Trauma Flashcards
(48 cards)
What is a primary brain injury
Happens in the moment of incident when excessive energy is transferred to the head
What are the can diffuse head injury be split into
Axonal
Concussion
What is a diffuse Axonal injury
Axons are sheared, torn, stretched away from cell body
What is diffuse concussion injury
Brain jarred towards and then away from site of injury can self resolve
What can focal brain injuries be split in to
Contusion
Intercranial haemorrhage
They are focused on specific area of brain
Type of intercranial haemorrhage
Epidural Extradural Subdural Subarachnoid Intracerebral
Secondary brain injury is
When the brain tissue does not have adequate perfusion
Head injuries bad signs
Low blood pressure
Hypoxia
Asymmetry pupils
Monroe Kellie doctrine is
Skull is rigid container any increase in component causes an increased icp and can cause herniation
Work out CPP
CPP = MAP -ICP
What will happen if ICP rises
The CPP will decrease unless the blood pressure increases
What does cpp need to be
60 or above
Management of head injury
If isolated head injury give fluids to maintain blood pressure at 110
If not isolated then maintain blood pressure at 90
Give TXA on route
Give O2
Assist ventilation if needed
What is normal capnography
35-45 mmHg
Head injury considerations
PHEA
RSI
What is pupil asymmetry a sign of
Herniation
Early signs of increasing ICP h
Vomiting Headache Dizziness Amnesia Visual disturbances Altered LOC Seizures
Late signs of increased ICP
Cushing triad
Hypertension with widening pulse pressure
Bradycardia
Irregular respiration e.g cheynes stokes
Pupils changes
Coma
Posturing
What is normal ICP
5-15 mom Hg
Work out MAP
DBP+ 1/3 of pulse pressure
What’s in Cushing triad
Hypertension (widening pulse pressure)
Irregular respiration
Bradycardia
Isolated head injury give fluids when…
Systolic below 110
Head injury and limb injury give fluids when…
Below 90 systolic
Head injury and torso injury give fluids when
Below 60 systolic
