Head Evaluation Flashcards
Determination of Consciousness
Secondary Survey
Head and neck injuries take precedence, but check the body for other trauma
Bleeding, fractures, dislocations
Signs and Symptoms
Amnesia, Confusion, Disorientation, Irritability, Uncoordinated, Dizziness, Headache, Blurred vision, Photophobia, Nystagmus, Tinnitus,Nausea, Vomiting,Unusually fatigued
MOI of Head Injuries
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
Cervical Vertebrae
Observe alignment of spinous processes
Mastoid Process
Note any ecchymosis, Battle’s sign = skull fx
Skull and Scalp
Swellling,bleeding, deformities
Nystagmus
Observe both eyes simultaneously.
Look for involuntary cyclical movement - may indicate pressure on the eye’s,motor nerves, or disruption of inner ear
Anisocora
Unequal pupils
Cranial nerve III
Nose and Ears
Inspect for CSF, nose bleed, raccoon eyes that may indicate skull or nasal fx
Retrograde Amnesia
Inability to recall events before injury
Anterograde Amnesia
Inability to recall events after injury
Ataxia
Profound loss of muscular coordination
Apneustic
Prolonged inspirations; trauma to pons
Biot’s
Periods of apnea, followed by short, fast respiration; increased intracranial pressure
Cheyne-Stokes
Periods of Apnea followed by increased depth and frequency breathing; frontal lobe/brain stem trauma
Slow Breathing is less than_____breathes/min
12
Thoracic breathing
Breathing occurs only through expansion of chest, abdominal movement is absent; disruption of phrenic nerve or its nerve roots
Accelerated BPM is…
> Greater than 150 BPM
Deficit
Radial pulse is less than cardiac pulse;cardiac arrhythmia
High Tension
Force of beat is increased;cerebral trauma
Low Tension
Short, fast, faint pulse with rapid decline; heart failure, shock
Normal Pulse Pressure
40mm Hg
Greater than 50 mm Hg may indicate increased intracranial bleeding
Determination of Consciousness
Primary Survery
If unconscious, check ABC’s - look,listen,and feel
Send someone to call EMS
Use modified jaw thrust to open airway
