Modified Brain Injury Guidelines (mBIG)

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