How should IV fluids be administered to head injury patients to avoid complications?

• A. Rapid bolus
• B. No fluids
• C. Fluids cautiously to prevent overload and rising ICP
• D. Activated charcoal

Answer: (C)

In head injury, the brain is vulnerable to swelling, so the goal with IV fluids is to keep blood flow to the brain without pushing fluid into the swollen tissues. Administering fluids too quickly can raise cerebral blood volume and ICP, which can worsen brain injury. Therefore fluids should be given cautiously and titrated to the patient’s condition, using appropriate isotonic solutions, while closely monitoring blood pressure, urine output, mental status, and signs of fluid overload. This balanced approach seeks to restore perfusion when needed but avoids rapid shifts that could elevate ICP. Activating charcoal is not relevant to head injury management, and giving no fluids risks inadequate perfusion if the patient is hypotensive.