Traumatic brain injury and Spinal cord injury

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    Traumatic brain injury and Spinal cord injury - Presentation Transcript

    1. MANAGEMENT OF NEUROLOGIC DISORDERS
    2. What is Traumatic Brain Injury?
      Closed – head collides with another object but there is no opening through the skull and dura
      Open – object penetrates the skull, enters the brain and damages the soft brain tissue in its path. Exposes the brain
    3. STATISTICS
      Annual number of people who experience a traumatic brain injury:
      1. 4 million annually in the United States
      • Deaths: 50,000
      • Hospitalization: 235,000
      Among children ages 0 to 14 years
      • Deaths: 26, 850
      • Hospitalizations: 37,000
      Number of Americans living with a traumatic brain injury: Approximately 5.3 million
    4. LEADING CAUSES OF TBI :
    5. CLASSIFICATION OF TBI:
      MILD
      loss of consciousness and/or confusion and disorientation is shorter than 30 minutes
      The person looks normal and often moves normal in spite of not feeling or thinking normal.
      SEVERE
      loss of consciousness for more than 30 minutes and memory loss after the injury or penetrating skull injury longer than 24 hours
      Results in permanent neurobiological damage that can produce lifelong deficits to varying degrees. 
    6. CONCUSSION vs CONTUSION
      CONCUSSION
      Temporary loss of neurologic function with no apparent structural damage lasting for a few seconds to few minutes
      Jarring of the brain that caused it to stop functioning momentarily
      CONTUSION
      More severe injury in which the brain is bruised, with possible surface hemorrhage
      Unconscious for more than a few seconds or minutes
      Picture is somewhat similar to that of shock
    7. MANAGEMENT of TBI
    8. MAINTAINING THE AIRWAY
      Keep unconscious patient in a position that facilitates drainage of oral secretion
      Establish effective suctioning procedures
      Guard against aspiration and respiratory insufficiency
      Monitor for pulmonary complications
      MAINTAIN HYDRATION &ADEQUATE NUTRITION
      Fluid is administered through the IV for nutrition and liquid.
      A urinary catheter is put in the bladder for urine collection.
      It is important to maintain the unconscious patient's blood pressure through IV fluid and medication.
    9. MAINTAINING SKIN INTEGRITY
      The patient is turned and positioned in bed
      Acompression device wrapped around the legs that prevents blood clots.  Daily injections are also given to prevent blood clots.
      SEIZURE PRECAUTION
      Dilantin is the usual medication administered through the IV to prevent seizures. A tetanus shot also may be given.
    10. RECOVERY
      Duration of Coma. The shorter the coma, the better the prognosis.
      Post-traumatic amnesia. The shorter the amnesia, the better the prognosis.
      Age.  Patients over 60 or under age 2 have the worst prognosis, even if they suffer the same injury as someone not in those age groups.
    11. What is it?
      Spinal cord injuries cause myelopathy or damage to white matter or myelinated fiber tracts that carry signals to and from the brain. It also damages gray matter in the central part of the spine, causing segmental losses of interneurons and motorneurons.
      SPINALCORD
    12. CAUSES OF SCI
    13. STAGES
      Stage of spinal shock
      sensation and motor power localized below the vertical height of the lesion are lost. This stage lasts for 2 to 3 weeks in humans, and hours to days in other animals due to a lesser degree of encephalitis.
      Stage of recovery
      after a period typically ranging from 2 to 3 weeks of injury, the nerves partially recover, and the return of segmental reflexes produce paraplegia-in-flexion.C. Stage of reflex failure
      after a period of days the recovered reflexes again start to give way due to complete degeneration of nerve cells.
    14. SYMPTOMS
      The location of the injury
      In general, injuries that are higher in your spinal cord produce more paralysis.
      The severity of the injury.
      Spinal cord injuries are classified as partial or complete, depending on how much of the cord width is damaged.
    15. COMPLICATIONS
      Thrombophlebitis
      Measures such as ROM exercises, thigh-high elastic compression stockings, adequate hydration and anticoagulation medications (heparin and warfarin ) as prescribed are given
      Orthostatic Hypotension
      Activity should be planned in advance and adequate time given for a slow progression of position changes
      Autonomic Dysreflexia
      Stimuli that may trigger this: distended bladder ( most common ); distention or contraction of visceral organs, especially the bowel; or stimulation to the skin
    16. NURSING BEDS
      Clinitron Bed
      Tilt Bed
    17. STRYKER FRAME
    18. ROTAREST BED

    + Dave Jay  ManriquezDave Jay Manriquez, 4 months ago

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