This document provides guidance on caring for patients with head injuries. It discusses assessing neurological status, managing blood pressure/volume, oxygenation, temperature, seizures, nutrition, positioning, bladder/bowel care, minimizing stimulation, safety, rehabilitation, and educating family members. Key aspects include monitoring vital signs, avoiding hypotension, maintaining oxygen levels, managing ICP rise through osmotherapy, keeping the patient normothermic, starting early rehabilitation, and supporting family members through the recovery process.
Brain cancer can have a wide variety of symptoms including seizures, sleepiness, confusion, and behavioral changes. Not all brain tumors are cancerous, and benign tumors can result in similar symptoms.
Diagnostic tests for brain cancer involve a history, physical exam, and usually a CT or MRI brain imaging procedure; sometimes a brain tissue biopsy is done.
Treatments usually are directed by a team of doctors and are designed for the individual patient; treatments may include surgery, radiotherapy, or chemotherapy, often in combination.
Side effects of treatments range from mild to severe, and patients need to discuss plans with their treatment team members to clearly understand potential side effects and their prognosis (outcomes).
Presented by Mr B.Kalyankumar Msc (N) Dept Of MSN
There are numerous types of brain surgery. The type used is based on the area of the brain and the condition being treated.
Brain surgery is a critical and complicated process. The type of brain surgery done depends highly on the condition being treated.
Intracranial surgery refers to various medical procedures that involve repairing structural problems in the brain.
Craniotomy
A craniotomy involves making an incision in the scalp and creating a hole known as a bone flap in the skull. The hole and incision are made near the area of the brain being treated.
During open brain surgery, it is done to remove tumors, clip off an aneurysm, drain blood or fluid from an infection & remove abnormal brain tissue
Decompressive craniectomy
It is a neurosurgical procedure in which part of the skull is removed to allow a swelling brain room to expand without being squeezed. It is performed on victims of traumatic brain injury, stroke and other conditions associated with raised intracranial pressure.
Brain cancer can have a wide variety of symptoms including seizures, sleepiness, confusion, and behavioral changes. Not all brain tumors are cancerous, and benign tumors can result in similar symptoms.
Diagnostic tests for brain cancer involve a history, physical exam, and usually a CT or MRI brain imaging procedure; sometimes a brain tissue biopsy is done.
Treatments usually are directed by a team of doctors and are designed for the individual patient; treatments may include surgery, radiotherapy, or chemotherapy, often in combination.
Side effects of treatments range from mild to severe, and patients need to discuss plans with their treatment team members to clearly understand potential side effects and their prognosis (outcomes).
Presented by Mr B.Kalyankumar Msc (N) Dept Of MSN
There are numerous types of brain surgery. The type used is based on the area of the brain and the condition being treated.
Brain surgery is a critical and complicated process. The type of brain surgery done depends highly on the condition being treated.
Intracranial surgery refers to various medical procedures that involve repairing structural problems in the brain.
Craniotomy
A craniotomy involves making an incision in the scalp and creating a hole known as a bone flap in the skull. The hole and incision are made near the area of the brain being treated.
During open brain surgery, it is done to remove tumors, clip off an aneurysm, drain blood or fluid from an infection & remove abnormal brain tissue
Decompressive craniectomy
It is a neurosurgical procedure in which part of the skull is removed to allow a swelling brain room to expand without being squeezed. It is performed on victims of traumatic brain injury, stroke and other conditions associated with raised intracranial pressure.
This ppt is related to the Meningitis for nurses. it gives you broad concept of Meningitis definition, types, sign and symptoms, etiology and risk factors, complications, pharmacological management, non pharmacological management, Nursing management, Home care management, concept care Map and quizzes for final evaluation
This ppt is related to Encephalitis and Brain abscess. Definition, etiology & risk factors, Diagnostic evaluation, pharmacological treatment, non pharmacological treatment, nursing management and concept care Map with quizzes for student evaluation.
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
5. Major Types of Head Injuries
Hematoma - a collection, or clotting, of
blood outside the blood vessels.
6. Major Types of Head Injuries
Hemorrhage is uncontrolled bleeding ( bleeding in the
space around your brain (SAH) /bleeding within your brain tissue
(ICB)).
7. Major Types of Head Injuries
Concussion is a brain injury that occurs when your brain
bounces against the hard walls of your skull.
The loss of function associated with concussions is temporary
but repeated concussions can eventually lead to permanent
damage (exp :- hockey , football)
8. Major Types of Head Injuries
Edema - swelling of the surrounding tissues, but it’s
more serious when it occurs in your brain.
9. Major Types of Head Injuries
Skull Fracture
Diffuse Axonal Injury
Does not cause bleeding but does
damage your brain cells.
10. Symptoms of a Head Injury
MINOR HEAD INJURY
a headache
lightheadedness
a spinning sensation
mild confusion
nausea
temporary ringing in the
ears
SEVERE HEAD INJURY
a loss of consciousness
seizures
vomiting
balance or coordination
problems
serious disorientation
an inability to focus the eyes
abnormal eye movements
a loss of muscle control
a persistent or worsening
headache
memory loss
changes in mood
15. Neurological Assessment
Components of the neurologic assessment
should include:
level of consciousness
spontaneous movement and muscle tone
pupil size and reactivity
reflexes
muscle tone and posturing
respiratory pattern
somatic complaints (typically communicated nonverbally)
response to pain.
16. Blood pressure and volume
management
During the acute post-injury phase hypotension should be
avoided; if it occurs, the patient’s volume status should be
evaluated first and hypotension should be corrected rapidly.
arterial catheter to be inserted, to monitor blood pressure
and allow frequent blood sampling.
