Traumatik brain injuri management penangan.pptx

Jurnal

1. Trauma from A to Z: Comprehensive Approaches for Integrated Professional Care WEBINAR SERIES II TRAUMATIC BRAIN INJURY MANAGEMENT For Nursing Professionals Ristina Mirwanti , S.Kep ., Ners , M.Kep .

2. TRAUMATIC BRAIN INJURY Traumatic brain injury (TBI) is defined as injury to brain function, or the indication of brain pathology, caused by an external force ( Khellaf et al 2019). Severe TBI can cause significant physical, psychosocial and social deficits and, in up to 60% of cases, has mortality rates of 30–40% ( Khellaf et al, 2019). Severe TBI is a leading cause of morbidity and mortality worldwide, particularly among young people. Trauma from A to Z: Comprehensive Approaches for Integrated Professional Care WEBINAR SERIES II

3. EPIDEMIOLOGY The epidemiology of TBI is changing. The worldwide yearly incidence of TBI is estimated at 50 million; In high-income countries , the number of older people sustaining TBIs is increasing, primarily due to falls ; in lower-income countries , the number of TBIs caused by road traffic collisions is increasing (Maas et al, 2017). Small regional studies reported a decrease in TBI during Covid-19 lockdowns, reflecting decreased mobility, sports and recreational activity, and possibly a reluctance to seek medical help for milder injuries (Mass et al, 2022). Trauma from A to Z: Comprehensive Approaches for Integrated Professional Care WEBINAR SERIES II

4. PRIMARY BRAIN INJURY Primary brain injury occurs at the moment of impact and is irreversible. Primary brain injuries can be: Penetrating; Blunt. A penetrating brain injury involves an open wound to the head from a foreign object, for example, during a shooting or stabbing. It is typically evident due to focal damage occurring along the route through which the object has travelled in the brain; this includes fractured skull, torn meninges (layers that protect the brain), and damage to the brain tissue. A blunt brain injury is usually caused by a fall, blunt assault or road traffic collision (American College of Surgeons (ACS), 2018). Trauma from A to Z: Comprehensive Approaches for Integrated Professional Care WEBINAR SERIES II

5. SECONDARY BRAIN INJURY Secondary brain injuries can: Evolve from primary damage; Be a result of insult from highly preventable and treatable causes, such as hypotension and hypoxia. Trauma from A to Z: Comprehensive Approaches for Integrated Professional Care WEBINAR SERIES II

6. PRE HOSPITAL MANAGEMENT Pre-hospital management of patients includes initial resuscitation and interventions to stabilise them at the scene of injury and when they are on the way to hospital. This assessment and management should focus on preventing secondary brain injury and follow the Advanced Trauma Life Support course (NICE, 2014). Trauma from A to Z: Comprehensive Approaches for Integrated Professional Care WEBINAR SERIES II

7. TO AVOID HYPOXIA Patients should be intubated, and ventilation should be started if they have: Severe HI and a GCS score of ≤8; Facial fractures; Injuries that compromise oxygenation and ventilation (ACS, 2018). Trauma from A to Z: Comprehensive Approaches for Integrated Professional Care WEBINAR SERIES II

8. PRE HOSPITAL Hypotension (systolic blood pressure of <90mmHg) has the highest correlation with increased morbidity and mortality (Vella et al, 2017). The Brain Trauma Foundation (BTF) (2016) guidelines recommend maintaining a mean arterial pressure (MAP) of around 90mmHg. Intravenous access should be established, and volume resuscitation with isotonic fluids is recommended (McNair, 2019). Cervical spine immobilisation must be maintained until full clinical assessment and imaging are completed. Effective pain management is important to reduce the ICP, and GCS and pupil response should be continuously assessed for any abnormalities. Immediate transport to the nearest trauma centre to further evaluate and manage the HI is essential. Trauma from A to Z: Comprehensive Approaches for Integrated Professional Care WEBINAR SERIES II

9. PRE HOSPITAL MANAGEMENT During the prehospital or ED phase, emphasis is placed on assessment of the airway maintenance with cervical spine protection, breathing and ventilation, circulation with bleeding control, disability/neurological examination, and exposure and environmental control These assessments should be performed during triage and transport. Trauma from A to Z: Comprehensive Approaches for Integrated Professional Care WEBINAR SERIES II

