TBI Flashcards
What is the glascow coma scale based on?
Eye opening, verbal response, and motor control
Highest GCS score?
15
Lowest GCS score?
3
When should GCS be performed?
At triage and repeatedly during evaluation
What does a decreasing GCS score mean?
BAD NOT GOOD NO GET HELP
Rate these 1-4 on GCS Scale: No eye opening, Eye opening in response to pain, eye opening to speech, eyes opening spontaneously
No eye opening = 1
Eye opening in response to pain = 2
Eye opening to speech = 3
Eyes opening spontaneously = 4
Rate these 1-5 on GCS scale: No verbal response, incomprehensible sounds, inappropriate words, confused, oriented
No verbal response = 1 Incomprehensible sounds = 2 Inappropriate words = 3 Confused = 4 Oriented = 5
Rate these 1-6 on GCS scale: No motor response, extension to pain (decerebrate), abnormal flexion to pain (decorticate), flexion/withdrawal to pain, localizes to pain, obeys commands
No motor response = 1 Extension to pain (decerebrate) = 2 Abnormal flexion to pain (decorticate) = 3 Flexion/withdrawal to pain = 4 Localizes to pain = 5 Obeys commands = 6
GCS 13-15
Mild TBI
GCS 9-12
Moderate TBI
GCS less than 8
Severe TBI
Membranes covering the brain and spinal cord
Meninges
Three types of primary brain injuries
Compression, tensile, shear
Tissue stretching
Tensile
Tissue distortion when tissue slides over tissue
Shear
When does secondary brain injury occur?
AFTER the initial insult (could be minutes, hours, days)
Cerebral arterial dilation, intracranial hemorrhage, cerebral edema, ischemia/hypoxia, increased ICP, and intracellular swelling and electrolyte imbalance are all forms of??
Secondary brain injury
What is important to do when evaluating a patient with a TBI?
Maintain C spine immobilization!
Battle’s sign, raccoon eyes, CSF rhinorrhea or otorrhea, and hemotympanum are all signs of?
Basilar skull fx
Headache, vomiting, age over 60, intoxication, deficits in short term memory, physical evidence of trauma above clavicles and seizure…. What should you suspect?
SUSPECT TBI
Who gets a CT?
Everyone! Unless you’re in Canada. JK this card is useless give yourself a 5 and carry on.
Are skull radiographs recommended for TBI?
No get a non-contrast head CT
Complex pathophysiological process affecting the brain, induced by traumatic biomechanics forces. Traumatically induced structural injury and/or physiologic disruption of the brain function as a result of external force
Concussion
Can result from direct blow to the face, neck, or elsewhere on the body; Can result in loss of consciousness; associated with grossly normal structural neuroimaging studies; rapid onset, short-lived impairment of neurologic function that resolves spontaneously; neuropathological changes
Concussion
