Dos and Don’ts in Head Injury
Impacted foreign body-Head and Neck |
Impacted foreign body-Head |
Decompressive Craniotomy |
Dos and Don’ts in Head Injury
External Bleeding-Pressure Bandage
Internal Bleeding or CSF Leak-Do not try to stop
Head to be Tilted to one side- To avoid Aspiration
Do not pull out an impacted foreign body-At the site of the Event!
Classification of Brain Injury -Primary and Secondary
Primary brain injury -Injury caused at the time of impact- acute neuronal damage & cell death---directly due to traumatic force-and is irreversible in nature.
Examples:-
Cerebral concussion ( No anatomical damage)
Cerebral contusion ( Both anatomical & Functional damage)
Laceration
Diffuse axonal injury
Causes of secondary brain injury
■ Hypoxia: PO2 < 8 kPa
■ Hypotension: systolic blood pressure (SBP) < 90 mmHg
■ Raised intracranial pressure (ICP): > 20 mmHg
■ Low cerebral perfusion pressure (CPP): < 65 mmHg
■ Pyrexia
■ Seizures
■ Metabolic disturbance
Clinical situations in Trauma
Situation 1.
HYPERTENSION + BRADYCARDIA= HEAD INJURY
Situation 2.
HYPOTENSION +BRADYCARDIA= SPINAL INJURY
Situation 3.
HYPOTENSION +TACHYCARDIA= HYPO VOLUMEA
Suspect - Thoracic/Abdominal-injury/Poly trauma
Situation 4.
HYPERTENSION +TACHYCARDIA= STRESS/ HYPOXIA
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