Head Trauma

Question 1

What are the three aspects of GCS?

Answer 1

Eye Opening, Verbal Response, Motor response

Question 2

What are the scores for each of these?

Answer 2

4, 5, 6

Question 3

Eye opening 1-4?

Answer 3

4 - spontaneous
3 - to voice
2 - to pain
1 - none

Question 4

Verbal response (what’s your name, where are you?)

Answer 4

5 - oriented
4 - confused (babble)
3 - inappropriate words
2 - sounds
1 - none

Question 5

Best motor response (thumbs up, squeeze my hand)

Answer 5

6 - obeys command
5 - localised to pain
4 - normal flexion (withdraws pain) 
3 - abnormal flexion
2 - extension (abnormal)
1 - none

Question 6

Definitions of minor, moderate, severe and coma

(GCS)

Answer 6

Minor : 13 - 15
Moderated: 9 - 12
Severe: 3-8
Coma <8

Question 7

NICE criteria for preforming CT head within 1 hr of injury (7)

Answer 7

GCS < 13 on initial assessment 
GCS <15 at 2 hrs after injury 
Suspected open/depressed skull fracture
Post traumatic seizure 
Signs of basal skull fracture 
Focal neurological deficit 
> 1 episode of vomiting

Question 8

Signs of basal skull fracture? (3)

Answer 8

haemotypanum 
'Panda eyes' (periorbital ecchymosis) 
Battle's sign (bruising over mastoid process) 
rhinorrhea 
otorrhoea

Question 9

NICE criteria for preforming CT head within 8hr of injury (4)

Answer 9

> or equal to 65 yrs
30 mins retrograde amnesia of event before the injury
Any history of bleeding/clotting/on warfarin
Dangerous mechanism of injury

Question 10

What drug must you CT any patient on?

Answer 10

WARFARIN

Question 11

How many members required in a log roll?

Answer 11

5

Question 12

Each member role in log roll? (5)

Answer 12

one stands at the head, keeps control of head, neck and airway and gives commands

one takes arms and trunk

one takes upper legs and pelvis

one supports the calves

one examines back and performs rectal examination