Trauma (Traumatic head injury) Flashcards
1
Q
when assessing pattern of injury, the patient can be considered to have a serious blunt head injury with or without loss of consciousness/amnesia and GCS 13-15 with any of what?
A
- any loss of consciousness exceeding 5 minutes
- skull fracture (depressed, open or base of skull)
- vomiting more than once
- neurological deficit
- seizure
2
Q
Recite the Traumatic head injury CPG
A
3
Q
What is 5HEDS?
A
- (5) any LOC exceeding 5 mins
- (H) Head injury → skull # (depressed, open or BOS)
- (E) Emesis → vomiting more than once
- (D) neurological Deficit
- (S) Seizure
4
Q
What is a primary head injury?
A
- initial insult
- coup/contre-coup injuries
5
Q
What is a secondary head injury?
A
- delayed (minutes to days)
- oedema/vasodilation/increased ICP
- Decreased Na+/K+ pump
6
Q
What are some bad signs of a traumatic HI?
A
- Widening pulse pressure e.g. 220/40
- Bradycardia
- decreased respirations
7
Q
What sats, ETCO2, CPP and position should you aim for in patients with a HI to prevent a secondary HI?
A
- sats >94%
- ETCO2 35-45
- CPP >120 mmHg
- HOB 30 degree (has potential to improve cerebral blood flow by improving venous drainage)
8
Q
Can you insert an OP/NP in a patient with a HI?
A
- No
9
Q
Can you give midazolam to a combative patient with a HI?
A
- No - they need analgesia