What is the primary focus in the management of a patient with a severe head injury?

The primary focus in the management of a patient with a severe head injury is to monitor and protect against increased intracranial pressure (ICP). This is crucial because severe head injuries can lead to swelling of the brain or bleeding, which can subsequently raise ICP to dangerous levels. Elevated ICP can compromise cerebral perfusion, potentially leading to irreversible brain damage and other complications.

Managing ICP involves several strategies, including ensuring adequate oxygenation, maintaining proper ventilation, and possibly using medications such as mannitol to reduce swelling. Additionally, healthcare providers may need to implement measures to keep the patient’s head in an elevated position to facilitate venous drainage from the skull.

The other options do not address the immediate and life-threatening complications that can arise from a severe head injury. While surgery may be required in certain cases, it is not the primary focus at the onset of management. Maintaining high blood pressure is not typically a goal in head injury treatment; rather, the focus is on preventing further damage from increased ICP. Encouraging the patient to stay awake is not a standard management strategy, and in fact, patients with severe head injuries are often monitored for their level of consciousness and may require sedation.