Emergency management of traumatic brain injury patients and adherence to treatment guidelines in tertiary care hospitals of Lahore, Pakistan

The cross-sectional prospective study aimed to study the factors associated with traumatic brain injuries (TBIs) and acute management of patients presenting at emergency departments in two tertiary care hospitals in Lahore, Punjab, Pakistan, as well as compliance with international guidelines. Data was collected from 1,000 patients between February 2nd to August 2nd, 2022. Among TBI patients, 82.1% were male, and most TBIs resulted from road traffic accidents (62.6%). Headaches were experienced by 97.8% of patients, while 72.3% experienced vomiting. The diagnostic procedures included X-rays (98.9%) and CT scans (86.4%). The adherence to trauma guidelines at EDs showed blood pressure monitoring in 100% of patients, oxygen monitoring in 69.4% of patients, hyperosmolar therapy (59.2%) and infection prophylaxis (93.65%). Diagnostic procedures like X-ray (98.9%) lactulose (3.3%), anti-seizure prophylaxis (59.9%), steroid therapy (4%) and anesthetic and sedative administration were not in accordance with international guidelines. Intracranial pressure monitoring facility was not available in EDs. Deep vein thrombosis prophylaxis and nutrition were not provided in EDs. This study revealed that emergency management of TBI patients adhered to most of the international guidelines, with prompt diagnosis and therapeutic care provided in both tertiary care hospitals.