TBI and Coma

Question 1

What is a traumatic brain injury

Answer 1

A non congenital, non degenerative insult to the brain by an external force

Question 2

What is hypoxia

Answer 2

Not enough oxygen getting to the brain

Question 3

What is hypotension

Answer 3

Low blood pressure

Question 4

What is Advanced Trauma Life Support?

Answer 4

ABCDE
airway 
breathing
circulaion
GCS
Exposure

Question 5

How often is GCS monitored?

Answer 5

Continually

Question 6

Why is a CT good to test for brain injury?(3)

Answer 6

It’s quick, easy to perform and can detect bleeding and fractures

Question 7

What is a haematoma

Answer 7

solid swelling of clotted blood

Question 8

What is a contusion?

Answer 8

Bruising in the brain = swollen tissue and small blood leaks

Question 9

Name two focal injuries

Answer 9

Haematomas and Contusions

Question 10

Why does axonal injury occur?

Answer 10

Rapid acceleration and deceleration causing the brain to shoogle around

Question 11

What does axonal damage affect?

Answer 11

Nerve cells ability to communicate and integrate with one another

Question 12

What is ICP?

Answer 12

Intracranial Pressure

Question 13

What does CPP stand for and what is it?

Answer 13

Cerebral Perfusion Pressure = net blood pressure

Question 14

What is ischaemia?

Answer 14

Inadequate blood supply to an organ

Question 15

What is oedema?

Answer 15

Fluid retention that causes swelling

Question 16

What is hydrocephalus?

Answer 16

Build up of CSF within the ventricular system, this causes high ICP

Question 17

What causes hydrocephalus?

Answer 17

Blocked CSF

An overproduction of fluid

Question 18

What would the intervention be for hydrocephalus?

Answer 18

Surgically remove blockage in ventricles and drain fluid

Question 19

What causes high ICP?

Answer 19

High levels of CSF

Oedema/mass/haemorrahge

Question 20

How would you surgically treat a haematoma?

Answer 20

Burr Holes

Question 21

What does an EVD allow?

Answer 21

Temporary drainage of CSF, relieving ICP

Question 22

Name some consequences of TBI

Answer 22

Physical changes, Cognitive processing, Emotional changes e.g. depression, anxiety, Social changes e.g. isolation, inappropriate behaviour

Question 23

What can cause a coma?

Answer 23

Head injury

drug overdose

Question 24

What GCS indicates a coma

Answer 24

8 or less

Question 25

If coma lasts more than 24 hours what is the percentage prognosis

Answer 25

10% chance of recovery

Question 26

After 7 days of a coma what is the percentage chance of recovery

Answer 26

3%

Question 27

What are the four arousal and awareness states?

Answer 27

1. Brain Death 2. Vegetative State 3. Minimally Conscious State 4. Locked-In SYndrome

Question 28

What classifies brain stem death?

Answer 28

Permanent loss of potential for consciousness and ability to breathe without support

Question 29

why might a fracture to the base of the skull be problematic?

Answer 29

it may cause damage to nerves and such structures

Question 30

what might happen if there is a fracture that extends into the sinuses?

Answer 30

CSF may leak from the nose or ears

Question 31

what are depressed skull fractures and what can be done to fix them

Answer 31

they are fractures in which part of the bone presses on or into the brain can be treated surgically

Question 32

what is the main goal of the ICU

Answer 32

to prevent secondary insults

Question 33

what are secondary insults?

Answer 33

hypoxia hypotension mass lesions

Question 34

how can you medically manage high ICP?

Answer 34

sedation venous drainage of brain decompressive craniectomy

Question 35

what are burr holes?

Answer 35

small holes drilled into the skull with a tube inserted to remove a haematoma

Question 36

what classifies a coma

Answer 36

inability to eye open or verbalise no sleep/wake cycle no voluntary movements

Question 37

what is the reticular activating system?

Answer 37

the brainstem which controls consciousness