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All Journal Ahmad Dahlan Medical Journal
Arrifqi, Faiyana Nurul
Unknown Affiliation
Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Public Health

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Early Tracheostomy in Adult Patient with Head Trauma: A Case Report Abdullah, Adnan; Arrifqi, Faiyana Nurul; Firmansyah, Rizky; Daniswara, Deoni
Ahmad Dahlan Medical Journal Vol. 6 No. 1 (2025): May 2025
Publisher : Universitas Ahmad Dahlan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.12928/admj.v6i1.13239

Abstract

Traumatic brain injury (TBI) is a serious condition that can cause temporary or permanent physical, cognitive, and emotional impairments. Tracheostomy in TBI patients can help reduce airway resistance, improve secretion clearance, and support weaning from mechanical ventilation. Early tracheostomy (ET) may also reduce ICU stay, ventilation time, and long-term mortality. A 30-yearold female was referred after a motorbike accident without a helmet. She was unconscious, with a Glasgow Coma Scale (GCS) of E1V2M1. Vital signs: temperature 38.1°C, pulse 74/min, respiratory rate 25/min, blood pressure 84/47 mmHg. Eye examination revealed lagophthalmos, chemosis, and a corneal epithelial defect. Neurological findings included anisocoria (right pupil 5 mm, left 3 mm), with no response in cranial nerves III, IV, and VI. Reflexes were normal, and no neck stiffness was observed. CT scan showed subdural hematoma (SDH), subarachnoid hemorrhage (SAH), and intracerebral hemorrhage (ICH). The patient underwent tracheostomy, central venous catheter placement, craniotomy, decompression, and hematoma evacuation. The bleeding volume was 15 cc. She survived and regained consciousness (GCS compos mentis). This case highlights the potential benefit of early tracheostomy in severe TBI. While patients with more severe injuries may face delays due to instability, early intervention can support better outcomes and survival.
Co-Authors Abdullah, Adnan Daniswara, Deoni Rizky Firmansyah