Traumatic Brain injury Flashcards
What is a primary brain injury?
First insult
What is a secondary brain injury?
The injury we can prevent
List the types of primary/traumatic brain injuries
Contusion
Epidural hematoma
Subdurral hematoma
Traumatic subarachnoid hemorrhage
Diffuse axonial injury
What is a diffuse axonal injury?
Primary brain injury where the head gets shaken so much the axons shear
Main 3 symptoms of diffuse axonial injury?
Coma - most people have this
Confusion
N/V
Main two goals of managing the secondary injury of a traumatic brain injury
Increase oxygen supply to the brain
Decrease metabolic needs
Mild GCS score
13-15
Moderate GCS score
9-12
Severe GCS score
Less than 8
What brain injuries are diagnosed with CT
Hematomas
Hemorrhage
Fractures
Cerebral edema
Brain injuries that are diagnosed with an MRI
Severe diffuse axonial injuruy
Herniation of brainstem
Aneurysm
What is the concern with an aneurysm?
The bulge will hemorrhage and cause a stroke
List the traumatic brain injuries again (same as primary)
Contusion
Epidural hematoma
Subdurral hematoma
Traumatic subarachnoid hemorrhage
Diffuse axonial injury
What are the main 3 fractures that can occur to the skull?
Linear
Depressed
Basilar
Linear fracture description
Hairline fx, no treatment needed
Depressed fracture description
Part of the bone is depressed down into the brain. Need to remove with surgery
Basilar fracture description
At the base of the neck. Will have CSF leakage from nose and ears.
Battles sign may be present on children at the ears.
Priority nursing diagnosis for Traumatic Brain injuries
Respiratory
Volume
Lower O2 demand
Risk for immobility complications
How do we address the respiratory care for a traumatic brain injury?
Airway management - make sure its not compromised
Give oxygen - NC
Ventilate or intubate the patient if needed
How to address the volume concerns with a traumatic brain injury patient?
Give fluids
Monitor ICP
Monitor CPP & give pressors such as dopamine etc
How can we lower the o2 demand for a traumatic brain injury patient?
Sedation
What are the risks for the immobility for a traumatic brain injury patient?
Pneumonia (lung sounds)
PE (lung sounds)
DVT (anticoagulation)
Skin integrity (turning)
