T3-Head Injuries in Infants Flashcards
The head of infants and younger children is proportionately ____ and ____ in relation to other body parts, therefor it is ____ likely to be injured
Large and heavy head= MORE likely to be injured!
What contributes to falls at young ages?
Incomplete motor development
What are head injuries major causes?
Falls
MVA
Bicycle injuries
Are infants heads more or less vascular than infants? What does this mean?
More vascular–head injuries can cause them to bleed to death
Acceleration forces: bruising at point of impact (___) and rebound bruising (___)
Impact: Coup
Rebound bruising: Contre coup
Brain mass movement rips across structure, breaks small filaments holding it together (shearing forces)–this results in what 2 things?
Cerebral edema
Compression of brain mass
Assessment: Head injury. What are the steps?
- ABC
- Spinal cord injury
- Evaluate for shock
- Neuro exam
Hypoxic-ischemic brain injury: Near drowning
Where do infants drown?
Where do toddlers drown?
Infants: bathtub
Toddlers: Toilet bowel
Hypoxic-ischemic brain injury near drowning–what is the definition of this?
Survival 24 hours after incident
What is prevention for hypoxic-ischemic brain injury near drowning?
TEACH
What head problem:
- Coup injury from initial impact
- Subdural vessels torn
- Bruising bc brain moves over skull floor
- Countercoup injury from secondary impact as brain moves forward and backward within skull
Shaken baby syndrome
What is the most common head injury?
Concussion
What are hallmark signs of concussion?
Amnesia
Confusion
Cranial injury: trauma must be extreme to ____
Fracture
T/F: Basal skull is relatively easier to fracture
True
Is basal skull protected or unprotected?
Unprotected
What fracture: Skin laceration and fracture
Compound
Meds for compound fracture?
Antibiotics and surgery
What fracture: Results in dural tear, hemorrhage into nose and middle ear
Basilar fracture
What type of fracture: Traumatic separations of cranial sutures
Diastatic
What type of fracture has racoon eyes ?
Anterior basal fractures
What type of fractures has battle sign? What does this mean?
Basilar–effusion of blood under ear
What are two characteristics of cranial injury—basal skull fracture?
Battle’s Signs
Raccoon Eyes
Is this battle sign or raccoon eyes?
-Bilateral periorbital ecchymosis; associated with orbital fractures
Raccoon eyes
Is this battle signs or raccoon eyes?
- Retroauricuar ecchymosis
- Associated with fracture of auditory canal and lower areas of skull
Battle sign
Basilar skull fracture may tear dura..What does this mean?
Permit CSF to drain through an external passageway
Hematomas: Physical characteristics
What kind of support of the head? Who is particularly vurnuable? What kind of brain? What does this result in?
- Insufficient musculoskeletal support of head
- Very young particularly vulnerable
- Thinner and softer brain
- Results in greater, long term damage
Hematomas: Physical characteristics
Thinner and compliant skull of younger children allow for?
Increased tolerance to ICP and blunt force that causes fractures
Management of head injuries in children: Observation? (2)
- Neuro checks
- Changes in VS
Management of head injuries in children: Surgical interventions? (3)?
- Craniotomy
- Craniectomy
- Repair of lacerations
Unilateral dilated and reactive pupil is accounted with?
Intracranial mass
A fixed and dilated pupil may be a sing of ?
Impending brainstem herniation
Bilateral fixed and dilated pupils are associated with?
Brainstem herniation from increased ICP
How is decorticate posturing characterized?
Rigid flexion –associated with lesions above the brainstorm in the corticospinal tracts
How is decerebrate posturing distinguished? Associated with?
Distinguished by rigid extension; associated with lesions of the brainstem
What kind of meds for head injuries?
Antiinflammatory and pain management
What kind of long term problems may be associated with head injuries in children?
Physical problems and cognitive impairments
