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Head Trauma

181 st INF BDE Combat Lifesaver Plus. Head Trauma. Overview. Anatomy of head and brain Pathophysiology of traumatic injury Assessment, management, potential problems. Head Trauma. Traumatic brain injury (TBI) Major cause of death and disability

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Head Trauma

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  1. 181st INF BDE Combat Lifesaver Plus Head Trauma

  2. Overview Anatomy of head and brain Pathophysiology of traumatic injury Assessment, management, potential problems Head Trauma -

  3. Head Trauma Traumatic brain injury (TBI) • Major cause of death and disability • Present in 40% of multiple trauma casualties Head Trauma -

  4. Head Trauma Open • Skull compromised and brain exposed Closed • Skull not compromised and brain not exposed Head Trauma -

  5. Head Injuries Scalp wound • Highly vascular, bleeds briskly • Shock: child may develop • Shock: adult another cause • Management • No unstable fracture: direct pressure, dressings • Unstable fracture: dressings, avoid direct pressure Head Trauma -

  6. Head Injuries Skull fracture • Linear nondisplaced • Depressed • Compound Suspect fracture • Large contusion or darkened swelling Management • Dressing, avoid excess pressure Head Trauma -

  7. Basilar Skull Fracture Battle’s sign Raccoon eyes Head Trauma -

  8. Bullet Fragments Head Injuries Penetrating trauma Head Trauma -

  9. Forces that cause skull fracture can also cause brain injury. Head Trauma -

  10. Brain Injury Primary brain injury • Immediate damage due to force • Coup and contracoup Management • Directed at prevention Head Trauma -

  11. Brain Injury Secondary brain injury • Results from hypoxia or decreased perfusion • Develops over hours Management • Rapid evacuation care can help prevent Head Trauma -

  12. Early effortsto maintain brain perfusioncan be life-saving. Head Trauma -

  13. Brain Injuries Concussion • No structural injury to brain • Level of consciousness • Variable period of unconsciousness or confusion • Followed by return to normal consciousness • Retrograde short-term amnesia • May repeat questions over and over • Associated symptoms • Dizziness, headache, ringing in ears, and/or nausea Head Trauma -

  14. Decreased level of consciousnessis an early indicator ofbrain injury or rising ICP Head Trauma -

  15. Head Trauma Assessment Casualty Evaluation Limit patient agitation, straining • Contributes to elevated ICP Airway • Vomiting very common within first hour Head Trauma -

  16. Pupils Both dilated Unilaterally dilated • Reactive: ICP increasing • Nonreactive (altered LOC): increased ICP • Nonreactive (normal LOC): not from head injury • Nonreactive: brainstem • Reactive: often reversible Anisocoria Eyelid closure • Slow: cranial nerve III • Fluttering: often hysteria Head Trauma -

  17. Summary Early detection and rapid transport is essential Key actions • Rapid assessment, airway management, prevent hypotension, frequent Ongoing Exams • Altered mental status is common Head Trauma -

  18. Discussion Head Trauma -

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