CNS Trauma

Question 1

How often in the UK is someone admitted with a head injury

Answer 1

Every 3 minutes

Question 2

How many cases and deaths per year

Answer 2

1.4 million cases / year

3000 deaths- 50% in RTAs

Question 3

Describe the GCS scale

Answer 3

Glasgow Coma Scale
Rating out of 15
Score of 3 is dead 
3 aspects are assessed
Verbal - scale of 1-5
Eye opening - scale of 1-4
Motor response- scale of 1-6

Question 4

What could affect being able to assess a persons GCS

Answer 4

Eye opening- if eyes are swollen or taped
Verbal response- if they are intubated
Motor response - if they have been given muscle relaxants
All affected if person is under anaesthetic

Question 5

When would an anaesthetist be called

Answer 5

If a GCS is less than 8
If they are struggling to maintain airway
If they won’t remain still for CT scan

Question 6

Why do you get blown pupils with head injuries

Answer 6

Occulomotor nerve runs 2/3 of the way along the brain. If the brain swells and puts pressure in the nerve the pupils are unable to contract

Question 7

What is considered mild, moderate and severe with GCS scores

Answer 7

Mild- 13-15
Moderate- 9-12
Severe 3-8

Question 8

Describe some secondary problems from head trauma that can be helped

Answer 8

Hypoxia (not enough oxygen)
Hypotension
Raised intracranial pressure
Infections such as meningitis

Question 9

Describe different forms of intracranial haematomas

Answer 9

Extradural- above the dura
Intracerebral- within brain
Subdural- below dura

Intra and sub can be combined

Question 10

Intracranial pressure calculation

Answer 10

CSF+blood+brain

Question 11

What is coning

Answer 11

It is when the increased pressure in the brain causes the brain to squeeze out of the foramen magnum

Question 12

Which injuries take priority

Answer 12

Chest and abdominal

Question 13

What happens with a diffuse axonal injury

Answer 13

Mild- concussion

Severe- prolonged unconsciousness due to widespread tearing of axons