45 - head and cervical trauma Flashcards Preview

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

what determines cerebral perfusion pressure (CPP)

A

MAP-ICP

2
Q

5 signs of basal skull fracture

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

3 parts of GCS

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

3 classes of head injury

A

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

5
Q

what is CT rules def. of minor head injury

A
  • presence of amnesia
  • LOC
  • disorientation
  • GCS 13-15
6
Q

5 high risk cat. and 2 mod risk

A
high
1. GCS2 episodes
5. age >65
mod
1. amnesia >30min
2. dangerous mech
7
Q

def. concussion

A

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

8
Q

in major injury what is important for ABC

A
  • if GCS 90
9
Q

other things to ensure in major

A
  • analgesia
  • normothermia and lyte imbalances
  • look for coag states
  • NO steroids
10
Q

8 steps in intial ther. for high ICP

A
  1. elevate bed
  2. keep head midline
  3. sedate
  4. avoid unecc. stim
  5. analgesia
  6. manitol
  7. neuromuscular bloack
    8 .mild hyperventilation
11
Q

4 secondary ther. for ICP

A
  1. barbituates or propofol
  2. hypertensive ther
  3. mod. hyperventilation
  4. decompressive craniotomy
12
Q

part of Phx for c-spine

A
  • protect
  • palpate spinous processes
  • do neuro exam
13
Q

intial radiology used

A

Xray

- AP, lateral, odontoid

14
Q

ABCs approach to interpret

A
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
Q

what to look for on AP

A
  • trace bony contour

- look for alignment of spinous processes