• Am. J. Crit. Care · Jan 2020

    Practice Guideline

    Critical Update on the Third Edition of the Guidelines for Managing Severe Traumatic Brain Injury in Children.

    • Karin Reuter-Rice and Elise Christoferson.
    • Karin Reuter-Rice is an associate professor, Duke University School of Nursing, Duke University School of Medicine Department of Pediatrics, and Duke Institute for Brain Sciences, Durham, North Carolina.
    • Am. J. Crit. Care. 2020 Jan 1; 29 (1): e13-e18.

    BackgroundSevere traumatic brain injury (TBI) is associated with high rates of death and disability. As a result, the revised guidelines for the management of pediatric severe TBI address some of the previous gaps in pediatric TBI evidence and management strategies targeted to promote overall health outcomes.ObjectivesTo provide highlights of the most important updates featured in the third edition of the guidelines for the management of pediatric severe TBI. These highlights can help critical care providers apply the most current and appropriate therapies for children with severe TBI.Methods And ResultsAfter a brief overview of the process behind identifying the evidence to support the third edition guidelines, both relevant and new recommendations from the guidelines are outlined to provide critical care providers with the most current management approaches needed for children with severe TBI. Recommendations for neuroimaging, hyperosmolar therapy, analgesics and sedatives, seizure prophylaxis, ventilation therapies, temperature control/hypothermia, nutrition, and corticosteroids are provided. In addition, the complete guideline document and its accompanying algorithm for recommended therapies are available electronically and are referenced within this article.ConclusionsThe evidence base for treating pediatric TBI is increasing and provides the basis for high-quality care. This article provides critical care providers with a quick reference to the current evidence when caring for a child with a severe TBI. In addition, it provides direct access links to the comprehensive guideline document and algorithms developed to support critical care providers.©2020 American Association of Critical-Care Nurses.

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