Guidelines for Prehospital Management of Traumatic Brain Injury 3rd Edition: Executive Summary

Area of Science:

• Neuroscience
• Emergency Medicine
• Trauma Surgery

Background:

• Prehospital care significantly impacts traumatic brain injury (TBI) outcomes but is highly variable.
• The Brain Trauma Foundation's guidelines aim to standardize best practices in TBI prehospital care.
• Previous guideline editions have been linked to improved survival rates.

Purpose of the Study:

• To develop updated, evidence-based recommendations for the prehospital assessment, treatment, and transport of TBI patients.
• To incorporate new research and strengthen existing guidelines based on the latest scientific evidence.
• To address emerging areas in TBI management, such as the use of tranexamic acid.

Main Methods:

• A literature search from May 2005 to January 2022 supplemented existing data from the 2nd edition guidelines.
• Identified studies were critically assessed for quality to inform evidence-based recommendations.
• A working group synthesized evidence to generate new and revised recommendations.

Main Results:

• The guideline update is based on 122 published articles, including Class I, II, and III evidence.
• Forty evidence-based recommendations were generated, with 30 classified as strong and 10 as weak.
• New guidelines were developed for topics such as the prehospital administration of tranexamic acid.

Conclusions:

• These updated guidelines identify best practices for prehospital TBI care.
• The guidelines aim to reduce variability and improve outcomes for patients with traumatic brain injury.
• The study highlights knowledge gaps to guide future research in prehospital TBI management.