Head Injuries Flashcards
General types of head injuries (3)
- Scalp
- skull injries
- brain injuries
Skull fx s/s
- pain,swellung or tenderness at the injury site
- deformities
- CSF leadkage
- Battles signs (basal fx), Racoon eyes (frontal skull fx)
- bleeding from nose/ears
- unequal dilation of pupils
What is a brain contusion
- wrose than a concussion
- bruising or swelling of the brain
- doesnt have to bleed, can just be accumulation of fluid in head
- usually an acceleration/deceleration injury
s/s of brain contusions
- decreased mental status/unresponsiveness
- paralysis/motor dysfunction
- unequal pupuls
- vomiting
- alteration of vital signs
- profound personality changes
- impaired coordination
- amnesia
What is an epidural hematoma / what is it an injury to
usually caused by a frontal/temporal bone fx (middle menigieal artery)
-bleeding from MMA between skull and dura mater
S/s of epidural hematoma
Gradual onset of symptoms
- Loss of responsiveness, followed by reponsiveness
- decreasing mental status
- several headaches
- pupil fixed and dilated on side of impact
- seizures
What is a subdural hematoma / what is injured
Blood vessels on the surface of brain are torn, causing bleeding between brain and dura mater
-more bleeding than epudural
what age is a subdural hematoma high risk for
<2 and >65
s/s of subdural hematomsa
- deterioration in lvl of repponse
- vomitting
- dialation of one pupil
- abnormal respiration
- possible increasing systolic BP
- decreasing Pulse
management for brain injuries
Check
Call EMS
Care: ABCs
Secondary: tx non life treating injures, full neuro, observe head, eyes, ears
What are the canadian CT head rules
indication for cranial CT
High risk for ct of cranium (5)
- GCS score <15 at 2 hrs post
- Suspected open/depressed skull fx
- Any sign of basal skull fx
- Vommiting > 2 epi
- > 65
What is prolonged recovery for concussion in adults/children
> 10 days adults
>4w kids
do u have to lose consciousness to have concussion
no, most occurs without LOC (90%)
-prolonged (>1min) LOC would be considered as a factor that may modify management
What is rowans law
Immediate removal of play for any athlete that is suspected of having sustained a concussion
-mandatory concussion education for athletes, parents/gaurdiants, coaches and educators in contact sport
Acute injury management of concussion
- no return to game
- should be left along and reg monitoring for deterioration for 2-3hrs after
return to sport steps concussion (6)
- symptom limiting activity
- light aerobic activity
- sport specific exercise
- non contact training drills
- contract practice
- return
First aid for spinal injuries
check: the scene, tell person not to move
Call: EMS
Care: In line stabalizeation (minimize head and neck mvmt), ABCs, maintain open airway, vital signs
Initial physical exam in pot spine injury
- palpate entire spine
- neuro exam
- baseline vitals
- spinal percussion
- open and maintain airway during this**
What is neurogenic shock + loc
Damage usually above T6
-Low HR + BP-> indicative of loss of sympathetic tone
What is spinal shock and lvl
Trauma at any level
Falccidity and loss of reflexes
How to perform in line stability
place both hands on side of head and in line w body (anatomical position) and support
-do not remove helmet if wearing it
What are situations where you wouldn’t move the causaltuies head in line w body
- severly angled to one side
- if they are in severly abnormal pos but their ABCs are maintained, keep them there
- if they complain of pain, pressure, mm spasms in the neck when you align
- if you feel resistance
When should you move a casualty in a spinal injury
- if the airway is blocked
- if the scene is dangerous
- if there is no organized EMS response in the region
How= log roll
How to log roll
The first person holds head and the log rollers slowly roll hum
when should you leave helmet on
the helmet fits well and little movement
No impending airway/breathing probs
alone and unable to do it
can properly immobilize w helmet on
Remove helmet id
- interfere w ability to assess and care for ABCs
- Helmet doesn’t fit and there is excessive mvmt
- pt is in cardiac arrest
- cant properly immobalize
