Background: Thai emergency nurses play a vital role in caring for patients with severe TBI,
and are an important part of the healthcare team throughout the resuscitation phase. They are
also responsible for continuous physiological monitoring, and detecting deterioration associated
with increased intracranial pressure and preventing secondary brain injury. However, there is
known variation in Thai nurses’ knowledge and care practices for patients with severe TBI.
In addition, there are no specific evidence-based practice guidelines available for emergency
nursing management of patients with severe TBI.
Aim: The aim of this paper is to describe the development of an evidence-based care bundle for
initial emergency nursing management of patients with severe TBI for use in a Thai ED context.
Results: An evidence-based care bundle focused on seven major elements: (1) establish a secure
airway along with c-spine protection, (2) maintain adequacy of oxygenation and ventilation,
(3) maintain circulation and fluid balance, (4) assessment of GCS, and pupil size and reactivity,