Head, ****** and Neck Trauma/ Neuro
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| 🇬🇧 | 🇬🇧 |
| Some signs of cerebral herniation | Deteriorating GCS <9 with any of the following - dilated/ unreactive pupils, asymmetric pupillary response, asymmetric motor response or motor exam extension posturing or no response |
| If ETCO2 monitoring is unavailable how any bpm should you hyperventilate an adult that is showing hypoxemia and hypotension | Approx. 20 bpm |
| If ETCO2 monitoring is unavailable what bpm should you hyperventilate an child that is showing hypoxemia and hypotension | Approx. 25 bpm |
| GCS | Glasgow Coma Scale |
| Most common head # | Linar # at 80% |
| Halo sign | Blood mixed w/CSF from nose, mouth, ears |
| What is the wave the a bullet causes | Cavitational wave |
| Retroauricular Ecchymosis | Blood pooling below ear |
| Epidural Hematoma | Bleeding between mater and skull, involves arterial bleed, ICP builds up quickly |
| Subdural Hematoma | More common - bleeding w/in meninges, usually venous bleed, complaints of focal symptoms , occurs above pia mater |
| Intracerebral Hematoma | Rupture blood vessel w/in brain, presentation similar to stroke |
| DAI | Diffuse Axonal Injury (stretching or tearing of nerve fibres w.subsequent axonal damage) |
| Hallmark of Concussion | They only improve |
| Retrograde amnesia | Forgetting events prior to incident |
| Anterograde amnesia | Forgetting events post incident |
| Reduced levels on CO2 in CSF | Cerebral vasoconstriction - results in cerebral anoxia |
| As CO2 levels rise in CSF | Cerebral arteries dilate - encourage blood flow - reduce hypercarbia |
| Already high ICP | Causes classic hyperventilation and hypertension |
| Severe Diffuse Axonal Injury | Brainstem injury, significant mechanical disruption, high mortality rate |
| Presentation of Severe Diffuse Axonal Injury | Prolonged unconsciousness, cushings reflex, decorticate or decerebrate posturing |
| Herniation | Portion of the brain structure pushed through opening (foramen magnum), pressure on upper brain (vomiting, decreased LOC, pupil dilation), pressure on medulla oblongata ( disturbs respiration, BP, HR) |
| Cushing's Reflex | Increasing BP, slowing pulse rate, erratic/irregular respirations |
| What kind of posturing would be present with an upper brainstem compression | Decorticate posturing |
| What kind of posturing would be present with an middle brainstem compression | Decerebrate posturing |
| Can you remove a foreign object from eye | Yes, only if the object is not on the cornea and is visible, accessible and easily removed |
| Hyphema | Blunt trauma to the anterior chamber of the eye, blood in front of iris or pupil |
| What medication is used for head injuries | Mannitol (Diuretic) |
| Treatment for headache under the medical directive | Acetaminophen |
| What is the conditions in order to give Acetaminophen | >18 and unaltered |
| Contraindications for give Acetaminophen | Use w/in previous 4hrs or allergy or sensitivity to Acetaminophen and S&S of intoxication |
| What is atrovent | Is an anticholinergic - atropine and ventolin together, it is bronchodilator |
| Remember for Atropine overdose : | "Hot as hell, Blind as a bat, Dry as a bone, Red as a beet, mad as a hatter" |
| MAOIs | Epi, nonepi, dopamine |
| What will MAIO react with | Fermented foods |
| What is the Big 5 | Epinephrine, Nonepinephrine, Serotonin, Antidepressants, GABA |
| Extrapyramiday movements | Shaking in Parkinson's |
| Schizophrenia | Lack of contact with reality and disorganized thinking |
| Dilantin is used for | Adults |
| Valproic acid is used for | Children |
| SLUGE | Salivation, Lacrimation, Urination, Defecation, Gi disturbances, Emesis |
| Most frequent cause of dementia in the elderly | Alzheimer's disease |
| Amyotrophic lateral sclerosis | Slowly loosing motor function |
| Brain abscess | Collection of puss |
| Neoplasma | The growth of a new tumour |