TBI Flashcards
Coup Injury
Injury at site of impact
Contrecoup Injury
Shaken baby
Missile Injury
Blast effect, entering the brain
General Nursing Management of head injuries
- Monitor and support ABCs
- C-spine precautions
- Monitor and treat ICP
- Maximize PBTO2 (nml is 20-35mmhg)
- Assess for other injuries
- Sz precautions
- Assess for leakage of CSF
- Prevent Infection
- Monitor and manage increase in temp
- Skin Care
- Maintain of bowel and bladder function.
Linear skull fx
crack in surface of skill without bony displacement.
Depressed skull fx
Inward depression of bone fragments
If >5mm, surg required for repair.
Measure ICP
Compound Skull fx
Depressed skull fx with lac of the scalp.
Presents with bleeding with bony displacement of skull.
Surgery to repair.
Measures to control ICP.
Prevent/treat infection.
Concussion
Brief LOC
Brady
May be followed by post concussion syndrome for up to 1 year or more. - Would see personality changes.
Stay with pt and assess pupils and LOC Q2H
May give Tylenol for HA- NO ASA
Contusion
Bruising of the brain
Necrosis, infarction, hemorrhage, and edema.
Considered MAJOR HEAD TRAUMA.
Common complication: Seizures
Possible increased ICP.
Diffuse axonal injury (DAI)
widespread damage after a mild, moderate or severe brain injury. “Tornado effect”
MRI
If survive, typically in a veg state
Epidural Hematoma
bleeding between skull and dura mater
ARTERIAL
WAX>WANE LOC with lucidity
Subdural Hematoma (SDH)
SLOW bleed
Acute: within 48 h
SubAcute 48h-2weeks
Chronic:2wks to 2mo
Intracerebral bleeding
Bleeding within cerebral tissues #1 cause: Uncontrolled HTN
Subarachnoid hemorrhage
#1 cause: Aneurysms "Worst of my life headache" Triple H therapy: Hypertensive Hypervolemic Hemodilation
Aneurysm precautions: Dim lights, limit visitos, descrease stimulation, elevate HOB, avoid valsalva, give sedatives, alalgesics
