The updated version of the 2012 exe

The updated version of the 2012 exercise of the Best-Trip protocol has been called the CREVICE protocol (Protocol for the Treatment of Severe Traumatic Brain Injury Based on Imaging and Clinical Examination for Use When Intracranial Pressure Monitoring Is Not Employed). It was published in 2020 and includes several recommendations for patient monitoring measures, general management measures, CT scan recommendations, treatment goals for adequate cerebral perfusion and oxygenation, initial therapeutic interventions, specific therapeutic interventions (tier 1, 2 and 3), the definition of neuroworsening, recommendations for escalation of therapy, tapering therapy, contraindicated treatments and tapering blood pressure support. As this protocol is based on imaging and clinical exam, we select the specific recommendations for identification of neuroworsening and the specific recommendations for CT imaging, including the reclassification for patients that arrive to a health care facility in a postoperative state, appropriated for developing protocols of TBI care in LMICs [22]: