neurotrauma Flashcards
1
Q
what is assessed in D
A
diability
- GCS, pupils
2
Q
3 parts of GCS and scores
A
- eyes
- verbal
- motor
score 3-15
3
Q
3 score levels of GCS
A
mild - 13-15
mod - 9-12
severe
4
Q
5 possible CT findings in TBI
A
- normal
- epidural (lens)
- subdural (midline shift and squished vents)
- intracerebral contusions
- diffuse axonal injury ( shear forces)
5
Q
Sx and mgmt of mild
A
normal CT
- no Sx
can be discharged if get to 15, or obs. at 13-14
6
Q
what to do for moderate
A
CT head
admit for obs
- if deteriorate, CT again
7
Q
what to do for severe
A
ABC are critical
- hypoxemia and hypotension incr. mortality
8
Q
what is goal in severe TBI
A
prevent more injury
9
Q
4 main things to prevent in severe
A
- maintain CPP = MAP-ICP
- hyperthermia
- seizures
- hyprglycemia
10
Q
what is monroe kelly doctrine
A
skull is rigid, so more volume will incr. ICP
11
Q
why manage ICP
A
- leads to small A compression - brain ischemia
- assoc. with worse outcomes
12
Q
when to monitor ICP
A
GCS
13
Q
4 devices to monitor ICP
A
- intraparncyhmal
- external ventricular (most common)
- epidural transducer
- subdural bolt
14
Q
what levels to aim ICP and CPP
A
ICP
15
Q
4 main contents of skull and how to manage
A
- hematoma - craniotomy
- CSF - drain
- ICF/ISF - hyperosmotics
- blood (A and V)
V - elevate
A - hyperventilate
