Modified Brain Injury Guidelines (mBIG)

mBIG guidelines apply only to adult trauma patients (18 yrs and older). Pediatric trauma patients (less than 18 yrs of age) are excluded from these guidelines and neurosurgical consultation should be obtained for any intracranial hemorrhage.

Modified Brain Injury Guidelines (mBIG)

Treatment Plans:

mBIG 1:

Place in observation (2OBS) if isolated head injury, otherwise admit to appropriate level of care

Neuro checks q2 hours (if in 2OBS), otherwise neuro checks q4 hours

If exam stable after 6 hours in 2OBS, discharge if GCS 15 

No Keppra, no BP goals, OK to start DVT prophylaxis if not being discharged after 6 hours

Follow-up with neurocritical care outpatient** 

mBIG 2:

Admission to SDCC if isolated head injury, otherwise admit to appropriate level of care

Neuro checks q2 hours

Repeat CT-head at 6 hours, OK to start DVT prophylaxis after 24 hours from stable head CT

Neuro checks q4 hours after 24 hours observation

Keppra 7 days, no BP goals

Follow-up with neurocritical care outpatient**

mBIG 3:

Neurosurgery consultation

Follow-up with neurosurgery outpatient