Head injury accounts for approximately a third of all trauma deaths and is the leading cause of death and disability in young adults.

Secondary brain injury occurs after the initial insult and is the result of cerebral hypoxia and ischaemia. Assess and act on abnormalities found to prevent further insult to the vulnerable brain.

■ Airway (with cervical spine control)

• Prevent hypoxia aim for a clear unobstructed airway and SpO2 > 95%.

• If there is airway compromise intubate with a rapid sequence induction, cricoid pressure and inline cervical spine stabilisation.

Pass an orogastric tube. 249

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