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Flashcards in Head Injury Deck (8)
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1

Red flags

GCS under 15 initially
Shock or other sig injuries
Coag disorder or anticoags
Alc or drug intox
Any LOC after injury
Any post trauma seizure
Any previous brain surgery
Amnesia lasting over 5 mins
Persis headache since injury
Vom since injury- over 1 in adult, over 3 in kid
Visual changes
Focal neurology
Suspected skull fracture
Penetrating inj or skull trauma
Suspected C spine injury
Non accidental injury

2

History

Mechanism
LOC
What happened afterwards
Anticoags/bleed risk
Nausea and vom
Headache
Vision changes
Muscle weakness or face weakness
Amnesia
Neurology
Neck pain
Alc or drugs
Pre injury baseline congnition

3

ED ix

A to E
Bloods
XR
Maybe CT head

4

neurosurgery if

Persis GCS under 8
Over 4hr confusion
Deter GCS after admission
Prog focal neurol
Seizure without full recovery
Suspected penetrating injury
CSF leak

5

CT adult in 1hr if

GCS under 13 init, or under 15 after 2hr
Suspected skull fracture
Post traumatic seizure
Focal neurol deficit
Vomit more than once

6

CT adult in 8 hr if
LOC OR amnesia AND one of

65 or over
Bleeding or clotting disorder
Dangerous mechanism eg over 1m fall or RTA
Over 30 min retrograde amnesia

7

Exam

GCS 8 or less is severe, 9-12 mod
Neuro incl speech, read, write, balance
CNs
CVS- shock eg HR, BP, CRT
Secondary survey
Neck
Signs of skull frac- CSF leak, periorbital ahematoma, haemotympanium, battles sign.

8

Mx

If non specif- reassure, safety net, analgesia, rest
Neuro for more severe