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Head, ****** and Neck Trauma/ Neuro


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Krystal Pickard


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[Front]


What should you attempt to maintain the PTs ETCO2 values ?
[Back]


35-45 mmHg

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Head, ****** and Neck Trauma/ Neuro - Details

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Some signs of cerebral herniation
Deteriorating GCS <9 with any of the following - dilated/ unreactive pupils, asymmetric pupillary response, asymmetric motor response or motor exam extension posturing or no response
GCS
Glasgow Coma Scale
Most common head #
Linar # at 80%
Halo sign
Blood mixed w/CSF from nose, mouth, ears
Retroauricular Ecchymosis
Blood pooling below ear
Epidural Hematoma
Bleeding between mater and skull, involves arterial bleed, ICP builds up quickly
Subdural Hematoma
More common - bleeding w/in meninges, usually venous bleed, complaints of focal symptoms , occurs above pia mater
Intracerebral Hematoma
Rupture blood vessel w/in brain, presentation similar to stroke
DAI
Diffuse Axonal Injury (stretching or tearing of nerve fibres w.subsequent axonal damage)
Hallmark of Concussion
They only improve
Retrograde amnesia
Forgetting events prior to incident
Anterograde amnesia
Forgetting events post incident
Reduced levels on CO2 in CSF
Cerebral vasoconstriction - results in cerebral anoxia
As CO2 levels rise in CSF
Cerebral arteries dilate - encourage blood flow - reduce hypercarbia
Already high ICP
Causes classic hyperventilation and hypertension
Severe Diffuse Axonal Injury
Brainstem injury, significant mechanical disruption, high mortality rate
Presentation of Severe Diffuse Axonal Injury
Prolonged unconsciousness, cushings reflex, decorticate or decerebrate posturing
Herniation
Portion of the brain structure pushed through opening (foramen magnum), pressure on upper brain (vomiting, decreased LOC, pupil dilation), pressure on medulla oblongata ( disturbs respiration, BP, HR)
Cushing's Reflex
Increasing BP, slowing pulse rate, erratic/irregular respirations
Can you remove a foreign object from eye
Yes, only if the object is not on the cornea and is visible, accessible and easily removed
Hyphema
Blunt trauma to the anterior chamber of the eye, blood in front of iris or pupil
Contraindications for give Acetaminophen
Use w/in previous 4hrs or allergy or sensitivity to Acetaminophen and S&S of intoxication
What is atrovent
Is an anticholinergic - atropine and ventolin together, it is bronchodilator
Remember for Atropine overdose :
"Hot as hell, Blind as a bat, Dry as a bone, Red as a beet, mad as a hatter"
MAOIs
Epi, nonepi, dopamine
What is the Big 5
Epinephrine, Nonepinephrine, Serotonin, Antidepressants, GABA
Extrapyramiday movements
Shaking in Parkinson's
Schizophrenia
Lack of contact with reality and disorganized thinking
SLUGE
Salivation, Lacrimation, Urination, Defecation, Gi disturbances, Emesis
Amyotrophic lateral sclerosis
Slowly loosing motor function
Brain abscess
Collection of puss
Neoplasma
The growth of a new tumour