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GCS 14 Monitoring — RACP Adult Medicine MCQ

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EasyNeurologyGCS 14 MonitoringRACP Adult Medicine

A 55-year-old man has GCS 14 (E4V4M6) after a fall. He has a scalp laceration but is alert and following commands. CT brain shows a small acute subdural haematoma (5 mm, no midline shift). He is on aspirin. What is the most appropriate airway management?

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Correct answer: B — Supplemental oxygen via NRB mask

GCS 14 — alert, following commands, protecting airway. No intubation needed. Supplemental oxygen and close neurological monitoring (GCS checks every 30 minutes). Small SDH without midline shift — neurosurgical consultation for conservative management vs surgical evacuation. Reverse aspirin effect (platelet transfusion if active bleeding or surgical intervention planned). Serial CT to monitor SDH size.

Reference: ATLS 10th Ed; eTG Emergency 2024