Evidence-based Early Intervention in Neurotrauma Patients with Suspected Elevated Intracranial Pressure

The treatment of suspected increased intracranial pressure (ICP) in neurotrauma patients is one of the most critical aspects of early trauma care. Delayed treatment can lead to secondary brain injury and a worse outcome. In this article, evidence-based pretreatment, positioning, and early imaging in the treatment of increased ICP in neurotrauma patients are discussed. Critical interventions include early application of hypertonic agents, i.e. mannitol and hypertonic saline. This helps to reduce ICP and improve cerebral perfusion. Head-of-bed elevation (30°–45°) and hyperventilation also optimize ICP and improve cerebral blood flow. Parallel processing – performing interventions and imaging simultaneously – minimizes delays and optimizes the timeliness of critical care. This requires prompt transportation and early imaging to identify structural causes of raised ICP, such as hematomas or cerebral edema, to allow early surgical interventions.