Intracranial Regulation
How do you calculate CPP?
MAP-ICP = CPP
What are the two most common causes of a TBI
Falls & Motor Vehicle Accidents
0.9% NaCl
What percent of the body's O2 does the brain use?
20% (It also uses 25% of glucose!)
Name two manifestations of skull fractures
Basilar, frontal, orbital, parietal, posterior fossa, temporal.
How are phenobarbital/thiopental dosed in ICP?
Dosing is based on EEG tracing and the level of ICP.
>20 mmHg
Name five assessment findings of a head injury
Bruises or contusions on face, Battle's sign, fracture or depression in skull, raccoon eyes, scalp lacerations, asymmetric facial movements, combativeness, confusion, CSF leaking from ears and nose, decreased LOC, depressed/hyperactive reflexes, dilated or unequal pupils, garbled speech, incontinence, involuntary movements, seizures, central neurogenic hyperventilation, Cheyne-Stokes respirations, decreased O2 sat, pulmonary edema
When are phenytoin/levetiracetam NOT effective for PTS prophylaxis in a TBI
7 days after injury
False (A normal CPP is 60-100 mmHg; a CPP < 50 is associated with ischemia and neuronal death. A CPP < 30 mmHG results in ischemia and is incompatible with life.)
What are five initial interventions for a head injury
ABCs, assume neck injury with head injury, stabilize cervical spine, apply O2, establish IV access with 2, large-bore needles and begin fluid resuscitation, intubate if GCS <8, control external bleeding, prepare for possible surgery.
What is a normal GCS.
15!