Re: Transport of a patient with pneumocephalus

[Helodoc@aol.com]

The question is whether the air is in an open or closed space - i.e. can a 
tension situation develop?  If the space is open, such as an open skull fracture 
or better yet, a craniectomy, then the pressure change should equalize.  If 
the space does not communicate with the atmosphere, then the question becomes 
one of risk / benefit.  If the patient is stable, then wait for an aircraft 
which can minimize the pressure change. If unstable, then one has to decide 
whether the risk of the pressure change causing a worsening of the patient's 
condition is worth the transport. In that case, perhaps someone can perform a 
ventriculostomy.

Dave Thomson
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