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9 Cards in this Set
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- Back
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Canadian CT head rules
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Hish risk factors:
- GCS <15 at 2 hr post inj - Suspected open or depress skull fracture - Suspected basal Skull fracture - Vomiting >2 episoes - Age >65yr (>92% sen, 65% spec) Minor Risk factors: - Amnesia before impact >30min - Dangerous mechanism (pedestrian VS car, ejection from vehicle, fall >3 feet or 5 stairs) (>95% sen. 50% sepc) |
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New Orleans criteria CT head.
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CT if meet one or more:
- Headache - Vomiting - age >60yr - Drug or ETOH intoxication - persistent antegrade amnesia - visible trauma above clavicle seizure (Sen is higher than Canadian but lower specificity) |
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Signs of basal skull fractures
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Battle sign
subconjunctivial haemorrhage Haemotympanum CSF rhinorrhoea or otorrhoea |
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Signs of raised ICP?
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- ACS
- HT - bradycardia - papiloedema (>6hours post) - Absent retinal venous pulsation (if retinal pulsation present, ICP is not elevated!) - VI nerve plasy - pupil dilation - anisocoria - decorticate or decerebrate |
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Test for CSF leak
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- Testing for glucose +
- Halo test: a drop should produce double ring |
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Early & late complications of head trauma?
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Early:
- raised ICP - extradural/ subduralhaematoma - skull fracture - Cranial Nn injury -Haemorrhagic shock (only in neonates) - Aspiration pneumonia - deep inverted T wave on ECG - Neurogenic pulmonary oedema Late: - CSF leak - Post traumatic epilepsy - Hyperthermia - Diabetes inspidus - Crushings ulcer |
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CRASH study
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- Steroid do not appear to have any significant beneficial effect.
- Randomised placebo controlled trial - risk of death increased by steroid 25.7% VS 22.3% placebo |
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Definition of Minor traumatic brain injury (Concussion)
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Anyone of:
- LOC <30mins - GCS 13-15 forrlow LOC - loss of memory of the event - post traumatic amnesia <24 hours - Alteration of mental state at the time of accident |
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Which is not ture for Hanging?
a. <1% of cervical spine injury b. Hangman fracture only if drop > patient height and knot put in front of chin c. cause Arterial obstruction immediatly d. Present with reflex bradycardia e. Present with Tardieu spots and subconjuntivial haemorrhage |
. cause venous obstruction than arterial
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