Traumatic Brian Injuries

Question 1

What are the signs of mild brain injury?

Answer 1

Brief change in mental status; short term amnesia; seeing stars; nausea; vomiting; headache; dizziness; lethargic

Question 2

What are the signs of severe brain injury?

Answer 2

any change in the level of responsiveness, disorientation, combative; unconsciousness; confusion; headache; vision change; loss of balance; nausea; vomiting; slow pulse or irregular breathing (hyperventilation or erratic); unequal pupils; lethargy; seizures; heart rate changes; blood or CSF in ears or nose; raccoon eyes; bruising behind ears

Question 3

What does A-V-P-U stand for and how do we use it?

Answer 3

A)wake and alert
V) not awake but responsive to verbal stimulus
P) not awake but responsive to pain
U) not awake and unresponsive

Use: continuous monitoring of the level of responsiveness/consciousness

Question 4

How do you treat brain injuries in the wilderness?

Answer 4

ABC (basic life support; assume c-spine injury; if vomiting roll to side); control any scalp bleeding; keep head elevated slightly above the level of the heart; record neuro assessment over time

Question 5

Why do we have a low threshold for evacuation of head injuries?

Answer 5

difficult to assess; serious symptoms and signs can be masked and require healthcare provider tests and imaging; can very quickly deteriorate into something more serious