Head Injury Flashcards
1
Q
Assessment
A
- ABC’s
- C-spine immobilization
- HOB at 30 degrees
- Provide 100% prn r/t pt condition
- Protect airway/assisst ventilation as needed
- IV access
- Assess for signs of shock and other injuries
- Assess mental status, GCS, pupillary reaction
- Avoid fever, hypoglycemia, hypoTN, and hypoxia
- Control Pain, consider SZ prophylaxis (keppra)
2
Q
GCS >8
A
-Maintain oxygenation
-Mainain MAP:
Adolescent: >80 mmHg
Children: (Age in yrs x2) +50
Infants: >50
3
Q
GCS = 8 (Or rapidly decreasing GCS)
A
- BVM ventilation
- Intubation, maintaining C-spine immobilization
- *Use Etomidate and Lidocaine
4
Q
Signs of Herniation
A
- Unilateral dilated pupil
- Bradycardia
- HTN
- Cheyne-Stokes/agonal respirations
5
Q
Herniation Tx
A
3% Saline 5 mL/kg IV over 20 min, *OR mannitol 0.5-1g/kg (if requested)
- Therapeutic Hyperventilation (ETCO2 = 30)
- Whith Medical Control advice may repeat *3% Hypertonic saline 5 mL/kg IV, *OR Mannitol 0.25-0.5 g/kg
- May run 3% as continuous infusion at 0.1-1 mL/kg/hr
- Maintain oxygenation, normothermia, Maintain MAP
