![]() The crani occurred more than 4 hours after arrival. This one looks straightforward, right? But not so fast. He is taken to the OR for craniotomy by neurosurgery at 4:15. GCS was 14 on arrival, but has declined to 12 by the time you leave the CT scanner. ![]() Head CT shows a 12mm epidural hematoma with 8mm midline shift and ventricular effacement. He enters your trauma center at exactly midnight as a trauma activation. Today, I’ll give you my answer to the first case.Ī young male is involved in a motor vehicle crash and strikes his head. ![]() I asked for your input as to when the clock should actually start for the 4-hour craniotomy/craniectomy rule. In my last post, I presented two potential performance improvement (PI) cases.
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