Head Trauma Flashcards
T/F Head injury patients may or may not be full stomach
False. Assume full stomach in all head injury patients.
How would one perform in line cervical stabilization?
An assistant will need to hold the occiput down on a backboard, with fingers on the mastoid process
When do you avoid nasal intubations?
basal skull fracture, severe facial fractures, or suspected bleeding diathesis.
Why don’t you use hypotonic solutions in head trauma?
because they are more likely to cause brain swelling.
Which fluid do you use in brain trauma?
Isotonic solutions (0.9% NaCl). it prevents immediate increases in ICP and maintains plasma volume
In head trauma, maintain the CPP above what?
Above 60.
Should you routinely use pressors in head trauma? What states do you want to avoid in head trauma?
No you don’t routinely use pressers
Avoid hypoxia, hypercarbia (cerebrovasodilation can increase ICP), hypotension (be above 90 mmHg of mercury), avoid anemia, avoid hyperglycemia (glucose above 200)
T/F Actively try to decrease patient’s elevated blood pressure in head trauma
False! Leave BP alone!
Non-operative treatment of diffuse cerebral swelling (increased ICP) . How long does the second one last, and how long before it works?
Hyperventiaition-not to below 35
Osmotic diuretic-15-30 min to work, and effects last for 90 min to 6 hours
Can you use barbiturates in head trauma?
You could because it decreases CMRO2, but you have to be careful because it can lower blood pressure.
Glasgow Coma Scale-go over scale in its entirety:
eyes (4) Voice (5) motor (6) Eyes: 4-spontaneous 3-to voice 2-to pain 1-not at all
Motor: Obey (6) Localizes pain (5) Draws back in pain (4) Bends (decorticate) (3) Extends (decerebrate) (2) Nothing (1)
Vocal: Voiceless (1) OoOh (incomprehensible sounds) 2 Inappropriate 3 Confused 4 Elegant speech 5
How is hypothermia beneficial in head trauma? What is bad about it?
Hypothermia decreases the CMRO2, but it can cause coaguloathy, increased infection rate, delayed emergence from anesthesia, cardiac dysrhythmias
When evaluating a patient with head trauma, they must be evaluated where? How do you feel about sux in head trauma patients?
They eedd to be evaluated in the trauma bay BEFORE proceeding to another place
Sux does lead to a transient increase in ICP, but the benefits of rapid airway securement outweigh this transient change
In a patient with head trauma that must go to the OR, what is a monitor that you don’t think about often but want to make sure you have?
Foley catheter
is sympathetic hyperactivity common in head trauma? What about seizures? What to do about the seizures?
Yes, its common. Seizures are also common after head trauma. Anti-eleptics are usually started immediately post op?
