What is the primary goal of initial resuscitation in moderate-severe TBI?

• A. Stabilize airway, breathing, circulation with prevention of hypoxia and hypotension and optimization of cerebral perfusion pressure
• B. Achieve normoglycemia
• C. Initiate early DVT prophylaxis
• D. Begin antibiotics prophylactically

Answer: (A)

The priority in initial resuscitation for moderate-severe TBI is to prevent secondary brain injury by ensuring the brain receives enough oxygen and blood flow. That means securing the airway and ensuring adequate ventilation and oxygenation to avoid hypoxia, and maintaining circulation to prevent hypotension. By keeping oxygen delivery high and blood pressure sufficient, you protect cerebral perfusion pressure (CPP), which is the driving force for blood flow to the injured brain. CPP is roughly the difference between mean arterial pressure and intracranial pressure, so if you keep MAP up and ICP in check, you support the brain’s perfusion during the critical early phase. While managing glucose, infections, or clot prevention is important, they are not the main focus of the initial resuscitation itself.