| ID | 231 |
|---|---|
| Name | HEAD INJURY |
| Cause | |
| Signs Symptoms | |
| Diagnosis | Diagnosis: 1. Clinical diagnosis: by observation and clinical examination- if the unconsciousness persists from the time of injury and progressively deteriorates, then diagnosis lies between intracranial hemorrhage and cerebral oedema. 2. Skull & cervical radiographs- provide evidence of skull or cervical spine fractures (as it may be related to cord compression). 3. CT scan- helps in demonstrating intracranial hemorrhage or hematoma and cerebral oedema (if any) or any intracranial lesion. Lumber puncture is contraindicated. |
| Investigations | |
| Management | Immediate management of an unconscious patient due to head injury: This may be considered under the following headings- 1. Quick clinical examinations-Head is examined for scalp wound or fracture. Neek rigidity is tested. There may be fracture of cervical spines. The CNS is examined with particular attention to the level of consciousness and the reactions of the pupil to light. Ear, nose, eyes and mouth are examined for bleeding or C.S.F. leakage. Tone of the muscles and reflexes are examined. Pulse, temperature, respiration and blood pressure are recorded. X-ray of the skull is essential and blood should be sent for grouping and cross matching. A head injury patient, who has become unconscious for 2 minutes or more, should be transferred to the hospital as soon as possible.’ 2. Primary nursing care- a. Maintenance of air way- this is maintained by frequent aspiration of blood and mucus. Head should be turned to one side. A sucker must be available. If the patient is deeply comato-sed and cough reflex is absent, an emergency tracheostomy should be performed, b. Restlessness- may be controlled by phenobar-bitone or paraldehyde. Sometimes catheteri-zation releives restlessness when it is due to distended bladder. Morphine is contraindicated. c. Feeding- if the patient is unconscious for more than 12 hours. It is necessary to given fluid diet through ryles tube. d. Care of the skin- patient should be turned repeatedly to prevent bed sores. Passive movements to all the joint to prevent contractures. e. Care of the bladder and bowel- an unconscious incontinent patient should have an indwelling catheter. Urinary antibiotics should be given to control infections. Specialized management: For further management and neurosurgical manoeuvre, please refer the patient to a neurosurgical consultant or consult a text book of neurosurgery. |
| Introduction | Accidental trauma or assaults are the commonest causes of head injury. The prognosis usually depends upon the site and severity of brain damage. |
| History | |
| Etiology | |
| Clinical Features | |
| Preventions | |
| Treatment | |
| Complications | |
| Prognosis | |
| Types | types- 1. Injury to the scalp. 2. Fracture of the skull, vault, base, 3. Brain damage, a. Concussion, b. Contusion and laceration, c. Compression. |
| Classification | |
| Observation | Observation: This is necessary to detect the features of intra-cranial hemorrhage or cerebral compression. The followings should be noted - i. Level of consciousness, ii. Pupils size, shape, reaction to light, iii. Pulse, temperature, blood pressure. iv. Examination of the nervous system to detect the development of hemiparesis or hemiplegia. |
| Pathology |
© Pakistan Drug Directory. All Rights Reserved.
Designed By: Pakistan Drug Directory Team