head injuries

altered mental state

• tbi

• hypoxaemia

• hypovolemia/shock

• hypothermia can contribute

mech of head injury

• rta

• being within 50m of any blast

• direct blow to the head

• exposed to multiple blasts

• gsw or shrapnel to the head

either penetrating or blunt force injury

s + s

• obvious scalp wound or deformity

• altered level of consciousness

• leaking csf

• bruising around eyes and ears

mild tbi - concussion

• no/brief loc

• headache, tinitus, blurred vision

• dizziness, light headed, loss of coordination

• gcs 13-15

moderate tbi

• confusion or disorientation more then 24 hrs

• loc between 30 mins and 24 hrs

• memory loss between 24hrs and 7 days

• gcs 9-13

• headaches, dizziness, nausea

severe tbi

• confusion or disorientation more than 24 hrs

• loc more than 24 hrs

• memory loss more than 7 days

• gcs 8 or below

• dilated or fixed pupils

• abnormal posture

• erratic breathing

• cardiovascular/resp abnormalities

management

treatment should be as soon as possible to prevent a secondary brain injury by hypoxia or hypotension

• txa

• give o2

• resusitate if needed

• control cat hem

• prevent and treat hypothermia

• give antibiotics if open wounds

cerebral compression

• pressure may happen immediately or after a few days

• severity if related to mech on injury and impact on cas

icp

• haematoma

• subarachnoid haemorrhage

• intercerebral haemorrhage or tumor

cushings triad - cerebral herniation

• irregular rr

• low hr/pulse

• high bp

s + s

• deteriorating loc

• dilated blown or fixed pupils

• erratic breathing

• severe headaches, vomiting, seizures

• abnormal posture

• cardiovascular/resp irregularities