injuries that occur to the scalp, skull, brain, and underlying tissue and blood vessels in the head

A head injury is a broad term that describes a vast array of injuries that occur to the scalp, skull, brain, and underlying tissue and blood vessels in the head. Head injuries are also commonly referred to as brain injury, or traumatic brain injury (TBI), depending on the extent of the head trauma.

1. WELCOME

2. HEAD INJURY Head injury is also called traumatic brain injury. It is an insult to the brain capable of producing physical ,intellectual ,emotional , social and vocational changes and it produces compromised neurological functions , resulting in diffuse symptoms.

3. ETIOLOGY AND RISK FACTORS Motor vehicle accident. Falls sports related injuries, workplace accidents, assults or bullets. Gender : most males younger than 30 A person who has had a head injury and if experiencing the following symptoms should seek immediate medical care Serious bleeding from head or face and clear fluid drainage from the nose or ear. Loss of consciousness, however , brief , confusion and lethargy. Lack of pulse or breathing.

4. PATHOPHYSIOLOGY Cells within brain become anoxic and cannot metabolize properly, producing ischemia, infarction,irreversible brain damage and eventually brain death. Brain suffers traumatic injury Brain swells or bleeds which increases intracranial volume Rigid cranium has no space to expansion of contents

5. Increased intracranial pressure Pressure in the blood vessels within the brain causes blood flow the brain to slow Cerebral hypoxia and ischemia occur ICP continue to rise , brain may herniated or cerebral blood flow ceases Altered level of conciousness Coma and death

6. DIAGNOSTIC PROCEDURE History taking and physical examination s Blood test : CBC , coagulation profile, X-ray skull, MRI and CT scan Diagnostic burr hole Neuropsychological test : during rehabilitaion phase to determine cognitive defects

7. TREATMENT AND MANAGEMENT Treatment dependent on the site and severity of the injury. The management focuses on supporting all organ system. The support includes: Ventilatory support Management of fluid balance and elimination Management of nutrition and gastro intestinal function. Patient with minor head injury with concussions, the medical treatment includes -keeping the patient in observation for 24hrs with complete bed rest. -symptomatic treatment and discharge .

8. 2.If patients need further management and have severe brsin injury he/she should be admitted in the special unit and carried out following treatment. -For all the patient with head injury , prophylactic antibiotic are given to prevent potential CNS infection -Sedatives should be given if seizures -Medical decompression is done to reduce edema.

9. NURSING MANAGEMENT Airway : - patient airway should be assessed and maintained. -incubate the patient who has GCS less than 8 score -placement NG tube with intubation to prevent aspiration Breathing : -all the intubated patient should have in ventilatory support and provide oxygen as needed. Circulatory support and maintenance : - prevent hypotension and maintain SBP above 110mmof hg - maintain normal fluid volume.

10. Support care : -nutritional support , rehabilitaion support services and skin care. Performed routine basic care : - position change frequently,physiotherapy etc - antibiotic to prevent infection with open skull fracture. - treatment of hyponatremia by fluid intake and output