Dos and Don’ts in Head Injury

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

ž External Bleeding-Pressure Bandage

ž Internal Bleeding or CSF Leak-Do not try to stop

ž Head to be Tilted to one side- To avoid Aspiration

ž 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

Secondary brain injury  -occurring anytime after the primary impact and it is preventable from of head 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