Ch. 16: Head, Neck, and Brain Injuries Flashcards
Your patient presents with a high fever, chills, intense headache, and a stiff neck. What condition do you suspect?
Meningitis
Procedures for treating a head injury (5)
- AVPU
- History
- Cranial Nerve Assessment
- Concussion Assessment
- Monitor patient and note any changes
12 Cranial Nerves and their functions:
- Olfactory: smell
- Optic: vision, peripheral and forward
- Oculomotor: PERRLA, middle and downward motion
- Trochlear: Upward eye movement
- Trigeminal: Cheek flex and face sensation
- Abducens: Sideward movement
- Facial: eyebrow movement, taste
- Vestibulocochlear: Balance, hearing
- Glossopharyngeal: Taste, swallow
- Vagus: Swallow, gag
- Accessory: Shoulder shrug, side view
- Hypoglossal: Tongue midline
Most comprehensive concussion assessment tool:
SCAT 5
Immediate concussion assessment (4 guides):
- Red flags
- Observable signs
- Memory
- Glasgow Coma Scale (eye, verbal, motion)
Off the field concussion assessment (4):
- Patient Background
- Symptoms
- Cognitive Screening
- Neurological Screen
Parts of the cognitive screening (3):
- Orientation
- Memory
- Concentration
Examples: countbackwards, months backwayrds, alphabet backwards
Parts of the neurological screening (2):
Balance and coordination
Red flags when analyzing a head injury:
- Pain/tenderness in the neck
- Vomiting
- Severe headache
- Change in behavior
- Loss of balance
- Loss of consciousness
- Double/blurry vision
How many concussions can an athlete sustain before being medically disqualified? Why?
Decision is only made by a physician depending on how many concussions they received because their brain is more vulnerable to other conditions. Changes after concussion is considered as well. No specific number is specified because of the severity of each concussion.
Why are concussions so dangerous?
- Post-concussion syndrome
- Diffuse Cerebral Swelling
- Epilepsy
Post concussion syndrome:
Lasting effects of concussion, no longer than 1 month
Diffuse cerebral swelling:
Rapid and fatal brain swelling
Epilepsy:
Doubles risk of seizure disrorder within the first five years after the injury
Loss of memory PRIOR to trauma:
Retrograde amnesia
What’s your name? What happened right before you got hit? Where are you? MAKE SURE YOU KNOW THE ANSWERS
Loss of memory AFTER the trauma:
Anterograde amnesia
What did you do after getting hit? Did you walk or run to the sidelines? Give words and have them recall
Which amnesia is worse and why?
Anterograde amnesia is worse because it indicates a progressive deterioration of memory, bleed or pressure caused by injury, activate EMS right away.
What is the most comprehensive concussion assessment?
SCAT 5
What does the SCAT 5 include?
- Immediate on field assessment: look for red flags, observable signs, glasgow coma scale
- Symptoms
- Cognitive screening: immediate memory, digits backward
- Neurological Screen: Balance and examination
- Delayed recall: after 5 minutes, 5 or 10
- Decision
Concussions are NOT graded:
1 sign or symptom is enough
Why shouldn’t you administer pain medications to concussed patients?
Thins blood and increase bleed
Why shouldn’t you administer pain medications to concussed patients?
Thins blood and increase bleed, mask symptoms
Steps when evaluating head injury:
- AVPU
- History
- Cranial Nerve Assessment
- Concussion assessment (SCAT 5)
Concussion assessment includes:
- Patients background
- Observable signs
- Cognitive assessment/memory
- Neurological assessment: balance and coordination