10. INITIAL ASSESSMENT Trauma from A to Z: Comprehensive Approaches for Integrated Professional Care WEBINAR SERIES II

11. AIRWAY Trauma from A to Z: Comprehensive Approaches for Integrated Professional Care WEBINAR SERIES II

12. BREATHING Trauma from A to Z: Comprehensive Approaches for Integrated Professional Care WEBINAR SERIES II

13. CIRCULATION TEXT Trauma from A to Z: Comprehensive Approaches for Integrated Professional Care WEBINAR SERIES II

14. ADDITIONAL ASSESSMENT DISABILITY NEUROLOGIC EXAM TEXT Trauma from A to Z: Comprehensive Approaches for Integrated Professional Care WEBINAR SERIES II

15. ADDITIONAL ASSESSMENT DISABILITY NEUROLOGIC EXAM Trauma from A to Z: Comprehensive Approaches for Integrated Professional Care WEBINAR SERIES II

16. SYSTEMIC INJURY (ALSO KNOWN AS EXPOSURE AND ENVIRONMENT) Trauma from A to Z: Comprehensive Approaches for Integrated Professional Care WEBINAR SERIES II

17. INTRA HOSPITAL TRANSPORTATION TEXT Trauma from A to Z: Comprehensive Approaches for Integrated Professional Care WEBINAR SERIES II

18. ICU BUNDLE Assessment, prevention, and management of pain Both spontaneous awakening trials and spontaneous breathing trials Choice sedation/analgesia Delirium assessment, monitoring, and management E. Early mobility F. Family engagement and empowerment. Trauma from A to Z: Comprehensive Approaches for Integrated Professional Care WEBINAR SERIES II

19. ICU BUNDLE Trauma from A to Z: Comprehensive Approaches for Integrated Professional Care WEBINAR SERIES II

20. ICU BUNDLE Trauma from A to Z: Comprehensive Approaches for Integrated Professional Care WEBINAR SERIES II

21. HOSPITAL-ACQUIRED CONDITION Ventilator-associated pneumonia/hospital-acquired pneumonia Catheter-associated urinary tract infection Central-line associated bloodstream Infections Falls Hospital-acquired pressure injury (HAPI) HAPI related to a medical device Venous thrombosis/pulmonary emboli Contractures Infection due to invasive lines Trauma from A to Z: Comprehensive Approaches for Integrated Professional Care WEBINAR SERIES II

22. VENTILATOR-ASSOCIATED PNEUMONIA/HOSPITAL-ACQUIRED PNEUMONIA -PREVENTION Trauma from A to Z: Comprehensive Approaches for Integrated Professional Care WEBINAR SERIES II

23. Catheter-associated urinary tract infection Trauma from A to Z: Comprehensive Approaches for Integrated Professional Care WEBINAR SERIES II

24. Central-line associated bloodstream Infections TEXT Trauma from A to Z: Comprehensive Approaches for Integrated Professional Care WEBINAR SERIES II

25. Falls TEXT Trauma from A to Z: Comprehensive Approaches for Integrated Professional Care WEBINAR SERIES II

26. Hospital-acquired pressure injury (HAPI) Trauma from A to Z: Comprehensive Approaches for Integrated Professional Care WEBINAR SERIES II

27. HAPI related to a medical device-PREVENTION Trauma from A to Z: Comprehensive Approaches for Integrated Professional Care WEBINAR SERIES II

28. Venous thrombosis/pulmonary emboli Trauma from A to Z: Comprehensive Approaches for Integrated Professional Care WEBINAR SERIES II

29. Contractures Trauma from A to Z: Comprehensive Approaches for Integrated Professional Care WEBINAR SERIES II

30. Infection due to invasive lines Trauma from A to Z: Comprehensive Approaches for Integrated Professional Care WEBINAR SERIES II

31. COMMUNICATION Pasien Keluarga Trauma from A to Z: Comprehensive Approaches for Integrated Professional Care WEBINAR SERIES II

32. NURSING EDUCATION Pemulihan setelah TBI ( termasuk potensi gangguan fungsi kognitif , fisik , dan emosional ). Cara mengenali tanda-tanda perburukan . Rencana follow-up dan rehabilitasi jangka panjang . Trauma from A to Z: Comprehensive Approaches for Integrated Professional Care WEBINAR SERIES II

33. ETHICAL CONSIDERATION PENERAPAN PRINSIP ETIK PENGAMBILAN KEPUTUSAN END OF LIFE CARE Trauma from A to Z: Comprehensive Approaches for Integrated Professional Care WEBINAR SERIES II

34. PROFESSIONAL DEVELOPMENT Pelatihan terkait manajemen Traumatic Brain Injury Simulasi manajemen Traumatic Brain Injury Case Report Kolaborasi Trauma from A to Z: Comprehensive Approaches for Integrated Professional Care WEBINAR SERIES II

35. THANK YOU Trauma from A to Z: Comprehensive Approaches for Integrated Professional Care WEBINAR SERIES II