Paed Head Injury Flashcards
5heds
5 mins LOC
Head injury
Emesis >1
Neurological Deficits
Seizures
Agitated head injury pt mgx
Opioids
General care for head injury
Dress open skull#/wounds w/sterile dressing soaked in NS
Maintain neutral neck alignment and collar when appropriate
Maintain normal body temp
Aim for SBP >120mmHg in Adult and maintain MAP
NPA Indications
Support airway patency in the unconscious patient
- NPA may be preferable in patients with trismus, gag reflex, oral trauma or in addition to
other adjuncts to optimise airway patency
NPA Contras
Nil
NPA Precautions KNOW THIS
Facial fracture or suspected basal skull fracture (i.e. any CSF from nares or ears)
- Possibility of cerebral intrusion. Only insert if absolutely necessary to maintain patent
airway.
TBI / nTBI
- Stimulating a gag reflex in this group can significantly worsen intracranial pressure. Only
insert if absolutely necessary to maintain patent airway
How to Measure NPA
Tip of nose to ear lobe
OPA indications
Support airway patency in the unconscious patient
Bite block in intubated patient
OPA Contras
Trismus
Gag reflex
TBI / nTBI with adequate ventilation / oxygenation (Stimulating a gag reflex in this group can significantly worsen intracranial pressure)
OPA sizing guide
angle of jaw to middle of incisor (front teeth)
OPA Paediatric modifications
Do not insert upside down / rotate. Simply insert with curve in final position.
Paediatric patients have softer palates that are more likely to be damaged by upside-down OPA
insertion.
A laryngoscope may be used to help the OPA move past the tongue.
Inserting the OPA without rotation reduces the chance of damaging the soft palate but increases
the likelihood that insertion is obstructed by the tongue. Manipulating the tongue with a
laryngoscope may assist insertion.
