a non-experimental, descriptive-analytical design; the PRISMA 2020 statements were applied for the research structure. Scientific articles published from 2019 to 2023 were analyzed in Spanish and English and scientific databases such as Web of Science, SciELO, Scopus, PubMed, and Google Scholar. Results: Thirty-six articles were reviewed. Establishing the central management in emergencies to the Airway, Breathing, Circulation, Disability, Expose/Environment (ABCDE) and the importance of controlling complications such as increased in intracranial pressure (ICP), seizures, and neuroendocrine alterations. Conclusions: It has been shown that management is based on the primary measures of stabilization, intubation, adequate oxygenation, placement of two peripheral lines, blood pressure (BP) control, avoidance of hypothermia, ICP monitoring, fluid administration, and the possible need for surgery, reducing patient mortality.