Heamo Falls/TBI Flashcards
(10 cards)
What is the basic rules for falling and why should we care?
The furthur you fall the faster you go.
When you land then the higher you fell from the faster the deceleration (more damage)
What are the things you should consider when assesing MOI
Fall height
Impact surface (what did you fall on)
Area of contact
Transmission pathway of forces (where the forces go)
In St John what is the classification for determining if a pt has a severe or minor TBI
Minor = they can obey commands
Severe = if they cannot obey commands
What are the 2 paths of the patho when it comes to a TBI
Primary injury: This is the actual damage that comes from the trauma
Secondary: This comes after the primary and can be a result of any swelling or blood accumulation in the skull
What is the Monro - Kellie Hypothesis
What is the patho of secondary injury for a TBI
The second phase of the CNS Ischemic response
Oedema causes swelling leading to increased ICP. This causes reduced blood flow causing a shift of CSF fluid.
The pressure continues to build and then it causes the blood vessels to become pinched causing more ischemia and hypercapnia.
Eventually the pressure continues to build and then causes the herniation of the brain through the forman magnum
What are the 4 H’s of a secondary TBI
Hypoxia (the brain needs lots of 02 to function properly)
Hypotension (Pts need to be alteast normotensive. A episode of hypotension <90 results in a increased risk of mortality)
Hyper/Hypocarbia (Increased co2 increase vasodilation causing increased ICP, to little co2 can cause vasocontriction therefore decreasing CPP)
What are the key considerations for managing a TBI
Do you give levitracetam in Siezures caused by TBI even if the siezure stopped
YES!! You still administer 2g IV even if the seizure has stopped
