Trauma to the head, neck, face, and back JCCC EMT (EMS-132)

the area inside skull

cranial vault

how many cranial and spinal nerves

12 cranial

31 spinal

how many vertebrae do we have

33

how many injuries are there in there to a head trauma

2

primary - the blow itself (coup-contrecoup)

secondary- the after effects (Swelling)

concussion 

least severe head injury

no physical damage, but interrupts normal brain function

concussion, headache, and memory loss, N/V, dizzy

loss of consciousness is not always the case

the two types of memory loss

retro amnesia and antero amnesia

contusion

a bruise on the brain- worse than concussion

think more severe concussion s/s

epidural hematoma 

blood between skull and dura mater

arterial bleeding in epidural space will result in rapidly progressing symptoms

usually goes “unconscious>conscious>unconscious 

DAI

diffuse axonal injury

shearing stretching or tearing of nerve fibers from rapid accel. or. decel. of nerve fibers from falls, SBS, and falls

subdural hematoma

blood beneath dura mater but outside brain

most common TBI

usually after falls or injuries with strong decel forces

usually veinous bleeding so more gradual progression

fluctuating LOC and slurred speech

subarachnoid hemorrhage

bleeding subarachnoid space where CSF is

causes: rupture of aneurysm and trauma

usually results in death

another exp ? for decreased LOC

any recent head trauma

intracranial hematoma

basically a hem. stroke

increased ICP- what does it do

The MAP stays the same, so the perfusion to the brain decreases.

compresses the tissues in brain

tissues pushed out the foramen magnum

this causes cushing’s triad bc the brain stem is being damaged

what is cushing’s triad

htn

bradycardia

abnormal resp. 

SBS main s/s

lethargy

decreased appetite

behavior changes in general

the two signs of basal skull fracture

raccoon eyes and battle sign

general head injury s/s

AMS

N/V

seizure

cushings triad 

combative behavior

repetitive ?s

Dizzy

amnesia

CSF leaking

behavior change

blown pupils

posturing

facial trauma s/s that aren’t obvious

limited ocular movement (a fractured bone snags the muscle)

facial assym.

malocclusion (bad bite)

diplopia (double vision)

are alkali eye burns or acid worse

alkali

blow out orbital fracture

direct blow causes eye to push on thin base plate and fractures it.

s/s

flattened face

periorbital swelling

diplopia

inopthalmos (sunken eye)

impaired ocular movement

globe trauma in eye

an injury to the eyeball itself

pain

pupil irregularity

blood 

blurry vision

hyphema

blood in anterior chamber of eye

hyphema

what do the vertabrae connect by

ligaments called disks

types of spinal cord injuries

extension

flexion

distraction compression

the higher up the spinal cord injury…..

the more body is effected

neurogenic shock

the area below the injury no longer can connect to the sympathetic NS so no vasoconstriction.

They are not cool pale and clammy usually and will have a slow pulse bc of no sympathecic response

head injury treatment

continuous ETCO2

c-spine

BP monitoring

Administer high-flow oxygen via NRB (non-rebreather) as a precaution against

unanticipated deterioration, keep SPO2 from falling below 90%

Moist sterile dressing to any potential open skull wound

Severe head injury – Elevate head of bed 30 degrees

chemical eye burns how long to irrigate

20 mins

thermal/light eye burns care

cover eyes with moist sterile dressing 

conjunctivia

the membrane that lines eyelids and covers surface of eye

cornea

transparent tissue layer infront of pupil and iris

the iris

the muscle that dilates and constricts pupils

lens

transparent part of eye through which images are focused on retina

retina

the light sensitive area at back of eye that sends signals to brain

sclera

white fibrous portion of eye