Head Injury

Question 1

Can determine injuries on skull

Answer 1

Point out all: penetrating eye injuries , otterhea/rhinnorhea , contusion/hematoma. epistaxis, periorbital ecchymosis, open vault fracture, asymmetrical pupilary response, mastoid bruising

eye trauma: log cabin penetration and cover both eyes

Hematoma: possibly apply ice to it

epistaxis: squeeze nose and lean forward, roll a 4x4 and tape under nose…. a bad bleed will need cauterisation at the hospital

Question 2

treatment of open vault fracture

Answer 2

Moist sterile dressing, abdo pad and loosely wrap cling around the head

Question 3

Identifies csf and applies treatment

Answer 3

Halo test
and apply loose 4x4

Question 4

can identify signs of cerebral herniation

Answer 4

cushing triad
- High BP
- Low Heart rate
- respiration’s are irregular
Gcs less then 9 and
- dilate/unreactive pupils
- and or asymmetric pupilary response
- and or posturing

Question 5

prepares bvm

Answer 5

superset
mask,med port,end tidal, exstenion tubing, filter, resevoir bag

Question 6

can identify optimal end tidal value for ventilation of this patient

Answer 6

i would titrate between 30-35 mmhg etco2
below 30 is to fast
above 35 is to slow

Question 7

ventilate if end tidal is unavailable

Answer 7

hyperventilating at 1 breath every 3 seconds
adult 20br/min 1/3sec
child 25br/min 1/2.5sec
infant 30br/min 1/2sec

Question 8

whats cushings triad

Answer 8

High bp
low heart rate
irregular respirations

Question 9

why do we NOT Hyperventilate all patients with traumatic brain injuries

Answer 9

because hyperventilation leads to cerebral vasoconstriction which leads to cerebral ischemia and hypoxia

Question 10

oxygen is a vasodilator T/F?

Answer 10

False - vasoconstriction is based on co2 and co2 is a vasodilator