Head/Spine Injuries Flashcards
What does the central nervous system do?
controls all basic bodily functions, responds to external changes.
What does the Peripheral Nervous System?
Provides complete network of motor and sensory nerve fibres. Connecting the central nervous system to the rest of the body.
What makes up the spine?
Spinal Cord and spinal column
What is the Foramen Magnum?
The opening at the base of the skull through which the spinal cord passes from the brain.
What is Cerebrospinal Fluid?
Fluid that surrounds the brain and spinal cord
What are vertebrae?
Bones of the spinal column
What is a concussion?
mild/severe closed head injury without detectable damage to the brain.
What is a contusion (brain)
A bruised brain when force is great enough to burst blood vessels.
What is a laceration (brain)
a cut to the brain.
What is a hematoma (brain)
a collection of blood in the brain or within the skull
What are the types of MOI when it comes to brain injuries?
-direct impact
-acceleration/deceleration
-shock wave
What is it important to check for when you have an injury to the face/jaw?
bone fragments, blood clots, teeth, blood, and separation of the palate can all be obstructive to the airway.
When is it necessary to remove a helmet?
-if interfering with ABC’s
- Improper fit, allowing excessive head movement
-if interfering with immobilization
-cardiac arrest
What is Syncope?
fainting/passing out
What are the nervous system structures?
Brain
Spinal Cord
Nerves
What is the function of the nervous system?
-sensory information
- coordinate body response.
What are the Signs and Symptoms of Neurogenic Shock?
-Slow Pulse
-Difficulty breathing
-irregular respirations
-low Bp
-flushed warm extremities
What is a concussion?
-mild head injury, no obvious damage
-brief loss of consciousness
-headache, grogginess, short term memory loss
What is a brain contusion?
-bruising of brain tissue
-unconsciousness, or decreased LOC
What are the types of cranial hematomas?
-subdural
-epidural
-intercerebral
What is ICP? What is Cushing Reflex?
Inter cranial pressure, inside the skull
Cushing reflex- result of ICP
-hypertension
-bradycardia
-irregular breathing ~cheyne stokes breathing
What is Decebrate posturing?
-head and neck arched
-legs straight
-toes pointed down
-arms straight, extended, or curled
What is decorticate posturing?
-closed hands
-legs rotated up
-feet turned in
-arms flexed against chest
What are the spinal injury MOI’s?
Hyperextension - too far back
Hyperflexion - too far forward
Compression - weight of head + pelvis driven into spine
Rotation - over rotation or twist
Lateral Stress - forced to one side with no rotation
Distraction - stretching of column and cord
What are the signs and symptoms of Skull fractures or brain injuries?
-visible bone fragments or brain tissue
-altered mental status
-deep lacerations/bruise on skull
-decompression or deformity of the skull
-battle signs or raccoon eyes
-pupils are unequal or unresponsive
-one eye appears sunken
-bleed from ears or nose
-personality chnage
-blood pressure up, heart rate down
-irregular breathing
-impaired hearing
-forceful/projectile vomit
-decorticate or decebrate posturing
-paralysis
-seizures
-temperature increase
-deteriorating vitals
Explain the process of removing a helmet…
2 man team
1- #1 at the top of patients head, maintain manual stabilization, two hands hold helmet stable while fingers hold jaw.
2. #2 cuts/opens/removes chin straps
3. #2 reaches under helmet and stabilizes head and neck
4. #1 releases manual stabilization and pulls the sides of the helmet out and pulls off using a teetering motion.
When is it required to leave the helmet in place?
-if helmet fits snug, with little to no movement
-not impending airway or causing breathing problems
-if removal would worsen the injury
-proper spinal immobilization can be done with a helmet
-no interference with the ability to check ABC’s
When is it necessary to collar somebody?
-decreases LOC
-intoxication
-communication barrier
-cognitive impairment
-painful distracting injury
-paraesthesia in extremities
-palpable spinal deformity
-neck pain/ tenderness
-limited range of motion
-fall over 1 meter or 5 stairs
-axial load to the head
-MVC greater than 100KPh
-MVC with ejection or death
-MRV accident
-bike collision with immovable object
-65 years plus
-underlying spinal disease
-previous cervical spine injury
What are the signs and symptoms of a spinal cord injury?
