Head Injury Flashcards
1
Q
Red flags
A
GCS under 15 initially Shock or other sig injuries Coag disorder or anticoags Alc or drug intox Any LOC after injury Any post trauma seizure Any previous brain surgery Amnesia lasting over 5 mins Persis headache since injury Vom since injury- over 1 in adult, over 3 in kid Visual changes Focal neurology Suspected skull fracture Penetrating inj or skull trauma Suspected C spine injury Non accidental injury
2
Q
History
A
Mechanism LOC What happened afterwards Anticoags/bleed risk Nausea and vom Headache Vision changes Muscle weakness or face weakness Amnesia Neurology Neck pain Alc or drugs Pre injury baseline congnition
3
Q
ED ix
A
A to E
Bloods
XR
Maybe CT head
4
Q
neurosurgery if
A
Persis GCS under 8 Over 4hr confusion Deter GCS after admission Prog focal neurol Seizure without full recovery Suspected penetrating injury CSF leak
5
Q
CT adult in 1hr if
A
GCS under 13 init, or under 15 after 2hr Suspected skull fracture Post traumatic seizure Focal neurol deficit Vomit more than once
6
Q
CT adult in 8 hr if
LOC OR amnesia AND one of
A
65 or over
Bleeding or clotting disorder
Dangerous mechanism eg over 1m fall or RTA
Over 30 min retrograde amnesia
7
Q
Exam
A
GCS 8 or less is severe, 9-12 mod Neuro incl speech, read, write, balance CNs CVS- shock eg HR, BP, CRT Secondary survey Neck Signs of skull frac- CSF leak, periorbital ahematoma, haemotympanium, battles sign.
8
Q
Mx
A
If non specif- reassure, safety net, analgesia, rest
Neuro for more severe
