Introduction: Traumatic subdural hematomas beget significant morbidity and mortality if not rapidly decompressed. This presents a unique challenge to the emergency physician without immediate neurosurgical support.

Case Report: We report two cases of patients in Los Angeles County with traumatic subdural hematomas and clinical deterioration in the emergency department (ED) who were treated with decompression using an intraosseous needle drill.

Discussion: We believe these cases represent the first use of this technique to temporize a subdural hematoma in the ED.