Traumatic Brain Injury Flashcards
What are signs of TBI?
Deteriorating mental status CSF otorrhea or rhinorrhea Seizures Abnormal breathing pattern Unstable VS
What are sx of TBI?
Loss of consciousness Amnesia Dizziness HA N/V Limb weakness
What are lab/diagnostics for TBI?
BMP ABG Urine drug screen Blood alcohol screen CT
What is a primary brain injury?
Occurs at the time of trauma
What is a secondary brain injury?
Occurs from time of event to ours and days after trauma
What are the scales for TBI classification?
15 = normal 13-15 = mild brain injury 9-12 = mod brain injury 3-8 = severe brain injury
What are TBI treatment goals?
CAB Minimize secondary neuronal injury Monitor and manage intracranial pressure Seizure prophylaxis/treatment Medical management
What is the primary goal of initial resuscitaiton?
Prevent hypotension and hypoxia
What is CAB?
Secure airway, ensure adequate oxygenation
How do we maintain blood flow to brain and other organs?
Crystalloids
Vasopressors PRN after restoration of intravascular volume
Blood products when available
How do we calculate CPP?
MAP - ICP
How do we calculate MAP?
(SBP + 2xDBP)/3
What is goal CPP?
50-70
What is goal ICP?
<20
What are methods to lower ICP?
Elevated head of bed 30+ degrees
Sedation, analgesics, anxiolytics
Avoid hyperventilation
Ventricular drainage of CSF
