Trauma: Cranial, Brain, and Cervical Injuries Flashcards
High Risk behaviors
Acute or chronic ETOH use
Drug abuse
anticoagulation
nonuse of seatbelts
nonuse of helmets
no protective equipment in team sports
Types of Brain/Cranial Injuries
Skull fx
brain hemorrhage/contusions
Vascular injuries
Soft tissue injuries
Penetrating injuries
Scalp injuries
What are extra axial injuries?
What are intra axial injuries?
Bleeding that occurs w/n skull but outside of brain tissue
Bleeding intraparenchymal or ventricles
Canadian CT Head Rule
High Risk includes?
Medium risk includes?
Failure to reach GCS of 15 in 2h, open/depressed skull fx, vomiting, basal skull fx, age >/= 65
amnesia > 30 min
dangerous MOI
Types of Extra axial injuries include?
SDH
EDH
SAH
Types of Intra axial injuries include?
Intraparenchymal hemorrhage
Intraventricular hemorrhage
Early Signs of Increased ICP
HA
N/V
Altered MS / LOC / Amnesia
Restlessness or drowsiness
Late Signs of Increased ICP
Dilated Pupils
Unresponsiveness
Posturing
Cushing’s Triad
Management strategies for Increased ICP includes?
Hyperventilation
Osmotic Therapy
NSGY c/s
Surgery
Imaging is not necessary to clear a C-spine and remove the c-collar in which patients
awake alert trauma patients w/o neuro deficit
no distracting injury
no neck pain or tenderness with full ROM
If CS injury is suspected patient must have radiographic evaluation. What is the primary screening modality?
Axial CT from occiput to T1 w/ sagittal & coronal reconstruction
If CT of CS demonstrates injury do what?
If neuro deficit attributable to CS injury do what?
c/s spine service
obtain spine c/s and MRI
For neurologically intact awake & alert patients c/o neck pain with negative CT what are the options?
- Continue C-Collar
- Remove C-Collar w/ negative MRI
- Remove C-Collar if negative & adequate F/E films
For obtunded patient with negative CT do what?
Remove C-collar
