Table 2.

Criteria for the transfer of TBI patients to high-complexity facilities with access to neuroimaging and neurosurgical consultation. TBI = Traumatic Brain Injury; GCS = Glasgow Coma Scale.

It is recommended that patients with moderate to severe TBI (GCS 3-12) should be transferred immediately to high-level care hospitals with access to neuroimaging and neurosurgery.

It is recommended that patients with mild TBI (GCS 13-15) who present one or more of the following criteria be referred for evaluation at an institution that has access to neuroimaging and neurosurgery:

GCS <15 up to 2 h after injury

Severe headache

Two or more episodes of vomiting

Skull fracture, including depressed fractures or clinical signs of skull base fractures such as raccoon eyes, retro auricular ecchymosis, otorrhea and rhinorrhea

Age ≥60 years

Blurred vision or diplopia

Posttraumatic seizure

Focal neurologic deficit

Previous craniotomy

Fall from height ≥1.5 m

Retrograde amnesia ≥30 min or anterograde amnesia

Suspected intoxication from alcohol or other psychoactive substances

Use of anticoagulants, antiplatelet drugs or known coagulopathies

Pregnancy

Penetrating TBI