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Immediate threats and escalation
Critical status triggers
Airway compromise
If GCS 8 or rapidly declining mental status, secure airway
Shock or persistent hypotension
Alternative cause search
Refractory hypoxia
Thoracic injury consideration
Ongoing seizure
Benzodiazepine first line
Signs of herniation
Hyperosmolar therapy pathway
Focal neurologic deficit
Stroke and intracranial hemorrhage pathway
Repeated vomiting with worsening headache
Intracranial hemorrhage pathway
Agitation with unsafe behavior
De-escalation and chemical sedation pathway
Immediate stabilization
Cervical spine precautions when indicated
High risk mechanism
Midline cervical tenderness
Neuro deficit or paresthesias
Hemodynamic targets
Systolic blood pressure 100 to 110 mmHg minimum depending on age
Oxygen saturation 94 percent or higher
Glucose check
Hypoglycemia correction if present
Temperature
Hyperthermia treatment
Early decision points
Intracranial hemorrhage risk stratification
Anticoagulant or antiplatelet exposure
Age 65 years or older
Known bleeding disorder
High risk mechanism
Need for emergent head CT
Decision rule application
Override for deterioration
Observation vs discharge
Reliable supervision at home
Safe follow-up within 24 to 72 hours
Symptom trajectory stable or improving
Consultation triggers
Neurosurgery
Any intracranial hemorrhage with neurologic deficit
Depressed skull fracture
CSF leak concern
Deterioration despite normal initial CT
Trauma surgery
Polytrauma
Anticoagulated with significant mechanism
Neurology
Persistent deficits without structural lesion
Refractory post-traumatic symptoms
Child protection
Non-accidental trauma concern
SymptomDx is an educational tool for medical professionals. It does not replace clinical judgment. Verify all clinical data and drug dosages with authoritative sources.