45 - head and cervical trauma Flashcards Preview

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Flashcards in 45 - head and cervical trauma Deck (15)
1

what determines cerebral perfusion pressure (CPP)

MAP-ICP

2

5 signs of basal skull fracture

1. hemotympanum
2. blood in ear canal
3. rhrinrrhea
4. battle's sign
5. raccooon eyes

3

3 parts of GCS

1. eye opening (4)
2. verbal (5)
3. motor (6)

4

3 classes of head injury

mild - 14-15
mod - 9-13
severe - 8 or less

5

what is CT rules def. of minor head injury

- presence of amnesia
- LOC
- disorientation
- GCS 13-15

6

5 high risk cat. and 2 mod risk

high
1. GCS2 episodes
5. age >65
mod
1. amnesia >30min
2. dangerous mech

7

def. concussion

after direct or indirect blow to head characterized by transient change in cog or neuro function

8

in major injury what is important for ABC

- if GCS 90

9

other things to ensure in major

- analgesia
- normothermia and lyte imbalances
- look for coag states
- NO steroids

10

8 steps in intial ther. for high ICP

1. elevate bed
2. keep head midline
3. sedate
4. avoid unecc. stim
5. analgesia
6. manitol
7. neuromuscular bloack
8 .mild hyperventilation

11

4 secondary ther. for ICP

1. barbituates or propofol
2. hypertensive ther
3. mod. hyperventilation
4. decompressive craniotomy

12

part of Phx for c-spine

- protect
- palpate spinous processes
- do neuro exam

13

intial radiology used

Xray
- AP, lateral, odontoid

14

ABCs approach to interpret

Alignment
- anterior and post contour lines
- look for tranlation >3.5cm or angle >11
Bone
- follow cortex of bone looking for breaks
Cartilage
- look for equal disk spaces
- pre-dental space

15

what to look for on AP

- trace bony contour
- look for alignment of spinous processes