Head Evaluation

Question 1

Determination of Consciousness

Secondary Survey

Answer 1

Head and neck injuries take precedence, but check the body for other trauma
Bleeding, fractures, dislocations

Question 2

Signs and Symptoms

Answer 2

Amnesia, Confusion, Disorientation, Irritability, Uncoordinated, Dizziness, Headache, Blurred vision, Photophobia, Nystagmus, Tinnitus,Nausea, Vomiting,Unusually fatigued

Question 3

MOI of Head Injuries

Answer 3

Coup - stationary skull is by object traveling at high speeds.
Contrecoup - Skull is moving at high speed and abruptly stopped
Repeated sub-concussive forces - repeated non-traumatic blows
Rotational/Shear Forces - sudden twisting/acceleration/deceleration

Question 4

Cervical Vertebrae

Answer 4

Observe alignment of spinous processes

Question 5

Mastoid Process

Answer 5

Note any ecchymosis, Battle’s sign = skull fx

Question 6

Skull and Scalp

Answer 6

Swellling,bleeding, deformities

Question 7

Nystagmus

Answer 7

Observe both eyes simultaneously.

Look for involuntary cyclical movement - may indicate pressure on the eye’s,motor nerves, or disruption of inner ear

Question 8

Anisocora

Answer 8

Unequal pupils

Cranial nerve III

Question 9

Nose and Ears

Answer 9

Inspect for CSF, nose bleed, raccoon eyes that may indicate skull or nasal fx

Question 10

Retrograde Amnesia

Answer 10

Inability to recall events before injury

Question 11

Anterograde Amnesia

Answer 11

Inability to recall events after injury

Question 12

Ataxia

Answer 12

Profound loss of muscular coordination

Question 13

Apneustic

Answer 13

Prolonged inspirations; trauma to pons

Question 14

Biot’s

Answer 14

Periods of apnea, followed by short, fast respiration; increased intracranial pressure

Question 15

Cheyne-Stokes

Answer 15

Periods of Apnea followed by increased depth and frequency breathing; frontal lobe/brain stem trauma

Question 16

Slow Breathing is less than_____breathes/min

Answer 16

12

Question 17

Thoracic breathing

Answer 17

Breathing occurs only through expansion of chest, abdominal movement is absent; disruption of phrenic nerve or its nerve roots

Question 18

Accelerated BPM is…

Answer 18

> Greater than 150 BPM

Question 19

Deficit

Answer 19

Radial pulse is less than cardiac pulse;cardiac arrhythmia

Question 20

High Tension

Answer 20

Force of beat is increased;cerebral trauma

Question 21

Low Tension

Answer 21

Short, fast, faint pulse with rapid decline; heart failure, shock

Question 22

Normal Pulse Pressure

Answer 22

40mm Hg

Greater than 50 mm Hg may indicate increased intracranial bleeding

Question 23

Determination of Consciousness

Primary Survery

Answer 23

If unconscious, check ABC’s - look,listen,and feel
Send someone to call EMS
Use modified jaw thrust to open airway