Trauma Flashcards
What is the most common cause of death and disability in those under 40?
Head injury
Who are at most high risk of head injury?
Young men Elderly Alcoholics PWIDs Low income individuals
What are the most common causes of head injury?
Falls
RTAs
Sport
Alcohol is involved in 50% of cases.
Aside from the first hour following injury, when does the 2nd peak of deaths occur following head injury?
7 hours after injury.
What are the 3 categories in the GCS?
Eye opening
Motor
Verbal
Try to consider each as an individual component.
What does a GCS of 14-15 indicate?
Mild LOC.
Can have slight confusion.
What does a GCS of 9-13 indicate?
A moderate injury.
What does a GCS of 3-8 indicate?
A severe injury.
What does the ‘panda eyes’ sign suggest?
Basilar skull fracture.
What does the ‘battle’ sign suggest?
Haematoma across the mastoid.
What does leakage of blood/CSF from the ear indicate?
Basilar skull fracture.
Do extradural haematomas cross suture lines?
No, as the dura mater is bound tightly to bones.
How do extradural haematomas present?
Presents with LOC. May have had initial recovery following by a lucid episode.
They are lens-shaped lesions.
Can haematomas within the skull be left untreated?
No, as it will keep expanding.
Surgery is necessary to address haematomas.
What shape do subdural haematomas take?
Crescent-shaped.
They are not limited by suture lines.
How does an acute subdural haematoma appear on CT?
A hyperdense crescent-shaped lesion.
Not limited by suture lines.
How does a chronic subdural haematoma appear?
Will also be crescent-shaped, however will be less dense than an cute presentation.
Can be ‘flushed out’.
Which surgical procedure is used to treat an acute subdural haematoma?
Craniotomy
What is an intracerebral haematoma?
Bleeding that occurs within the brain tissue itself.
What are coup and contra-coup injuries?
When the brain strikes an object, rebounds and hits the skull on the other side.
Which appears more dense on a CT, acute subdural haematoma or chronic subdural haematoma?
Acute subdural haematoma.
How does an axonal injury present?
History of shearing forces
Reduced consciousness
No signs on CT scan (present on MRI but not regularly performed)
What are the 5 forms of brain herniation?
Sub-falcine Tentorial Uncal Tonsillar Transcalvarial
What is brainstem death?
When a person cannot survive without a life support machine. This is in the absence of drugs, hypothermia and metabolic disturbances.
How is raised ICP treated?
Sedation Maximise venous drainage from the brain CO2 control Osmotic diuretics CSF release
