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Head injury transfer — DIPIMC MCQ

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HardRetrieval and TransportHead injury transferDIPIMCDipIMC

You are transferring an intubated patient with a severe traumatic brain injury and must set ventilation and pressure goals. The end-tidal carbon dioxide is currently 3.0 kPa and the blood pressure is 100/60.

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: E — Target normocapnia and maintain an adequate systolic pressure to preserve cerebral perfusion.

During transfer of a head-injured patient, ventilation targets normocapnia of around 4.5 to 5.0 kPa, and the systolic pressure is kept adequate to maintain cerebral perfusion pressure and avoid secondary injury. Sustained hyperventilation causes cerebral ischaemia, and permissive hypotension is harmful in the presence of brain injury. Oxygenation is optimised rather than deliberately kept low.

Reference: NICE NG232 (Head injury)