During a MACE 2 exam on a suspected traumatic brain injury patient who reports a severe headache and vomiting, which action is inappropriate?

During a MACE 2 exam on a suspected traumatic brain injury patient who reports a severe headache and vomiting, which action is inappropriate?

• A. Continue with the MACE exam
• B. Stop the exam and assess vitals
• C. Administer antiemetic and reassess
• D. Stop the exam and secure airway

Answer: (A)

In this scenario, the principle is to protect the airway and reassess vital signs whenever there are red-flag signs after head trauma. A suspected traumatic brain injury with a severe headache and vomiting raises concern for intracranial injury and possible deterioration, so you pause the current assessment to stabilize and monitor the patient rather than pushing through the exam. Continuing with the MACE exam would delay critical actions and could allow a worsening condition, including airway compromise or aspiration risk if vomiting progresses. Stopping to assess vitals is essential to gauge hemodynamic status and detect any deterioration. Stopping to secure the airway is also appropriate if there are signs the patient may not protect their airway or if vomiting makes airway protection necessary. Administering an antiemetic and reassessing can be part of the plan to reduce vomiting and prevent aspiration, provided the airway is adequately protected or will be shortly. Overall, the action of continuing the exam without pausing is the inappropriate choice.

In this scenario, the principle is to protect the airway and reassess vital signs whenever there are red-flag signs after head trauma. A suspected traumatic brain injury with a severe headache and vomiting raises concern for intracranial injury and possible deterioration, so you pause the current assessment to stabilize and monitor the patient rather than pushing through the exam.

Continuing with the MACE exam would delay critical actions and could allow a worsening condition, including airway compromise or aspiration risk if vomiting progresses. Stopping to assess vitals is essential to gauge hemodynamic status and detect any deterioration. Stopping to secure the airway is also appropriate if there are signs the patient may not protect their airway or if vomiting makes airway protection necessary. Administering an antiemetic and reassessing can be part of the plan to reduce vomiting and prevent aspiration, provided the airway is adequately protected or will be shortly. Overall, the action of continuing the exam without pausing is the inappropriate choice.