head injury_ final cocamas, engie lee

8/2/2019 Head Injury_ Final Cocamas, Engie Lee

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HEAD INJURYBY: Engie Lee Cocamas


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HEAD INJURY

is any trauma that leads to injury

of the scalp, skull, or brain. The

injuries can range from a minor bump

on the skull to serious brain injury.


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INCIDENCE:

90 % of nervous system trauma

Most common among males

Peak occurrence- evening, nightsweekends


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CAUSE:

Accidents- motor vehicles, industrial Falls- abuse

Blows- sports injuries, crime relatedinjuries

Construction occupational hazards


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MECHANISM OF INJURY THAT

CONTRIBUTED TO HEAD TRAUMA:

1. Acceleration- occurs when the

immobile head is struck by a moving

object.


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2.Deceleration- moving head hits animmobile object.

Example: head hit the steering wheel

3. Deformation- injuries in which the force

results in deformation and disruption of theinjury of the impacted body part (skull

fracture)


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Category of head trauma:

1. closed- the head sustain a bluntforce by striking against anobject

2. Penetrating trauma- an objects

breaks through the skull andenters the brain


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3. Coup and countercoup injuries- theimpact to the head can cause the brainto move within the skull ,causing thebrain to impact the interior of the skull

opposite the head-impact)


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Types of Primary Injury:

1. Scalp injuries- Isolated scalp trauma is

generally classified as a minor injury. Becauseits many blood vessels constrict poorly , theblood bleeds profusely when injured.


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2.Skull fractures-is a break in one or more of the

bones in the skull caused by a head injury. It mayoccur with or without damage of the brain.

Skull Fractures are classified as:>Simple

>Comminuted

>Depressed>Basilar


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3.Brain injury:

1.Open headinjuries-means youwere hit with an object

that broke the skull andentered the brain.


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2.Closed-blunt

trauma- meansyou received ahard blow to thehead from

striking anobject, but theobject did not

break the skull.


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3.Concussion- result in loss of consciousnessfor 5 min or less and retrograde amnesia , nobreak in the skull or dura and no visibledamage


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4.Contusion- causemore extensive

damage , petechial and

punctuate hemorrhage

and bruised areas


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5.Diffuse axonal injury- one of the mostcommon and devastating types oftraumatic brain injury, meaning that

damage occurs over a more widespreadarea than in focal brain injury.


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.The major cause of damage in DAI is thedisruption of axons, the neural processes

that allow one neuron to communicate withanother.

Types:Mild- loss of consciousness 6-24 hours

Moderate- coma less than 24 hours, oncomplete recovery and awakening

Severe- primary injury to brain stem


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DIAGNOSTIC TEST:

Radiologic Examination

Physical Examination and Evaluation of Neurologic Status

CT scan

MRI ( Magnetic Resonance Imaging)

Cerebral Angiography


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Neurosurgery

Possible reasons for neurosurgery include:

1. haemorrhage (severe bleeding) inside your head,which puts pressure on the brain and may result inbrain injury (brain damage) and, in severe cases,death

2. haematoma (blood clot) inside your head, whichcan also put pressure on the brain

3.cerebral contusions (bruises on the brain), whichcan develop into blood clots

4.skull fracture

craniotomy


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Medications:1.Anti-epileptic drugs

Some people do suffer from seizures after brain injury. Often theseoccur only inthe early stages of your recovery but they can be a permanentconsequence ofyour brain injury. Such as Carbamazepine.

2.AntidepressantsIt is very common for people to experience symptoms ofdepression following a braininjury. Citalopram, Paroxetine, Fluoxetine

3.Diuretics are used to decrease the amount of water in thepatient's body. This makes less water available to the brain forswelling. Mannitol


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Clinical Manifestations: Loss of consciousness, confusion,

Bradycardia, bradypnea, hypotension

Convulsions Fracture in the skull or face- Fluid drainage

from nose, mouth or ears

Stiff neck or vomiting

Pupil changes


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Severe headache

Irritability, personality changes, or unusual behavior

Restless, clumsiness, or lack of coordination Slurred speech or blurred vision

Inability to move one or more of your limbs


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Get medical helpimmediately if the person:

Becomes unusuallydrowsy

Behaves abnormally

Develops a severeheadache or stiff neck

Loses consciousness,

even brieflyVomits more than once


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HEAD INJURY PREVENTION

Safety equipments during activitiesObey traffic signals

Be visible.

Use age appropriate car seats forbabies

Make sure children have safe area to

playSupervise children of any age

DO NOT DRINK and DRIVE


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DO NOT

Do NOT wash a head wound bleeding a lot.

Do NOT remove any object sticking out of a wound.

Do NOT move the person unless needed.

Do NOT shake the person if he or she seems dazed.Do NOT remove a helmet

Do NOT pick up a fallen child with any sign of head

injury.Do NOT drink alcohol within 48 hours of a serioushead injury.


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Nursing care:

1. Maintain airway

*logroll patient onto his side toprevent aspiration

*place support under pt.s head to

keep his cervical spine straight2. Check for presence of shock

*elevate extremities

3.Check for evidence of Spinal Injury*do not move newly injured until proven

there has no injury


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4. Observe for scalp and skull injuries

*cover open hand with cleanest material aspossible

*apply pressure to bleeding scalp only ifthere is no underlying fracture

*dont attempt to remove foreign objects

5. Prevent infection*antibiotics/tetanus infections

*never attempt to clean ears or nose


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7. Observe for CSF leakages

*CSF rhinorrhea- drainage from nose due tofracture of ethmoid bone

*CSF otorrhea- drainage from ears due tofractureof temporal lobe

Management:

Place loose, sterile cotton buds at the opening of ear ornose to absorb the discharge. Instruct not to cough,sneeze or blow the nose

dont use nasal section due to proximity of cerebrumand nasopharynx

8. Improve cognitive functioning

head injury_ final cocamas, engie lee

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