Head Trauma Flashcards
(10 cards)
Define: Primary Brain Injury
Occurs at the time of the traumatic incident = direct mechanical damage
Define: Secondary Brain Injury
Occurs in the minutes to days following the trauma = biochemical changes
How long post-trauma can cerebral swelling continue to worsen?
72 hours
After 72 hours, the swelling will stabilize and begin to resolve over time
What does the modified glasgow coma score tell us?
PREDICTS THE PROBABILITY OF SURVIVAL IN THE FIRST 48 HRS AFTER HEAD TRAUMA WITH 50% PROBABILITY IN A PATIENT WITH A SCORE OF 8
HIGH SCORE = HIGH PROBABILITY OF SURVIVAL
What is the clinical manifestation of increased ICP?
Low or low-normal heart rate (<60bpm) in the face of systemic hypertension (>250mmHg)
Cushing’s reflex
How should a head trauma patient be stabilized?
Elevate head and neck to 30 - 45 degree angle to maximize venous return
Avoid jugular compression
How should hypovolemic shock be treated?
Restore normal volemia
Maintain MAP 80-120mmHg to ensure CPP > 60mmHg
Do not volume limit fluids to victims of severe head trauma
How should oxygen therapy be provided?
Maintain PaO2 > 90
Maintain PaCO2 > 30
Nasal cannula or oxygen catheter preferred!
What are contraindications for mannitol use?
Hypovolemia
Electrolyte abnormalities
Should steroids be given in head trauma cases?
NO
