A 28-year-old male is brought to your helicopter after a motorcycle crash. He is unconscious with a Glasgow Coma Scale (GCS) of 6. Which of the following interventions is most appropriate to decrease the risk of secondary brain injury during transport?
Administering supplemental oxygen to maintain oxygen saturation between 94-98%
Elevating the head of the bed to 30 degrees
Administering isotonic fluids to maintain blood pressure
Hyperventilating the patient to maintain a PaCO2 of 25-30 mmHg
Administering supplemental oxygen to maintain the patient's oxygen saturation between 94-98% is crucial to prevent hypoxia, which can exacerbate brain injuries and contribute to secondary brain injury. Hyperventilation to reduce PaCO2 is generally avoided as it can lead to decreased cerebral blood flow, potentially worsening the injury. Administering isotonic fluids helps to maintain adequate blood pressure and cerebral perfusion, but without focusing on oxygenation, the intervention would be incomplete. Elevating the head of the bed can help reduce intracranial pressure, but it is less immediately important compared to oxygenation.
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