basic anatomy, introduction, definition, classification, risk factor, causes, types, pathophysiology, sign and symptoms, diagnosis, medical management, nursing management, diet management.

1. HEAD INJURY

2. SUBMITTED TO:-
SUBMITTED BY :-
Mrs. Mamta Toppo
Associated professor
College of nursing
rims ,ranchi Neelam rani
Roll no: 10
3rd year basic b.sc
nursing(2017-2021)
College of nursing
Rims ,ranchi

3.  1.BASICS ANATOMY
 2.INTRODUCTION
 3.DEFINITION
 4.CLASSIFICATION
 5.RISK FACTORS
 6.CAUSES
 7.TYPES
 8.PATHOPHYSIOLOGY
 9.SIGN AND
SYMPTOMS
 10.DIAGNOSIS
 11.MEDICAL
MANAGEMENT
 12.MEDICATION
 13.NURSING
MANAGEMENT
 14.DIET MODIFICATION
 15.COMPLICATION
 16.SUMMARY
 17.RECENT
ADVANCEs
 18.REFERENCECE
 19.BIBLIOGRAPHY

7.  Head injury is a broad
classification that
includes injury to the
scalp , skull or brain
 Head injury is a
general term use to
describe any trauma
to the head and the
most specifically to
the brain itself.
 Head injury refers to
trauma to the head

9.  According to glass gow coma scale
1. Mild (GCS 13-15 with loss of
consciousness to 15 min)
2. Moderate(GCS 9-10 with loss of
consciousness for up to 6 hr)
3. Severe (GCS 3-8 with loss of
consiousness greater than 6hr)

10.  Color blindness
 Alcohol addictions
 Youngsters
 Vertigo
 Males,(about 1.5 times as likely as females to
sustain a brain injury)
 Young children or teenager(especially infants to
4-year-olds and 15-19-years olds)
 Certain military personnel (for example,
paratroopers)
 African Americans(who have the highest death
rate from brain injury) .

11.  Penetrating trauma
 Blunt head trauma – direct blow
 Motor vehicle accident
 Assault
 Sport injury
 Cerebral edema
 Intra cranial hemorrhage
 Gunsot trauma

12. ACCORDING TO :
 Open and closed injury
OR
Site of injury:
A. scalp injury
B. skull injury
C. Brain injury


16. B. Skull injury: head injury may cause a minor
headache skull fracture, which may or may not be
associated with injury to the brain.
Skull fracture: it is a break in the bone surrounding
the brain and other structures within the skull

17.  (1.) DEPRESSED SKULL FRACTURE : These are
common after forceful impact by blunt objects-
most commonly ,hammers,rocks,or other heavy but
fairly small objects.
(2.) LINEAR SKULL FRACTURE: a common injury
, espially in children.it is a simple break in the
skull that follows a relatively straight line.

19. (3.) BASILAR SKULL FRACTURE: A fracture
of the bones that form the base of the skull
and results from severe blunt head trauma
of significant force .

20.  Traumatic brain injury is the result of an external
mechanical force applied to the cranium and
intracranial contents, leading to temporay or
permanent impairments ,functional disability ,or
psychosocial maladjustment.
TYPES:
 (1).CONCUSSION :cerebral concussion is considered a
mild brain injury and temporary loss of neurological
function with no apparent structural damage.
 (2).CONTUSION :brain contusion are bruises of the
brain tissue that occur as a result of brain trauma.In
some cases ,brain contusion lead to hemorrhages
which are absorbed into brain tissue.

22.  Axon tear within the white matter of brain.

23.  4).INTRACRANIAL HEMORRHAGE: Intracranial
describes any bleeding with in the skull .bleeding
in the skull major may not be associated with a
skull fracture .it is a serious condition that often
requires surgery and extensive recovery time.

24. There are three types :
A. subdural hematoma – when a vein ruptures
between the brain and duramater .
B .epidural hematoma - it is caused by a
rupture between the dura mater and the skull.
c. intracerebral hematoma - when blood
collects within the brain tissue.

