I meant to call the patient’s family for a consultation, and the phone was disconnected between calls, so I couldn’t reach you for a while! Answer from the Internet. I know a little bit about the condition from the brief introduction of the condition. The patient has had a traumatic brain injury for three days, is currently confused, has fractures of the clavicle, ribs and tibia, and has a hemopneumothorax. Although there was no intracranial hematoma after the accident, and there is no need to open the skull for surgery, the brain injury is also more severe in patients with closed craniosynostosis. The condition may not be mild if no hemorrhagic foci are seen on the brain CT film. “Diffuse axonal injury” may not be seen on the CT film, but the patient’s body is thrown in an arc at the time of trauma, and the cranial rotation generates a shear force that interrupts the connection between the white matter and gray matter of the brain. The patient may be unconscious for a long time. Hyperbaric oxygen therapy is effective for this type of brain injury. It may be considered. Patients with rib fractures and hemopneumothorax should not be treated with hyperbaric oxygen therapy at this time. Hyperbaric oxygen will aggravate the pneumothorax. Closed drainage is probably being performed now. When the pleural cavity is drained of blood and gas, the drainage tube is best removed and hyperbaric oxygen therapy can be considered. The patient is only 3 days old from the traumatic brain injury, and the internal environment is unstable and cannot be transported in the near future. If it is a “diffuse axonal injury”, it will take at least 5-7 days before long-distance transport can be considered. If the concussion is only mild, the patient can be awake in a relatively short time. Transfer can be considered. Without seeing the films, it is impossible to make a proper judgment. Hyperbaric oxygen therapy has clear benefits in reducing brain damage. Cervical spine fractures cannot be transported, but if it is only a fracture of the clavicle, ribs and lower extremities, it can be transported after adequate immobilization. If you have any questions, you can share them online.