Wednesday, November 29, 2006

HEAD INJURY

Head injury
Closed or open
Grade I= Mild. Not admitted. Short loss of consciousness.
Grade II= loss of consciousness. Lethargy, confusion, hemi paresis, admitted and require surgery.
Grade III= unable to follow even simple commands. Serious damage. Dilated pupils. Without rapid attention may die.
TYPEs
Concussion.--mechanical force and release enzymes. Contusion--brain bruise. Blunt object like a baseball bat. Hematoma.
Epidural or extradural Hematoma=
arterial blood between the dura and the skull. Pt loss of consciousness and regains it. Vomit. hemi paresis. Pupil changes. all leading to rapid worsening. The Tx is to remove the Hematoma by craniotomy.
Subdural Hematoma.= venous bleeding below the dura. ICP.
Complications of head injury= cerebral edema, DI, SIADH, Stress ulcer from use of steroids. Epilepsy. Meningitis. Hyper/hypothermia.
MEDICAL Tx of HEAD INJURY
Mannitol and steroids. Antibiotics.
KEEP DEHYDRATED TO AVOID INCREASE IN FLUID LEVEL.
SURGICAL Tx of HEAD INJURY

Craniotomy--supratentorial or infratentorial.
Burr holes--used to remove clots.
Nutrition following head injury
May need TPN…stress and steroids increase catabolism.
ASSESS
Airway. LOC. Pupils. Movement. Sensation. Hand grasps. ICP. Resp changes. VS. headache. Glasgow coma scale.
POST OP Craniotomy care
Resp. Deep breath q 2. NO COUGHING! Neuro checks. Suction. Strict I&O. Seizure precaution. CSF leaks. S&S of meningitis.
Supratentorial--head of bed up 30 degrees. On back or unoperative side.
Infratentorial--FLAT on either side.
Assess for bleeding. GI bleeds, assess for emotional response or knowledge deficit.
Brain death--irreversible loss of brain function. EEG will confirm no activity. Cerebral blood flow studies. MD will determine.
Remember Diabetes Insipidus…caused by a decrease in ADH---increased urine output…anticipate to give VASOPRESSINS….give fluids and lytes.
SIADH--restrict fluids….caused by increase ADH. Volume overload and a decreased urine output.

6 comments:

Anonymous said...

Hi theгe! I just wanteԁ to аsk if you
ever have any problеms ωith hаcκers?
My last blog (ωordpress) was hacked and I endeԁ uр losing mοnths of hard woгκ due to no back up.
Dо you have anу methоds
to рrevent hackerѕ?

mу web site - lowes garden center
My webpage > walmart garden center

Anonymous said...

Have you ever thought about writing an e-book or guest authoring on other blogs?
I have a blog based upon on the same ideas you discuss and
would love to have you share some stories/information.
I know my visitors would enjoy your work. If you are even remotely interested, feel
free to shoot me an email.

Also visit my site - safe diets

Anonymous said...

What's Going down i'm new to this, I stumbled upon this I have found It absolutely useful and it has aided me out loads.
I am hoping to contribute & help different customers like its aided me.
Great job.

My homepage ... Reputation Management

Anonymous said...

At thіs time іt seems liκe BlogEngine is the preferred blogging platfοrm available rіght nοw.
(from what I've read) Is that what you're using оn your
blog?

my webpage: Lloyd Irvin

Anonymous said...

I гeаԁ this paragraph completely аbout thе resemblаncе of most up-to-date
and еаrlieг technologies, it's amazing article.

Here is my page; reputation management

Anonymous said...

What's Going down i am new to this, I stumbled upon this I've discovered It absolutely helpful and it has
aided me out loads. I'm hoping to give a contribution & assist other users like its helped me. Great job.

my site ... http://thefatlossshangout.blogspot.com/2013/05/fat-loss-factor-guaranteed-success.html