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35 Cards in this Set
- Front
- Back
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What is the most common cause of Brain trauma? |
MVC |
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Who is at high risk for Brain trauma? |
1. Males of all age groups 2. Adolescents 15-19 b/c MVC 3. children under 4 b/c Falls 4. adults 65 and older b/c Falls |
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What does it mean by primary Brain injury?
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Primary is caused by the initial impact or damage Example: gunshot, nail in head, hit really hard in head. |
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What is secondary brain injury? |
Secondary is damage that occurs in addition as a result of the primary brain injury. *may take a couple of days to present
Example: ICP, Hypovolemic shock, edema, tissue anoxia |
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What is a Concussion? |
A temporary loss ( less than 6 hrs) of neurologic function with no apparent structural damage. Want to keep them awake. Should awake and be arousable. Dysphasia ( diff. speaking) |
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What is a contusion? |
A bruising to the brain causing damage
severe injury with possible hemorrhage.
longer period of unconsciousness (more than 6 hrs). Change in VS may have Cushions triad |
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Concern with a scalp wound? |
Excessive bleeding Portal of infection |
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Skull Fractures |
May have Battle's sign May have blood drainage from ears & nose & pharynx |
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Ecchymosis behind the ear is indicative of what? |
Skull fracture This is known as the battle's sign
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Halo's Sign? |
Stain of blood on pillow from cerebral spinal fluid leak from ear. Ring of fluid buildup. |
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Brain injury manifestations? |
Aphasia (cannot speak), ICP=change in LOC=Decreased memory, May have some pupil changes (one eye dilated), chronic headache, seizures. |
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Nuerological changes with brain injury? |
Anosia (loss of smell), Loss/weak reflexes, Cushions triad, Decreased motor response. |
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Cushions triad? |
Decrease in HR, Increase in BP, Increase in RR
Increase in BP b/c trying to compensate for cerebral ischemia. |
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Side effect of dilantin? |
Gingival hyperplasia (gums overgrow teeth)
*dilantin is used as a precautionary measure for seizures with brain injury. |
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Glascow coma scale less than 3? |
Considered in braindead. |
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glascow coma scale 8 or less |
indicative of brain injury |
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Epidural Hematoma? |
arterial bleed located between skull and dura. increased ICP
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Subdural hematoma? |
Venous bleed Slow response brain can reabsorb the blood ACUTE: happens instantly headache on/off 24-48hrs SUBACUTE: headache on/off and presents weeks later 48wks-2wks located between dura and arachnoid
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Chronic hematoma |
Months of severe headaches
Within the brain. |
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Intercerebral hemorrhage |
Restless, agitated, cause from blunt trauma like missile, gunshot, stab wound. control ICP administer. |
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what is the key thing to remember with head injuries? |
always assume there may be spinal injury treat until confirmed. |
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What do you want to limit with brain injury? |
any noise, any stimuli and anything that might increase ICP Mittens vs. restraints |
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Spinal Cord Injury commonly caused by? |
MVC |
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What is the major cause of death with a spinal cord injury? |
1.Pulmonary embolis 2.Thrombosis 3. sepsis |
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Paralysis happens where? |
Below the level of injury |
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can secondary spinal injury be reversed? |
Yes if treated with in the first 4-6hrs of the injury. |
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Spinal Shock? |
Loss of reflex activity below the spinal injury may have muscular flaccidity. |
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Neurogenic shock? |
Loss of function of the autonomic nervous system. Example: BP,CO decrease HR decrease b/c of loss of sympathetic tone.
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When are you at high risk for autonomic dysreflexia? |
Spinal cord lesions/injury above thoracic 6 T6 |
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What is autonomic dysrefexia? |
Become emergently HTN (like 240/180) and can have a headache and sweaty, N/V, decrease in HR |
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Triggers for autonomic dysreflexia? |
skin stimuli ( laying on something) Distended bladder (most common) constipated
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What is orthostatic hypotension? |
systolic drops by 20 diastolic goes up by 10 HR goes up 10 |
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hypercapnea |
CO2 increases usually show in ABG's |
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What kind of diet do you want to give a patient with spinal cord injury? |
high calorie, high protein, high fiber |
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pin care? |
once a shift twice a day |
