A head injury is a broad term that describes a vast array of injuries that occur to the scalp, skull, brain, and underlying tissue and blood vessels in the head. Head injuries are also commonly referred to as brain injury, or traumatic brain injury (TBI), depending on the extent of the head trauma.
2. HEAD INJURY
Head injury is also called traumatic brain
injury. It is an insult to the brain capable of
producing physical ,intellectual ,emotional ,
social and vocational changes and it produces
compromised neurological functions ,
resulting in diffuse symptoms.
3. ETIOLOGY AND RISK FACTORS
• Motor vehicle accident.
• Falls sports related injuries, workplace accidents,
assults or bullets.
• Gender : most males younger than 30
• A person who has had a head injury and if
experiencing the following symptoms should seek
immediate medical care
Serious bleeding from head or face and clear fluid
drainage from the nose or ear.
Loss of consciousness, however , brief , confusion
and lethargy.
Lack of pulse or breathing.
4. PATHOPHYSIOLOGY
Cells within brain become anoxic and cannot
metabolize properly, producing ischemia,
infarction,irreversible brain damage and eventually
brain death.
Brain suffers traumatic injury
Brain swells or bleeds which increases intracranial
volume
Rigid cranium has no space to expansion of contents
5. Increased intracranial pressure
Pressure in the blood vessels within the brain causes
blood flow the brain to slow
Cerebral hypoxia and ischemia occur
ICP continue to rise , brain may herniated or cerebral
blood flow ceases
Altered level of conciousness
Coma and death
6. DIAGNOSTIC PROCEDURE
• History taking and physical examinations
• Blood test : CBC , coagulation profile,
• X-ray skull, MRI and CT scan
• Diagnostic burr hole
• Neuropsychological test : during rehabilitaion phase
to determine cognitive defects
7. TREATMENT AND MANAGEMENT
Treatment dependent on the site and severity of the
injury.
The management focuses on supporting all organ
system. The support includes:
• Ventilatory support
• Management of fluid balance and elimination
• Management of nutrition and gastro intestinal
function.
1. Patient with minor head injury with concussions,
the medical treatment includes
-keeping the patient in observation for 24hrs with
complete bed rest.
-symptomatic treatment and discharge.
8. 2.If patients need further management and have
severe brsin injury he/she should be admitted in the
special unit and carried out following treatment.
-For all the patient with head injury , prophylactic
antibiotic are given to prevent potential CNS
infection
-Sedatives should be given if seizures
-Medical decompression is done to reduce edema.
9. NURSING MANAGEMENT
• Airway :
-patient airway should be assessed and maintained.
-incubate the patient who has GCS less than 8 score
-placement NG tube with intubation to prevent aspiration
• Breathing :
-all the intubated patient should have in ventilatory
support and provide oxygen as needed.
• Circulatory support and maintenance :
-prevent hypotension and maintain SBP above 110mmof
hg
-maintain normal fluid volume.
10. • Support care :
-nutritional support ,rehabilitaion support services and
skin care.
• Performed routine basic care :
-position change frequently,physiotherapy etc
-antibiotic to prevent infection with open skull
fracture.
-treatment of hyponatremia by fluid intake and output
