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Technician Course MOD E 2016 > MOD E Tech 32 Head & Maxillofacial injuries > Flashcards

MOD E Tech 32 Head & Maxillofacial injuries Flashcards

1
Q

Head Anatomy

Intracranial Contents:

A

Intracranial Contents:

•

  • Brain – 80%
  • Blood – 12%

CSF – 8%

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2
Q

Head Trauma - Types

A

Open

•Skull compromised
and brain exposed

Closed

•Skull not compromised
and brain not exposed

•Contra Coup injury

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3
Q

Head Injuries – Scalp Wounds

A

Scalp wounds

  • Highly vascular, bleeds briskly
  • May be difficult to pinpoint the source
  • Patient may suffer concussion
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4
Q

Base of Skull Fracture

signs

A
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5
Q

Brain Injury

A

Primary brain injury

•Immediate damage
due to force

  • Coup and contracoup
  • Fixed at time of injury
  • Localised
  • Diffuse

Management

•Directed at prevention

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6
Q

Brain Injury

Secondary brain injury

A

Secondary brain injury

•Results from hypoxia, hypercarbia
or decreased perfusion

  • Response to primary injury
  • Develops over hours

Management

•Good prehospital care can help prevent

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7
Q

Brain Injury

Response to injury

A

Response to injury

  • Swelling of brain
  • Vasodilatation with increased blood volume
  • Increased ICP
  • Decreased blood flow to brain
  • Perfusion decreases
  • Cerebral ischemia (hypoxia)
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8
Q

Early efforts
to maintain brain perfusion
can be life-saving.

A
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9
Q

Brain Injury - Contusion

A

Cerebral contusion

  • Bruising of brain tissue
  • Swelling may be rapid and severe
  • Level of consciousness

•Prolonged unconsciousness,
profound confusion or amnesia

  • Associated symptoms
  • Focal neurological signs
  • May have personality changes
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10
Q

Brain Injuries – Vascular Damage

A

Intracranial haemorrhage

  • Epidural / Extradural
  • Between skull and dura
  • Subdural
  • Between dura and arachnoid
  • Intracerebral
  • Directly into brain tissue
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11
Q

Intracranial Haemorrhage

A
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12
Q

Intracranial Haemorrhage

Acute epidural haematoma

A
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13
Q

Intracranial Haemorrhage

Acute subdural haematoma

A
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14
Q

Consequences & Complications of Head Injuries

A
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15
Q

Consequences & Complications of Head Injuries

A

Compression

  • Extradural and sudural haematomas can cause a sudden or gradual increase in ICP
  • Large pressure changes can result in shifting of the brain and “coning” of the brain stem
  • A deterioration in level of consciousness is an important indicator of an increasing ICP
  • Deterioration in LOC
  • Noisy, slow breathing (Cheyne-Stokes in terminal stages)
  • Slow, full pulse
  • Raised temperature
  • Hot, flushed face
  • Unequal pupils – dilated and fixed on side of injury
  • Unilateral facial or body weakness / paralysis
  • Intense headache
  • Convulsions
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16
Q
A
17
Q

Assessment

A
18
Q

Pupil Reaction

A
19
Q
A
20
Q
A
21
Q

Maxillofacial Injuries

A
  • Maxillofacial injuries are often associated with head and neck injury
  • Therefore they present a unique range of problems in terms of patient positioning and airway management
22
Q

Maxillo Facial Injuries

Special Problems

A
  • Facial distortion, bruising & swelling may mask a fracture
  • CSF leakage
  • Damage to teeth
  • Loss of cough reflex
  • Sense of taste & smell affected
  • Double vision
  • Inability to close jaw
23
Q

Airway & Breathing issues to think about

A
  • What may obstruct the airway?
  • Consider use of “unusual” airway maintenance, especially in facial fractures
  • Masks may not fit properly
  • Because the face is very vascular, profuse bleeding may be present, necessitating constant suction
24
Q

CSF Leakage

A
  • CSF may be identified as a pale/colourless liquid leaking (normally) from the nose or ears
  • Where is CSF normally contained?
  • What does CSF leakage imply?
  • What are the consequences of this for the patient?
25
Q

Management

Maxillo Facial Injuries

A
  • Ensure open airway – may require suction
  • Consider cervical spine damage
  • Postural drainage
  • Control bleeding
  • Take broken dentures / avulsed teeth to hospital
  • Encourage patient not to speak
26
Q

Eye Injuries

Eye Injuries - Types

A
27
Q
A
28
Q

Eye Injuries - Management

Chemical contamination:

A

Chemical contamination:

  • Flush the eye with copious amounts of water
  • If safe to do so – retain a sample of the chemical for the hospital
  • Reduce eye movement – cover both eyes
  • Do not apply direct pressure to the eye itself
  • Consider removal to specialist department
29
Q

Eye Injuries - Management

Embedded Objects or Injuries

A

Embedded Objects or Injuries

  • Do not remove embedded foreign bodies
  • Cover both eyes
  • Do not apply direct pressure to the eye itself
  • Consider removal to a specialist department
  • Reassurance
  • Constant communication
  • Be aware of displaced contact lenses
  • Avoid unnecessarily tampering with eye injuries
  • Reassurance
  • Constant communication
  • Be aware of displaced contact lenses
  • Avoid unnecessarily tampering with eye injuries

Technician Course MOD E 2016 (18 decks)

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