Head Injury: Transfer of the patient

Adult/Child

Resuscitation and stabilisation of the patient should be completed before transfer to avoid complications during the journey

• Carers and relatives should have as much access to the patient as is practical during transfer.
• All patients with a GCS ≤8 should be intubated and ventilated
• Patients should be intubated and ventilated immediately if:
  • Coma
  • Loss of protective laryngeal reflexes
  • Ventilatory insufficiency (hypoxaemia or hypercabia)
  • Respiratory arrhythmia

Intubate and ventilate before transfer if:

• Significant decrease in loss of consciousness, even if not coma
• Major facial fractures compromising airway
• Copious bleeding into mouth
• Seizures

An intubated patient should be ventilated with appropriate sedation and analgesia.

Aim for a PaO2 >13 kPa and a PaCO2 4,5-5 kPa .

Patient should be accompanied by a trained paramedic.