Head injury
Definition:
A head injury is any sort of
injury to the brain, skull and scalp.This can range from a mild bump or bruise
to a traumatic brain injury .common head injuries include concussions, skull
fractures and scalp wounds.
Causes of head injury:
Common
events causing head injury include the following:
A.
Falls: Falling
out of bed , slipping in the bath ,falling down steps , falling from ladders
and related falls are the most common cause head injury overall, particularly
in older adults and young children.
B.
Vehicle related collisions: collisions
involving cars, motorcycles or bicycles and pedestrian involved in such
accidents are a common cause of head injury.
C.
Violence:
About 20% of head injuries are caused by violence, such as gunshot wounds, Domestic
violence or child abuse.
D.
Sports injuries: Head
injuries may be caused by injuries from a number of sports soccer, boxing,
football, baseball, lacrosse, skateboarding, hockey and other high impact or
extreme sports, particularly in youth.
E.
Explosive blasts and other combat
injuries:
Explosive
blasts are a common cause of head injury in active duty military personnel.
Risk factors head injury:
The people most at risk of
traumatic brain injury include:
1.
Children, especially newborns to 4
–years-olds.
2.
Young adults, especially those between
ages 15 and 24.
3. Aults
age 60 and older.
4.
Males in any age group.
Sign and symptoms of head injury:
A.
Physical symptoms:
1. Loss
of consciousness for a few seconds to a few minutes.
2. No
loss of consciousness, but a state of being dazed, confused or disoriented.
3. Headache
4. Nausea
or vomiting
5. Fatigue
or drowsiness
6. Difficulty
sleeping
7. Sleeping
more than usual
8. Dizziness
or loss of balance
B.
Sensory symptoms:
1. Sensory
problems, such as blurred vision, ringing in the ear, a bad taste in the mouth,
changes in the ability to smell.
2. Sensitivity
to light or sound.
C.
Cognitive or mental symptoms:
1. Memory
or concentrations problem.
2. Mood
changes or mood swings.
3. Feeling
depressed or anxious.
Nursing management of head injury:
1.
Assess neurologic and respiratory status
to monitor for sign of increased ICP (increased intracranial pressure) and
respiratory distress.
2.
Monitor and record vital sign and intake
and output hemodynamic variables, ICP, cerebral perfusion pressure, specific
gravity, laboratory studies and pulse oximetry to detect early sign of
compromise.
3.
Observe for sign of increasing ISP to
avoid treatment delay and prevent neurologic compromise.
4.
Assess for CSF leck as evidenced by
otorhea or rinnorhea .CSF leck could leave the patient at risk for infection.
5.
Assess for pain, pain may cause anxiety
and increase ICP.
6.
Check cough and gag reflex to prevent
aspiration.
7.
Check for sign of diabetes incipidus (low
urine specific gravity, high urine output) to maintain hydration.
8.
Administration I/V fluids to maintain
hydration.
9.
Administer oxygen to maintain position
and patency of endotracheal tube if present to maintain airway and hyperventilate
the patient and to lower ICP.
10. Provide
suctioning; if patient is able, assist with turning, coughing and deep
breathing to prevent pooling of secretions.
11. Maintain
position, patency and low sunction of NGT to prevent vomiting.
12. Maintain
seizure precautions to maintain patient safety.
13. Administer
medication as prescription to decrease ICP and pain
14.
Allow a rest period between nursing activities
to avoid increase in ICP.
Complications:
1. Infection.
2. Post-concussion
syndrome.
3. Impaired
consciousness.
4. Brain
injury.
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