Head Injury

Head Injury

Introduction

Any trauma to the scalp, skull, or brain is a head injury. The damage could be as simple as a bump on the skull or as severe as a brain injury. Both closed and open head injuries are possible ( penetrating ). A closed head injury occurs when you strike your head against something hard, yet the skull was not broken. When you have an open or penetrating head injury, it signifies that something struck you, breaking the skull and entering the brain. This typically occurs when you are moving quickly, such as when you crash through the windshield in a car collision. Additionally, a gunshot to the head may cause it.

Pathophysiology

• Trauma to the brain occurs.
• Intracranial volume is increased by brain swelling or hemorrhage.
• There is no place for the contents to expand inside a rigid skull.
• A rise in intracranial pressure.
• Blood flows through the brain because of pressure on the blood vessels there.
• To slow the brain.
• There is ischemia and hypoxia in the brain.
• ICP continues to rise, cerebral blood flow may stop, and the brain may herniate.

Brain Injury Involves Different Kinds of Injury

• Concussion.
• Confusion.
• Brain Hemorrhage.

Concussion

• A few seconds to several minutes of unconsciousness are typically associated with a concussion. After gaining consciousness, the patient can spend the night in the hospital for observation or be released from the hospital quickly.
• It's important to keep a close eye on the patient for symptoms including headaches, vertigo, lethargy, irritability, and anxiety.

Contusion

• The brain is damaged in this more serious injury, and there may even be surface bleeding.
• More than a few seconds or minutes pass while the patient is unconscious.
• The magnitude of the accompanying cerebral edema has an impact on the clinical s/s.

Brain Hemorrhage

• most severe brain damage. A hematoma could
  • Epidural
    • Above the dura
  • Subdural
    • Below the dura
  • Subarachnoid
    • Below the arachnoid
  • Intracerebral
    • Within the brain.

Sign and Symptoms of Brain Injury

• Changed state of consciousness
• Confusion.
• Abnormalities of the papilla
  • Alteration in pupil size, shape, and reaction to light.
• Corneal reflexes aren't there.
• Missing or altered gag reflexes
• Altered vital signs
• Hearing or vision problems.
• Headache, vertigo, and sensory impairment.

Causes

• Accident.
• Fall.
• Gunshot.
• physical attack.
• Stab wound

Assessment Finding on Acute Head Injury

Assault, car accidents, falls, physical trauma, etc. are all examples of potential causes of acute brain injuries. To manage these patients, the medical team should provide serious and critical care, and an assessment should include;

• A loss of sense of time, place, or identity.
• Diminished pupillary response due to unequal pupil size.
• LOC decreased.
• Paresthesia.
• Ear, nose, and frequent swallowing.

Nursing Management

• Watch the patient for a full day.
• To look for signs of an elevated ICP and respiratory distress, evaluate your neurological and respiratory health.
• To find early signs of compromise, keep track of your vital signs, your intake and output, hemodynamic variables, ICP, and pulse oximetry.
• Evaluation of vital signs to spot any anomalies.
  • Tachycardia is a sign of bleeding.
  • Bradycardia is a sign of elevated ICP.
  • In shock from bleeding, low blood pressure is detected.
  • ICP is raised when BP is high.

Monitoring of Declining Neurological Function

• Highest level of awareness.
• Determine and preserve body temperature.
  • Suction as necessary, but don't keep it on for too long. Avoid sucking your nose.
  • Identify any pain. Anxiety and elevated ICP can result from pain.
  • Examine your gag and cough reflexes to stop aspirations.
  • To stay hydrated, look for diabetes insipidus symptoms.
  • Fluid should be given intravenously to keep hydrated.
  • If an endotracheal tube is present, administer O2 to keep it in place and ensure its patency in order to keep the airway open.
  • To stop vomiting, maintain the NGT's position, patency, and low suction.
  • Keep taking seizure safety precautions to protect patients.
  • Administer medication as directed to lessen pain and ICP.
  • Breathing, circulation, and airway care.
  • To lower ICP, raise the bed's head by 30 degrees.
  • Dressing and suturing may be required for wound care.

References

• justiceforyou.com/catastrophic-injury/
• medlineplus.gov › Medical Encyclopedia
• quizlet.com/134336128/theory-a-final-head-injury-flash-cards/
• slideshare.net/drjayeshpatidar/head-injury-48321255
• wn.com/Penetrating_Head_Injury