Head injury and its management

19. Oct 2020

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Head injury and its management

  2. What Are Head Injuries? • Head injuries are common in children and teens. • They can hurt the scalp, skull, brain, or blood vessels. • Head injuries can be mild, like a bump on the head, or more serious, like a concussion. • In kids, most are mild and don't injure the brain.
  3. What Causes Head Injuries? • Most head injuries in childhood are due to falls. They also happen from: CAR CRASHESH BIKE ACCIDENTS SPORT INJURIES CHILD ABUSE
  6. OLDER CHILDREN Automobile accidents Road traffic accidents Sports and recreation injury Fall from height Penetrating injury through eyes Crush injury Fall of heavy object on head
  7. What Are the Types of Head Injuries? Head injuries can be: • Involve the scalp EXTERNAL • skull, brain, or blood vessels INTERNAL
  8. An injury can cause a concussion, contusion, fracture, or bleeding • A concussion is a type of mild traumatic brain injury. • It happens when a blow to the head or another injury moves the head back and forth with a lot of force. • This causes chemical changes in the brain and sometimes damages brain cells.
  9. CONTUSION • A contusion (bruise) happens when a blow to the head injures the skin and the soft tissue under it. • Blood from small blood vessels leaks, causing red or purple marks on the skin. • Contusions often happen on the scalp or forehead. • More serious head injuries can cause a brain contusion
  10. • A skull fracture is a break in the skull bone. Skull fractures can happen in different parts of the skull. • Bleeding can happen on and under the scalp and in or around the brain.
  11. SIGNS & SYMPTOMS HAVE A SWOLLEN SCALP (because the scalp has many small blood vessels that can leak) HAVE A HEADACHE (half of children with a head injury get a headache) LOSE CONSCIOUSNES S (PASS OUT) (This isn't common) VOMIT ONCE OR TWICE (This happens in some children after a head injury)
  12. Symptoms can occur a bit differently in each child, and vary depending on how severe the injury is. • Symptoms of mild head injury may include: • Raised, swollen area from a bump or a bruise • Small, shallow cut in the scalp • Headache • Sensitivity to noise and light • Irritability or abnormal behavior • Confusion • Lightheadedness or dizziness
  13. • Problems with balance • Nausea • Problems with memory or concentration • Change in sleep patterns • Blurred or double vision • Eyes that look tired • Ringing in the ears (tinnitus) • Changes in taste • Tiredness • Lack of energy (lethargy)
  14. Symptoms of moderate to severe head injury may include any of the above plus • Loss of consciousness • Severe headache that does not go away • Repeated nausea and vomiting • Loss of short-term memory • Slurred speech • Trouble walking
  15. • Weakness in one side or area of the body • Sweating • Pale color of skin • Seizures or convulsions • Blood or clear fluid draining from ears or nose • Dark circle in the center of the eye (pupil) looks larger in one eye • Deep cut in the scalp • Loss of consciousness and can’t be awakened (coma) • Loss of thinking and awareness of surroundings (vegetative state) • Locked-in syndrome, a condition where a person is conscious and can think, but can’t speak or move
  16. What Should I Do When a Child Has a Head Injury? • Call your health care provider right away if your child had a head injury and: • Is an infant • Lost consciousness, even for a moment • Has any of these symptoms: – Won't stop crying – Complains of head and neck pain (younger children who aren't talking yet may be more fussy) – Vomits more than one time – Won't awaken easily – Becomes hard to comfort – Isn't walking or talking normally
  17. If your child is not an infant, has not lost consciousness, and is alert and behaving normally after the fall or blow: • Put an ice pack or instant cold pack on the injured area for 20 minutes every 3–4 hours. • If you use ice, always wrap it in a washcloth or sock. • Ice placed right on bare skin can injure it. • Watch your child carefully for the next 24 hours. • If the injury happens close to bedtime or naptime and your child falls asleep soon afterward, check in a few times while they sleep.
  18. • If your child's skin color and breathing are normal, and you don't sense a problem, let your child sleep unless the doctor tells you otherwise. There's no need to keep a child awake after a head injury. • Trust your instincts. If you think your child doesn't look or seem right, partly awaken your child by sitting them up. They should fuss a bit and attempt to resettle. If your child still seems very drowsy, try to awaken them fully. If you can't wake your child, call your health care provider or for an ambulance.
  19. What Should I Do if a Child Is Unconscious After a Head Injury? • Don't move the child in case there is a neck or spine injury. • Call for help. If you have a phone with you, call 911. • If the child is vomiting or having a seizure, turn them onto their side while trying to keep the head and neck straight. This will help prevent choking and protect the neck and spine.
  20. TREATMENT • Treatment is based on the severity of the injury. • Mild injury • Mild traumatic brain injuries usually require no treatment other than rest and over-the-counter pain relievers to treat a headache. However, a person with a mild traumatic brain injury usually needs to be monitored closely at home for any persistent, worsening or new symptoms. He or she may also have follow-up doctor appointments.
  21. IMMEDIATE EMERGENCY CARE Maintained A= Airway B=Breathing C=Circulation
  22. MEDICATIONS • Diuretics. These drugs reduce the amount of fluid in tissues and increase urine output. Diuretics, given intravenously to people with traumatic brain injury, help reduce pressure inside the brain. • Anti-seizure drugs. People who've had a moderate to severe traumatic brain injury are at risk of having seizures during the first week after their injury
  23. • An anti-seizure drug may be given during the first week to avoid any additional brain damage that might be caused by a seizure. Continued anti-seizure treatments are used only if seizures occur. • Coma-inducing drugs. Doctors sometimes use drugs to put people into temporary comas because a comatose brain needs less oxygen to function. This is especially helpful if blood vessels, compressed by increased pressure in the brain, are unable to supply brain cells with normal amounts of nutrients and oxygen.
  24. SURGERY • Removing clotted blood (hematomas). Bleeding outside or within the brain can result in a collection of clotted blood (hematoma) that puts pressure on the brain and damages brain tissue. • Repairing skull fractures. Surgery may be needed to repair severe skull fractures or to remove pieces of skull in the brain.
  25. • Bleeding in the brain. Head injuries that cause bleeding in the brain may need surgery to stop the bleeding. • Opening a window in the skull. Surgery may be used to relieve pressure inside the skull by draining accumulated cerebral spinal fluid or creating a window in the skull that provides more room for swollen tissues.
  26. Can Head Injuries Be Prevented? • It's impossible to protect kids from every injury. But you can help prevent head blows. Most important, childproof your home to prevent household accidents. • Kids should: • Always wear a bike helmet that fits well and is approved by the U.S. Consumer Product Safety Commission for biking. • Use the proper sports equipment for inline skating, skateboarding, snowboarding, skiing, and contact sports.
  27. • Use a child safety seat or seatbelt every time they're in the car. • Take it easy after a head injury, especially if they had a concussion. • Wait until the doctor says it's OK before returning to rough play or sports. If the brain gets injured again while it's still healing, it will take even longer to completely heal.
  28. COMPLICATION • Behavioural problems • Communication problems • Physical deformities • Death • Coma
  29. NURSING MANAGEMENT • Nursing assessment • Check level of consciousness • Nutritional management • Provide comfort • Post operative care • Treat complication • Encourage relative to participate in care
  30. PREVENTING HEAD INJURIES IN CHILDREN The following tips can help children avoid head injuries: • Install safety gates at the top of a stairway • Keep stairs clear of clutter • Install window guards to prevent falls • Put a nonslip mat in the bathtub or shower • Use playgrounds that have shock-absorbing materials on the ground • Make sure area rugs are secure • Don't let children play on fire escapes or balconies