Head injury: Definition, Causes, types, Risk factor, Signs & symptom, Nursing Management, Complication

 

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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