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Head Trauma

A head injury is any sort of injury to your brain, skull, or scalp. This can range from a mild bump or
bruise to a traumatic brain injury. Common head injuries include concussions, skull fractures, and scalp
Head injuries may be either closed or open. A closed head injury is any injury that doesn’t break your
skull. An open (penetrating) head injury is one in which something breaks your scalp and skull and enters
your brain.
Types of Head Trauma

Hematoma- A hematoma is a collection, or clotting, of blood outside the blood vessels.

Hemorrhage- A hemorrhage is uncontrolled bleeding.

Concussion- A concussion occurs when the impact on the head is severe enough to cause brain injury.

Edema- Any brain injury can lead to edema, or swelling.

Skull fracture- Unlike most bones in your body, your skull doesn’t have bone marrow.

Diffuse axonal injury- A diffuse axonal injury (sheer injury) is an injury to the brain that doesn’t cause
bleeding but does damage the brain cells.


 Moderate brain injury is defined as a brain injury resulting in a loss of consciousness from 20
minutes to 6 hours and a Glasgow Coma Scale of 9 to 12
 Severe brain injury is defined as a brain injury resulting in a loss of consciousness of greater than
6 hours and a Glasgow Coma Scale of 3 to 8

Common causes of head injury include:

Accidents at home, work, outdoors, or while playing sports


Physical assault

Traffic accidents

Most of these injuries are minor because the skull protects the brain. Some injuries are severe enough to
require a stay in the hospital.

FAST- Focus Assessment with Sonography Trauma

Physical symptoms

 Loss of consciousness for a few seconds to a few minutes

 No loss of consciousness, but a state of being dazed, confused or disoriented

 Headache

 Nausea or vomiting

 Fatigue or drowsiness

 Problems with speech

 Difficulty sleeping

 Sleeping more than usual

 Dizziness or loss of balance

Sensory symptoms

 Sensory problems, such as blurred vision, ringing in the ears, a bad taste in the mouth or changes
in the ability to smell
 Sensitivity to light or sound

Cognitive or mental symptoms

 Memory or concentration problems

 Mood changes or mood swings

 Feeling depressed or anxious

X-ray. A diagnostic test that uses invisible electromagnetic energy beams to produce images of internal
tissues, bones, and organs onto film.
Computed tomography scan (also called a CT or CAT scan). A diagnostic imaging procedure that
uses a combination of X-rays and computer technology to produce horizontal, or axial, images
Electroencephalogram (EEG). A procedure that records the brain's continuous, electrical activity by
means of electrodes attached to the scalp.
agnetic resonance imaging (MRI). A diagnostic procedure that uses a combination of large magnets
Depending on the severity of the injury, treatment may include:
 Ice
 Rest
 Topical antibiotic ointment and adhesive bandage
 Observation
 Immediate medical attention
 Stitches
 Hospitalization for observation
 Moderate sedation or assistance with breathing that would require being placed on a breathing
machine, or mechanical ventilator or respirator
 Surgery
 Assess neurologic and respiratory status to monitor for sign of increased ICP and
respiratory distress
 Monitor and record vital sign and intake and output, hemodynamic variables, ICP, cerebral
perfusion pressure, specific gravity, laboratory studies, and pulse oximetry to detect early sign of
 Observe for sign of increasing ICP to avoid treatment delay and prevent neurologic
 Assess for CSF leak as evidenced by otorhea or rinorrhea. CSF leak could leave the patient
at risk for infection
 Assess for pain. Pain may cause anxiety and increase ICP
 Check cough and gag reflex to prevent aspiration
 Check for sign of diabetes insipidus (low urine specific gravity, high urine output) to
maintain hydration
 Administer I.V fluids to maintain hydration
 Administer Oxygen to maintain position and patency of endotracheal tube if present, to
maintain airway and hyperventilate the patient and to lower ICP
 Provide suctioning; if patient is able, assist with turning, coughing, and deep breating to
prevent pooling of secretions
 Maintain postion, patency and low suction of NGT to prevent vomiting
 Maintain seizure precautions to maintain patient safety
 Administer medication as prescription to decrease ICP and pain