Monitoring traumatic brain injury in Papua New Guinea.

Continuous appraisal of clinical indices with appropriate tests and their recording as evidence of treatment are conducive for evidence-based management of traumatic brain injury (TBI). Monitoring of various neurological indices and relating them to set parameters of TBI is imperative for gauging ongoing treatment. These parameters include cerebral oxygenation, cerebral perfusion pressure (CPP) and intracranial pressure (ICP). These are measured directly or by use of transcranial Doppler complemented with microdialysis, which is in the frontiers of research. The use of an ICP monitor and computed tomography (CT) scan is part of the standard repertoire of intensive care for the management of TBI. In Papua New Guinea where there are no ICP monitors or CT scan, the detection of increased ICP or intracranial mass lesions is done by thorough neurological examination complemented by monitoring of oxygen saturation, blood pressure and the Glasgow Coma Score.