-
Normal pressure with a transducer
0-15
-
Clinical manifestations of increased ICP
- #1 decreased LOC
- BP increases to widen pulse pressure to deteriorated
- Pulse increases to weak and thready
- Decorticate and Decerebrate posturing
- HA
- N/V
-
Treatment goal for a person with increased ICP
to keep pressure below 20
-
Intraventricular catheter
put in the right side of the brain to measure ICP
-
Licox monitor and normal numbers
put in to ischemic brain tissue to measure O2 levels
normal-20-35
-
Interventions for a person with increased ICP
- HOB at 30
- head in neural position
- Intubation/mech. vent
- maintain cerebral perfusion
- mannitol to draw blood from brain cells
- nutritional therapy
-
How do you maintain cerebral perfusion
- fluids
- keep SBP between 100-160
- decrease cerebral metabolism by preventing seizures, sedate with propofol and keep patient cool
-
DVT prophylaxis for a person with increased ICP
SCD's/TEDS
-
Treatment priority for TBI
- #1 ABC
- #2 cervical spine precautions
-
Skull fx
- monitor neuro
- monitor loc
- watch for signs of increased ICP
-
S/S of basilar skull fx and treatment
s/s rhinorrhea, ottorhea, battle signs
treat-control and treat ICP, position FLAT in bed
-
Concussion.....monitor? teach family?
monitor neuro, LOC, pupil changes, vomiting?, worsening HA
- teach-wake up and ask hard question
- assess pupils and LOC q 2h for 24 hrs
- Tylenol only
- NO ASA, Sedatives or Alcohol
-
Contusion...describe and give treatment
brain bruise ....coup/counter coup...max edema will be 2-4 days after injury....mon. in hospital
treat-man ABC, control bleeding, watch for increaesd ICP and infections
-
Lacerations and treatment
tearing of brain tissue, possible hemorrhage, poor outlook
trt-ABC, control bleeding, infection?, increased ICP?
-
Diffuse axonal Injury....and treatment
seen as dots on a CT, usually from MVA and deceleration
treat-ABC, ICP control
-
Hematoma.....and treatment
brain bleed
- surgery
- ABC
- control bleeding
- watch ICP
-
Subarachnoid/Aneurysm
- control bleeding and ICP
- seizure precautions
- aneurysm precautions
- surgery clip and coil
Triple H therapy after coil/clip
-
Triple H therapy after Clip/Coil with aneurysm
- Hypertensive...keep BP high to increase brain perfusion
- Hypervolemic....lots of fluid to perfuse the brain
- Hemodilution....perfuses tissues
-
Aneurysm precautions
done pre surgery or if no surgery
- dim lights
- limit visitors
- decrease stimulation
- elevate HOB 30-45
- avoid valsalva
- give sedatives/analgesics
-
S/S of a brain tumor
- wake up with a HA...but decreases as walk around
- N/V
- seizures
- Dizziness/vertigo
- change in mental status
-
Sequence of tumor....best to worst to have
- glioma
- astrocytoma
- gliobastoma multiforme
-
Treatment for brain tumors
- early dx is crucial
- surgery when possible
- radiation
|
|