A urinary catheter is inserted to assess adequacy of renal
perfusion.
The kidney requires 20% to 25% of cardiac output;
commonly, it’s the first organ to show the effects of impaired
perfusion or intravascular volume.
17. Brain and tissue oxygenation
Low peripheral oxygen saturation values or low arterial
blood oxygen values (as shown by arterial blood gas testing)
should be avoided.
Maintaining adequate brain tissue oxygenation seems to
improve patient outcomes.
18. many TBI patients require prolonged mechanical ventilation
and may benefit from a tracheotomy.
A tracheotomy helps reduce the risk of ventilator-associated
pneumonia, as do suctioning of secretions above the
tracheotomy cuff, maintaining the head of the bed at 30
degrees, and performing good oral care every 4 hours.
19. Osmotherapy
Osmotherapy aims to increase the osmolality of the intravascular space,
which in turn helps mobilize excess fluid from brain tissue.
If ICP increases, mannitol (an osmotic diuretic) may be given to decrease
cerebral edema, transiently increase intravascular volume, and improve
cerebral blood flow.
Hypertonic saline solution (saline concentrations of 3% to 24%) may be used
to promote osmotic mobilization of water across the blood-brain barrier.
20. Anesthetic, sedative, and
analgesic agents
Short-acting anesthetic and sedative-analgesic agents, such as propofol and
fentanyl, typically are given.
When dosages are decreased, the patient can be awakened quickly,
permitting nonpharmacologically tainted assessment of neurologic status.
Analgesic should be considered to manage pain without causing significant
neurologic status changes.
21. Temperature management
Kept normo-thermic temperature (35° to 37° C) to reduce brain metabolism
and promote anti-inflammatory effects.
Tepid sponging continuously, encourage good air circulation helped in
reducing temperature.
Although ice packs may be used, they are labor intensive and may lead to
inconsistent cooling.
Once intracranial hypertension resolves, the patient’s temperature can be
allowed to normalize.
22. Seizure prophylaxis
TBI may increase the risk of nonepileptic seizures
Seizures that immediately are a reaction to the initial trauma, those
arising more than 2 weeks after injury are due to brain damage.
Although the seizure risk is low, seizures increase metabolic activity and
oxygen demands, which may further compromise the damaged brain.
Routine seizure prophylaxis later than 1 week after a TBI isn’t
recommended (phenytoin or valproate can be given – if needed)
23. Nutrition
A nasogastric or orogastric tube is inserted to decompress the stomach and
reduce the aspiration risk.
TBI patients have increased metabolic demands, so parenteral or enteral
nutrition should begin as soon as tolerated.
percutaneous gastrostomy tube (PEG Tube) may be used to deliver nutrition
and decrease the aspiration risk.
24. Positioning
keep the head of the bed elevated at least 30 degrees with the patient’s
neck in neutral alignment, to promote venous drainage of the brain and
reduce brain swelling. This position also decreases the risk of aspiration
Turning and repositioning, take measures to prevent skin breakdown.
Turning should be done as frequent as possible to promote good blood
circulation.
Ripple mattress help in reducing risk of skin damage.
25. Bladder care
To decrease the risk of urinary tract infection, the urinary
catheter is removed after ongoing assessment of urine output is
no longer critical.
If the patient is incontinent, use good-quality diapers and
protective barrier creams.
A male patient may benefit from use of a condom catheter.
26. Bowel care
A preventive bowel care regimen should be established, as
fluid restriction (used to help decrease cerebral swelling),
limited mobility, and enteral nutrition may contribute to
constipation.
Patients with TBIs also are at risk for stress ulcers, so be
prepared to give hydrogen ion blockers.
27. Minimizing environmental
stimulation
The damaged brain can’t process information as it normally
does, which may lead to increased ICP and, in later stages of
recovery, agitation and restlessness.
Take measures to limit noise and conversation in the
patient’s room, keep light levels low and minimize tactile
stimulation.
As the patient’s condition improves, assess tolerance to
stimulation and adapt the level of stimulation as appropriate.
28. Ensuring patient safety
If the patient becomes restless or agitated, investigate the
cause and take appropriate interventions.
Explain all care measures even if you’re not sure the patient
understands what’s being said.
Secure all devices and equipment and keep these out of the
patient’s sight and reach, even a seemingly simple device can
pose a hazard to a confused or agitated patient.
Use a soft voice and speak slowly to give the patient time to
process information.
Remember that the familiar voice of a family member or
friend may calm the patient and decrease anxiety.
If restraints are needed, they should be applied for the
shortest duration possible, in some cases, a netted safety bed
may be considered.
29. Rehabilitation and
consultations
Use splints as ordered to maintain the patient’s hands and
feet in functional positions and decrease the risk of
contractures.
As soon as possible, start range-of-motion exercises and
mobilization out of bed.
During the early post-injury period, consult such services as
physical therapy, occupational therapy, speech language
pathology, and physiatry as needed.
30. Health education for family
Because TBI affects the patient’s entire family, continuing
care must address family members.
They will require a great deal of emotional support and
preparation for what could be a prolonged recovery and
permanent disabilities.
Family members may be spending endless hours at the
bedside, watching for anything that could signal a change in
the patient’s condition.
Prepare them for good days and bad days, and explain that
the patient’s progress may be slow.
Know that maintaining caregiver continuity can help
establish a good relationship with family members, whose
coping skills may be depleted by fatigue, stress, fear, grief,
anger, and frustration.