Head and Neck Trauma Flashcards Preview

Adult and Ped Test 7 > Head and Neck Trauma > Flashcards

Flashcards in Head and Neck Trauma Deck (28):
1

Management of Injury: Pre-hospital

ABC's
neuro assessment
spine protection

2

Management of Injury: Hospital

assess immediately and refer stat

3

Describe AMPLE and when its performed:

As part of the secondary survey

allergies
medications
past medical history/pregnancy
last meal
events surrounding/environment

4

"A"

Airway
MUST AVOID HYPOXIA

SOAPME
Suction
Oxygen
Airway
Pharm
Monitoring
Equipment

5

What labs can help you assess "b"

ABGs and P02s

normal pc02 range is 35-45.
hypercapnea = increased MM
hypocapnea= decreased cerebral blood flow and perfusion

6

What is the Cushing Reflex?

1. HTN
2. Bradycardia
associated with increased intracranial pressure

7

How can you evaluate "d"

establish a GCS score and perform it frequently

8

You should look for reversible signs of altered mental state. What are they

AEIOU TIPS
alcohol, electrolytes, insulin, opiates/02, uremia, toxidromes/trauma/temp, infections, psych/polypharmacy, stroke/seizure/space occupying lesion

9

What is a healthy GCS score?

15 (e4, m6, v5)

10

what is a dead GCS score?

3

11

if someone is intubated, what is their V score?

1T

12

What is the sign of a basilar skull fracture?

"battle's sign" --> bruising over mastoid process due to fracture of the middle cranial fossa

13

How do you calculate a TBI GCS score's severity?

mild: 13-15
mod: 9-12
sever: <8

14

What is the difference between a focal and diffuse TBI?

focal = very specific part of brain
diffuse = problems with speech and cognition

15

Epidural hematoma:

arterial bleed, most don't have lucid period

16

subdural

venous leed

17

subarachnoid

worst headache of my life

18

diffuse axonal injury

morbidity can be very severe

19

What should you order if you suspect a skull fracture?

CT

20

How should you treat skull fractures?

closed: no specific treatment, observe

open: high risk of infection. tx with abx and surgery

depressed : found on palpation, admit for observation and surgical eval

basilar skull: Hemotympanu; battle sign' raccoon's eyes. CSF leaking from ear to nose, hearing loss. 7th cranial nerve palsy. Treatment: IV abx, hospitalize, neuro consult

21

What is the goal with minor head injuries:

determine if an intracranial mass lesion is present. R/o by CT

22

What are some indications for a CT

1. amnesia prior to event
2. altered LOC
3. vomit
4. >65
5. basilar fracture suggestions

23

What is a concussion?

injury to the brain that results in a temporary loss of normal brain function. usually caused a blow to the head. most people NEVER lose consciousness with a concussion.

24

How do you know its safe to discharge the patient?

1. minor head injury
2. negative CT
3. neurologically normal (with or without headache)
4. care of a resonpsible adult is nearby

25

how do you know if you should hospitalize?

1. persistent amnesia
2. persistent alterarion in level of consiouness
3. any abnormality on CT scan

26

What should you do with all cervical traumas?

immobilize the neck. NEXUS criteria is used to determine if collar can be removed or not

27

What imaging is REQUIRED for cervical spine injuries?

AP and Lat view from C1 to T1 and an Odontoid view.

28

What is a "Swimmer's" view?

paitent lies supine, one arm is abducted and extended. opposite arm is adducted and extended. X-ray shot through abducted axilla.