-pain tenderness in the spine
-deformity of the spine
-tingling or weakness in the extremities
-loss of sensation or paralysis
-incontinence
-priapism
-soft tissue injury in the spinal area
-shock
What is the Motor section of the glasgow coma scale?
6- obey command
5-localizes pain
4- withdraws
3-flexion
2-extension
1-none
What is the verbal component of the glasgow coma scale?
5-oriented
4-confused
3-inappropriate
2-incomprehensible
1-none
What is the eye component of the glasgow coma scale?
4-spontaneous
3-to voice
2-to pain
1-none
What is the emergency care for a head injury?
- C spine considerations
- Assess and maintain airway
- determine breathing adequacy
4.Oxygen w NRB - PPV with BVM
- ALS
What is the proper care
for a skull fracture or Brain Injury?
- Consider C-spine and ALS
- Open and maintain airway with a Jaw thrust, suction if needed
- Monitor Breathing
- Collar if needed, spinal motion restriction
- control any bleeding
- Keep Patient at Rest
- dress bandage any open wounds, stabilize any penetrations
- manage shock
- transport and monitor every 5 mins
What are the signs and symptoms of stroke with men?
-face droop
-arm weakness
-speech difficulty
-vision problems
-difficulty walking
-severe headache
what are the signs and symptoms of a stroke in women?
-face droop
-arm weakness
-speech difficulty
-difficulty walking
-severe headache
-general weakness
-memory issues
-fatigue
-nausea
What is central neurogenic hyperventilation?
a pattern of rapid deep breathing caused by a brain injury
What are ataxic respirations?
irregular and unpredictable breathing caused by brain injury
what is herniation?
pushing a portion of the brain downward, increasing icp
What are your AEIOU TIPS?
A - alcohol/ drug use
E - endocrine/ epilepsy/ electrolyte
I - infection
O- overdose/ oxygen deficiency
U - uremia
T- trauma/ tumour/ temperature
I - insulin
P- psychiatric/ poison
S - Stroke/ shock/ seizures
What is the proper care for a stroke?
1.blood glucose
2. score using LAMS
3. history ( ONSET)
4. SAMPLE
5. contact stroke neurologist to determine drop off location
What is important to remember when working with a injury to the face or jaw?
-bone fragments, blood clots, teeth, blood, and separating palates will cause an airway obstruction
Describe the Cincinnati Prehospital stroke scale…
Face - 0/1
0 - one side weak or flaccid
1 - both sides move normal
Arm - 0/1
0 - one arm is weak or doesn’t move at all
1 - both arms have equal normal strength
Speech - 0/1
0 - speech is slurred, inappropriate words or mute
1 - speech is normal and appropriate
Describe the LAMS
Face
0 - both move normally
1 - one side is weak or droopy
Arms
0 - both move normally
1 - one side is weak
2 - one side is flaccid / doesn’t move
Grip
0 - both sides move normally
1 - one side is weak
2 - one side is flaccid / doesn’t move
total 0-5
What are the MOI’s for a spinal injury?
hyperextension - too far back
hyperflexion - too far forward
compression - weight of head/pelvis driven into spine
rotation - over rotation or twist
lateral stress - forced to one side
distraction - stretching/ pulling
Recite the Spinal Restriction Care Map, regarding their indications for a C Collar…
Collar if-
1. Decreased LOC/Head Injury
2. Intoxication
3. Communication Barrier
4. Cognitive Impairment
5. Painful Distracting Injury
6. Tingling Extremities (Paraesthesia)
7. Palpitation of Spinal Deform
8. Neck Pain or tenderness
9. Limited Range of Motion
10. Fall greater than 1M, 3ft, 5 stories
11. Axial load to head (diving)
12. MVC greater than 100kph
13. MVC w ejection or death
14. MRV accident
15. Bike collision w immovable object
16. 65years and over
17. Know Underlying Spinal Disease
18. Pervious Cervical Spine Surgery
