During a MACE 2 exam on a suspected TBI patient who develops a severe headache and vomiting, which action should be avoided?

• A. Continue with the MACE exam
• B. Administer additional analgesia
• C. Transfer to a hospital for imaging
• D. Monitor neuro status

Answer: (A)

In this scenario, red flags after a head injury require rapid escalation rather than continuing a standard field assessment. Severe headache and vomiting raise concern for possible intracranial injury or increased intracranial pressure, and delaying imaging or transfer can allow a bleeding or swelling to worsen. Therefore, the action to avoid is continuing with the MACE exam in an attempt to complete the standard assessment on-site. The safer course is to expedite transport to a hospital for imaging (typically CT), while maintaining airway safety and ongoing neuro monitoring, and provide analgesia as appropriate within the protocol.