29.  History and physical examination
 CT scan and MRI
 X –Ray of skull
 Positron emission tomography
 Neuropsychological
 Electrocardiography
 Electroencephalography
 CSF analysis (halo ring)

30.  Coma
 Chronic headaches
 Loss of or changes in sensations, hearing,
vision , taste, or smell
 Paralysis
 Seizures
 Speech and language problems
 death

32.  The immediate management of head injury
includes:
 Control of airway,by intubation and
mechanical ventilation if necessary.
 Oxygen Therapy,and arterial blood gas
analysis.
 Restoration of circulating blood volume,
using fluid, colloid and blood
infusion.adequate venous access is required
(at least two large intravenous cannulae).
 Cervical spine examination and imaging.
 Temporary immobilisation of limb fractures.

34.  1.Management of increased intra cranial
pressure
 Administering manitol .
 Drainage of cerebrospinal fluid.
 Elevation of the head of the bed
 Complete bed rest
 Dopamine to maintain cerebral perfusion
pressure above 50mgHg
 Glucocorticoids :dexamethasone to reduce
cerebral edema

35. 2.ANTIBIOTICS THERAPY :
 Administration of antibiotics is required to prevent
infection with open skull fractures and penetrating
wound .
3.ANTIEPILEPTIC THERAPY :
 Medication to prevent seizures may be given to
prevent or treat seizures that occur from the head
injury.
4.SUPPORTIVE MEASURES:
 Ventilatory support
 Vasopressors may be required to maintain blood
pressure
 Fluid and electrolyte maintenance
 Nutritional support
 Pain and anxiety management .

36.  Craniotomy it is used to remove the
hematoma from the brain.
 Lumber puncture it is used to drain the CSF
,if the intracranial volume is increased.
 Cerebral angioplasty it is used to open
partially blocked vertebral and carotid
arteries in the neck ,as well as blood vessels
within the brain.
 Elevation of depressed fractures of the skull.
 Suturing of severe scalp lacerations.

37. MEDICATIONS
OSMOTIC DIURETICS
ANTICONVULSANTS- phenytoin or
phenobarbitone.
Analgesics- diclofenace.
Antibiotics -doxamethasone

38. NURSING ASSESSMENT:-
 ABC
 GCS SCORE
 NEUROLOGIC EXAMINATION
 SIGNS OF ELEVATED ICP
 SIGNS OF CSF LEAKAGE

39. 1.Ineffective breathing pattern related to
increased ICP or brain stem injury
2.ineffective airway clearance and ventilation
related to hypoxia
3.Altered cerebral tissue perfusion related to
ICP
4.Risk for injury related to disorientation
,restlessness and brain damage
5.Altered thought process related to head
injury
6.Impaired gas exchange related to altered
level of consciousness.

40.  Assist neurologic and respiratory status to monitor for
sign of increased ICP and respiratory distress.
 Monitor and record vital sign .
 Assess for CSF leak as evidence by otorhea
rhinorrhea.
 Provide suctioning ;if patient is able ,assist with
turning ,coughing and deep breathing to prevent
pooling of secretions.
 Turn the patient every 2 hrs or maintain in a rotating
bed if condition allows to prevent skin breakdown .
 Keep the head of the bed elevated about 30 degree
to decrease intracranial venous pressure
 Provide eye, skin , and mouth care to prevent tissue
damage

41.  The basics of a healthy diet
 Eat a variety of food including vegetables
,fruits ,and grains
 Eat lean meats ,poultry, fish, beans and low-
fat dairy products
 Limits intake of salt ,sugar and alcohol
 Eat unsaturated fats in moderation,strictly
limit saturated and trans fats.

44.  Define head injury.
 Enlist the clinical manifestations of head injury.
 What are the causes of head injury.
 What are the nursing diagnosis of head injury(
three)?.
 Glasgow coma scale has all, except-.
 A. Verbal response
 B. Motor response
 C .sensory impairment
 D. Eye opening

45.  BOOK
 INTERNET
 TEACHER

46.  PV a textbook of medical surgical nursing 11
page no - :306 to 312 .
 Wikipedia .com
 Head injury slideshare .net

47.  Head injury is any trauma to the scalp ,skull,
or brain . It can be open and closed head
injury.
 Some common causes of head injuries are
falls, motor vehicle accidents ,and sports
injuries.
 The warning signs of head injury are
repeated vomiting or nausea ,seizures,
slurred speech or loss of coordination etc.
and there treatment depends on the type of
injury and how severe it is .