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17 Cards in this Set
- Front
- Back
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What does GCS stand for |
Glasgow Coma Scale |
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Why might GCS monitoring be required? |
Head injury and trauma patient had a fall post op neurosurgery stroke seizure unresponsiveness severe alcohol or drug intoxication |
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What does (EO) stand for in GCS? |
Eye Opening |
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What does (VR) stand for in GCS? |
Verbal response |
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What does (MR) stand for in GCS? |
Motor response |
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What is secondary injury? |
Secondary injury is damage to the brain that occurs as a result of the initial injury. For example an initial injury may be trauma to the head, and the secondary injury may be ischemia as a result of hemorrhage |
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Name the types of secondary injury |
Ischemia, hypoxia, oedema and raised ICP |
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What problems following initial injury can cause secondary injury? |
Hypotension Seizure Hydrocephalus Hemorrhage Compromised pulmonary function Compromised cardiac function Deranged biochemisty (electrolytes etc) |
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What is hydrocephalus |
(CSF)Fluid accumulation on the brain. |
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How many fluid compartments in the brain? |
3 |
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Name the brain compartments and what percentage they make up on the brain |
Brain and interstitial fluid - 80% Intravascular blood - 10% Cerebro-spinal fluid (aka CSF) - 10% |
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What is the monroe kellie doctrine? |
The monroe kellie doctrine describes the relationships between the brain compartments; If one compartment should increase in volume, the others (one or both) should decrease |
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Name some signs and symptoms of neuro deterioriation |
Headache Nausea and vomiting Agitation and behavioural changes Respiratory changes Changes in speech Changes in motor function Changing levels of consciousness Pupilary changes Vital signs - cushings triad |
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What is Cushings triad? |
Bradycardia Hypertension Irregular Respirations |
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What is the frequency of neuro obs as advised by NICE (2014)? |
1/2 hourly until GCS = 15 then 1/2 hourly for following 2 hours then hourly for 4 hours then every 2 hours until otherwise instructed If GCS lowers back to below 15, back to 1/2 hourly |
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What 3 questions should be asked when assessing patients verbal response? |
What is your name? Where are you? What year/month is it? |
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To assess motor reponse what can you ask your patient to do? |
Wiggle toes, open eyes, show tongue, squeeze hands |
