Prehospital Trauma Life Support (PHTLS) Pre Test And Post Test Practice

In a trauma patient with possible brain injury, the goal is to keep enough blood flow to the brain and other organs while we work on bleeding control. Cerebral perfusion pressure depends on the mean arterial pressure minus the intracranial pressure, and when brain injury is suspected (GCS 7), you want a higher perfusion pressure to prevent ischemia if ICP is elevated. In the prehospital setting, a practical minimum systolic blood pressure of about 90 mm Hg is used to ensure adequate perfusion without over-resuscitating before hemorrhage control. Values well below that (60–70) risk dangerous hypoperfusion to the brain and other organs, while 80 is often not enough in a brain-injured patient. Therefore, aiming for at least 90 mm Hg supports cerebral and systemic perfusion until definitive bleeding control is achieved.