Head Injuries
A collection of blood between skull and dura usually a laceration of the middle meningeal artery. Presents with brief loss of consciousness, lucid period, sudden loss of consciousness.
What is epidural hematoma?
Components of the GCS
What are eye opening, verbal response & motor response?
Class of drugs to use with caution in patients with history of MI, strokes and angina.
What is triptans?
Main treatment for febrile seizure
What are antipyretics?
Percentage of patients who will suffer a stroke within 3 months of having a TIA
What is 10%
What is the first step of spinal protection?
What is the leader is positioned at the head of the patient with hands on each side of the patients head?
What is the correct sequence of events for initial assessment of an unresponsive patient with suspected head trauma?
What is Airway while protecting c-spine, breathing and circulation?
Name at least two examples of primary head injury.
1. Contusion
2. Laceration
3. Shearing injuries
4. Hemorrhage
Which manifestations are early signs of ICP?
What is restlessness, confusion, nausea, vomiting, sluggish pupillary response?
A headache that is unilaterall, pulsating and associated with nausea, photophobia and phonophobia
What is a migraine?
Seizure which includes apnea, tremors and a postictal period.
What is a tonic-clonic seizure?
Patient with stroke like symptoms who initial CT shows a bleed
What is a hemorrhagic stroke?
Characterized by the loss of reflexes and motor and sensory functions below the level of injury.
What is spinal shock.
In spinal stabilization for the adult, what action demonstrates correct stabilization technique?
What is keeping the patient's nose and umbilicus aligned at all times?
A condition that is characterized by a collection of venous blood caused by a rupture of the bridging veins.
What is a subdural hematoma?
Cranial nerve involved in sticking out the tongue
What is cranial nerve XII (hypoglossal)?
A condition to consider in a patient over 50 years old with a new headache and visual changes.
What is temporal arteritis?
Priorities when caring for a seizure patient
What are ensuring ABCs, stopping the seizure (giving meds) and investigating the cause?
Must be done prior to giving anything by mouth
What is the dysphagia screen?
May occur with injuries above T6 causing bradycardia, hypotension, warm dry skin
What is neurogenic shock?
Head midline, head of bed at 30 degrees, avoid hip flexion, short acting sedatives and analgesia.
What are ways to minimize increased intracranial pressure?
Give at least two examples of a secondary head injury.
What is...
1. Ischemia
2. Hypotension
3. Hypercapnia
4. Central edema
5. Metabolic derangements
This cranial nerve can affect equilibrium.
What is the acoustic nerve (CN VIII)?
Abrupt onset headache described as "The worst headache of my life"
What is a subarachnoid hemorrhage (SAH)?
Seizure activity lasting at least 5 minutes or two or more seizures without complete recovery.
What is a Status Epilepticus?
Complication of SAH that is characterized by frothy, pink sputum
What is flash pulmonary edema?
Can walk to the bar but can't take a drink.
What is central cord syndrome?
33 year old female arrives to your ED. Patient involved in MVC, ejected driver, hypotension, can't move lower legs. What is initial treatment for hypotension?
What is an isotonic fluid bolus?
This condition is caused by strong rapid acceleration -deceleration stimulus or sudden blow to the head with or without loss of consciousness.
What is a concussion?
Cranial nerves to assess in an unconscious patient
What are CN III (oculomotor), V (trigeminal), IX (glossopharyngeal) and X (vagus)?
These all have involuntary responses that can be tested such as pupil response, corneal reflexes and gag reflex
List three modifiable risk factors for migraines
What are:
Sleep deprivation, stress, dieting / inadequate nutrition, bright / fluorescent lights, cyclic hormonal changes, diet (including red wine, aged cheese, dark chocolate, caffeine, MSG).
A series of focal seizures with unilateral clonic movement that starts in one group of muscles and spread systematically to adjacent groups
What are Jacksonian Seizures?
Serious complication of TPA?
What is angioedema?
Ipsilateral motor paralysis and contralateral sensory deficit.
Brown-Sequard Syndrome
Two names...two different sides (loss of motor function on injured side. Loss of pain and temperature on opposite side)
74 year old female has had stroke like symptoms for 1 hour. CT negative for hemorrhage. Orders received for tPa. What do you need to know? and how much do you mix?
Weight in kgs?
dosage is_______?