craniocerbral trauma
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| Contraindicated in BASILAR SKULL FRACTURES | No nasal suctioning
NG through mouth
No Valsalva or
vigorous coughing
Do not drink
with a straw
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| Occurs at time of impact Direct traumatic forces that injure & kill brain cells Concussion, contusion, skull fractures, hemorrhage | PRIMARY BRAIN INJURY
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| Damage & death of brain cells that initially survived traumatic event Depends upon severity of primary injury IICP, cerebral edema, hematoma, infection, brain herniation Results in increased mortality | SECONDARY BRAIN INJURY
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| Who has the highest rate of CONCUSSIONS | Football highest, girls soccer 2nd
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| What is a hallmark sigh of concussion | Traumatically induced alteration in mental status (amnesia a hallmark sign)
Amnesia - not LOC - most predictive of severity
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| What is an increased risk factor of a consussion | After a concussion 3X more likely to sustain 2nd concussion, after 2nd 8X greater
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| Cumulative effect with a repeat concussion is known as | Second Impact Syndrome
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| Concussion Red Flags CDC – Heads Up Program | H/A that worsen, Looks drowsy; can't be awakened,Can't recognize ppl/places,Unusual behavior chg,Seizures,Repeated vomiting,Increasing confusion,Increasing irritability,Neck pain,Slurred speech,Weakness or numbness in arms or legs,Loss of consciousness
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| What is the name For sports related head trauma questions Where are we playing? Which team are we playing? What quarter/inning is it? Which team did we play last week? Did we win last week? | Maddock’s Questions Battery
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| Trauma to brain tissue Often occurs with laceration Cerebral edema – more pronounced 3 – 4 days after injury Contrecoup injuries | CONTUSION
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| Arterial bleeding between skull & dura Fracture of temporal bone with damage to middle meningeal artery “Talk & die;” initial lucid interval | EPIDURAL HEMATOMA
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| Venous bleeding between dura and arachnoid Highest incidence of hematomas – 24% pts with severe head injury Elderly & alcoholic more at risk Acute, subacute & chronic | SUBDURAL HEMATOMA
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| What criteria would you evaluate when predicting the outcome of a sever head injury | Hypotension & hypoxia critical
Hypotension with or without hypoxia doubles mortality rate
B/P < 90, ICP > 20 mm Hg
Age > 20
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| SEQUELAE AFTER SEVERE HEAD INJURY | Personality & behavior changes
Post traumatic epilepsy
Post concussion syndrome
Hydrocephalus
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| PREVENTIONS OF INJURIES | Seat Belts
Helmet use
Concussions/sports
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| The classic sign is an initial period of unconsciousness at the scene and a brief lucid interval followed by a decrease in LOC | Epidural hematoma
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| often results from injury to the brain and veins and develops more slowly | subdural hematoma
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| he classic sign or symptom of ___________ is a patient describing "the worst headache of my life." | subarachnoid hemorrhage
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| ___________ injury is widespread axonal damage occurring after a traumatic brain injury. | Diffuse axonal
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| An acute _________ manifests within 24 to 48 hours of the injury. The signs and symptoms are similar to those associated with brain tissue compression by increased intracranial pressure (ICP) and include decreasing LOC and headache. | subdural hematoma
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| a patient with a severe head injury the highest priority on assessment is | airway
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| vital signs of ICP known as Cushing’s triad | increasing systolic pressure with a widening pulse pressure, bradycardia with a full and bounding pulse, and irregular respirations.
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| Which assessments are components of the Glasgow Coma Scale | eye opening, best verbal response, and best motor response
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