Key Messages

The Victorian State Trauma System provides support and retrieval services for critically injured patients requiring definitive care, transfer and management. This traumatic brain injury guideline provides advice on the initial management and transfer of major trauma patients who present to Victorian health services with severe injuries.

This guideline is developed for all clinical staff involved in the care of trauma patients in Victoria. It is intended for use by frontline clinical staff that provides early care for major trauma patients; those working directly at the Major Trauma Service (MTS) as well as those working outside of a MTS.

These guidelines provide the user with accessible resources to effectively and confidently provide early care for critically injured patients. They provide up-to-date information for front-line healthcare clinicians. The guideline is evidence based, has followed the AGREE methodology for guideline development and is auspiced by the Victorian State Trauma Committee.

Clinical emphasis points

  • Traumatic brain injury is a significant cause of mortality in Australia
  • Primary and secondary insults can result in significant injury and early management to prevent further brain injury should begin at the scene.
  • Minimising secondary brain injury is best achieved by avoiding periods of hypoxia or hypotension. Maintaining adequate ventilation and cerebral perfusion is essential.
    Avoidance of hypoxia and hypotension is essential
  • Early activation of the retrieval process is crucial once it is identified that the patient has suffered from a major trauma.Time to definitive care at a neurosurgical specialist centre is crucial and ultimately may influence patient outcomes.

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