International Journal of Research in Medical Sciences | January 2019 | Vol 7 | Issue 1 Page 58 International Journal of Research in Medical Sciences Rosyidi RM et al. Int J Res Med Sci. 2019 Jan;7(1):58-62 www.msjonline.org pISSN 2320-6071 | eISSN 2320-6012 Original Research Article Early tracheostomy in patient with severe traumatic brain injury clinical experiences in rural and remote areas Rohadi M. Rosyidi*, Bambang Priyanto, Aulannisa Handayani INTRODUCTION Brain injury is defined as "a change in brain function, or brain pathology, caused by external forces." There are several symptoms of brain injury, such as disorientation, confusion, headache, nausea and vomiting, drowsiness, loss. memory, decreased level or loss of consciousness, and neurological deficits such as weakness, loss of balance, vision changes, sensory loss, paresis or paralysis. 1-5 Patients with severe brain injury usually require rapid evacuation and special care in the Intensive Care Unit (ICU) room for respiratory control, mechanical ventilation, neurosurgical evaluation, and intracranial pressure monitoring (ICP). 5,6 During admission to the ICU, these patients need tracheostomy because they required analgesia, sedation, and prolonged ventilation. Early oxygenation and ventilation administration aims to maintain adequate oxygenation, avoid extreme hypoxemia or hyperoxemia and reduce incident of mortality caused by brain injury. Patients with severe brain injury or those with GCS scores less than 8 is one of the indications of tracheostomy due to the risk of decreased ability of the patient to ventilate and to protect the patient's airway. A study showed that tracheostomy can improve good outcomes in patients with brain injury and may decrease mortality. 5-7 The high number of brain Department of Neurosurgery Medical Faculty of Mataram University, West Nusa Tenggara General Hospital, Mataram, Indonesia Received: 04 June 2018 Revised: 20 November 2018 Accepted: 29 November 2018 *Correspondence: Dr. Rohadi M. Rosyidi, E-mail: rha.ns2010@gmail.com Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. ABSTRACT Background: Brain injury accounts for most of the causes of death from trauma. Brain injury is defined as a change in brain function, or brain pathology, caused by external forces. Patients with severe brain injury usually required rapid evacuation and special care in the Intensive Care Unit (ICU) room for respiratory control, mechanical ventilation, neurosurgical evaluation, and intracranial pressure monitoring (ICP). During admission to ICU, patients using tracheostomy, because it requires analgesia, sedation, and prolonged ventilation. Methods: Descriptive retrospective study conducted in February and March 2018 at Medical Record Installation of General Hospital Province of West Nusa Tenggara. The sample size is determined by consecutive sampling method. Results: Sample size were 60 people from medical record. Male patient more common than female (90 %). Based on Age more patients are 40 years old (43.3%). More Patient with early tracheostomy was survived (68,33%), and the rest died (31,67%). Conclusions: Severe head injury patients with tracheostomy are common at <18 years and >40 years. Patients with Severe brain injury who get early tracheostomy have more good outcomes, and have relatively short duration of ICU care. Keywords: Tracheostomy, Severe traumatic brain injury DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20185363