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Flashcards in Head trauma Deck (8)
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1
Q

How many indications are there for a CT scan in a head injury?

A

Seven 7

2
Q

What is the mmnemonic

A

PASS GF >1

3
Q

What does the Pass stand for

A

Post traumatic seizure
Amnesia > 30 minutes before impact and Age >65
Suspected open/depressed skull fracture
Signs of basal/raccoon fracture

4
Q

What does GF >1 stand for?

A

GCS <13 at any time or < 15 2 hours post injury
Focal neurological deficit
>1 episode of vomitting

Also consider coagulopathy and dangerous mechanism of injury..

5
Q

What is the management of head injury

A

A-E [primary survey]
- In the A immobilise the C spinr until damage is excluded

Send for bloods and radiology

Secondary survey including involving neurosurgesons, brief exam, AMPLE, BP, pulse, RR, pupils every 15 minutes, check for CSF leak,

6
Q

What patients in the A management need immediate ventilation

A
  • GCS 8 or less
  • O2 on air less than 9 kpa [in air normally 21 and if you minus 10 for insensible loses should be 11 at least so 9 is too low] or less than 13 on oxygen or a co2 above 6
  • Spontaneous hyperventilation
  • Irregular respiration
7
Q

What is management of SAH

A
ABCDE
FeSS- ischaemic penumbra
CT head
Bloods FUC GC
ECG 
If suspect, and CT- do LP and wait twelve
ADMIT TO ICU FOR FREQUENT MONITORING AND MAINTAIN CEREBRAL PERFUSION
Nimodipine
Clipping or coil embolisation
8
Q

Risks of SAH

A

Rebleeding, ischeamia secondary to vasospasm, hydrocephalus and hyponatraemia [brain’s response to trauma is to salt waste, and so overall low volume so fluid restriction will further dehydrate]