logging in or signing up the head injured pt in er siyervijay Download Post to : URL : Related Presentations : Share Add to Flag Embed Email Send to Blogs and Networks Add to Channel Uploaded from authorPOINT lite Insert YouTube videos in PowerPont slides with aS Desktop Copy embed code: (To copy code, click on the text box) Embed: URL: Thumbnail: WordPress Embed Customize Embed The presentation is successfully added In Your Favorites. Views: 34 Category: Entertainment License: All Rights Reserved Like it (0) Dislike it (0) Added: September 17, 2011 This Presentation is Public Favorites: 0 Presentation Description what to do in the ER when the head injured pt arrives Comments Posting comment... Premium member Presentation Transcript The head injured pt in ER: The head injured pt in ERAIM: AIM compromised brain: prevent further damage maintain biological environment Promote cellular recoveryHead Injuries Presenting To ER: Head Injuries Presenting To ER 35% hypoxic (PaO2 <65) 15% hypertensive (s BP <95 ) 12% anaemic ( Hct <30) Limb # 30%, Chest 29%, Abd 17%,Spine 6% ( Prof J D Miller, Edinburg )ABC FIRST: ABC FIRST Informants history is important. Collar Airway : clear/ blood/ mucus/ foreign body Oxygen by mask SaO2 Breathing : Intubation--RR<12,>24, low Vt increased resp effort Circulation: 18, 16 I .V . line, saline If low BP-HI unlikely radial absent BP<80, carotid <60 -CPR Abdomen, Pelvis, Thigh Foleys catheterSlide 5: GCS <8 ventilate ? Prevent hypoxic damage Resolves atelectasis Counteracts pulmonary edema Prevents aspiration Artifact free CT in restless patient Decreases ICP ( PaCo2 around 30 )Neurological exam: : Neurological exam: GCS mild 14-15, mod 9-13, severe <8 AVPU, pupils ( herniation), EOMS ( Br stem integrity),Motor. Local exam : ecchymosis –orbit,mastoid Any rhinorrhoea,otorrhoea. Mannitol 0.5-1.0 g/Kg if BP stable.Admit Whom?: Admit Whom? Altered sensorium Focal deficits Skull # Seizure, amnesia 30 mins Repeated vomiting ETOH Previous LOC, cranial surgeryLabs & Imaging: Labs & Imaging Once stable , investigate: Bloods, ABG, coag profile, Group, Xmatch CT Brain, Spine or Cx spine X ray CXR Seizure prophylaxis (Epsolin 1gm, Fosolin 1.5 Gm ) Spl Lines : CVP, ArterialSlide 9: Good documentation is essential after repeated clinical examination. I D marks List of injuries File x ray, CT, USG reports Consent for procedures and discuss with relatives – prepare them for the ordeal aheadSlide 10: Sub dural clotCranioplasty : CranioplastySlide 12: SUBDURAL HEMATOMAExtradural Hematoma: Extradural HematomaSlide 15: D E P R E S S E D # You do not have the permission to view this presentation. In order to view it, please contact the author of the presentation.
the head injured pt in er siyervijay Download Post to : URL : Related Presentations : Share Add to Flag Embed Email Send to Blogs and Networks Add to Channel Uploaded from authorPOINT lite Insert YouTube videos in PowerPont slides with aS Desktop Copy embed code: (To copy code, click on the text box) Embed: URL: Thumbnail: WordPress Embed Customize Embed The presentation is successfully added In Your Favorites. Views: 34 Category: Entertainment License: All Rights Reserved Like it (0) Dislike it (0) Added: September 17, 2011 This Presentation is Public Favorites: 0 Presentation Description what to do in the ER when the head injured pt arrives Comments Posting comment... Premium member Presentation Transcript The head injured pt in ER: The head injured pt in ERAIM: AIM compromised brain: prevent further damage maintain biological environment Promote cellular recoveryHead Injuries Presenting To ER: Head Injuries Presenting To ER 35% hypoxic (PaO2 <65) 15% hypertensive (s BP <95 ) 12% anaemic ( Hct <30) Limb # 30%, Chest 29%, Abd 17%,Spine 6% ( Prof J D Miller, Edinburg )ABC FIRST: ABC FIRST Informants history is important. Collar Airway : clear/ blood/ mucus/ foreign body Oxygen by mask SaO2 Breathing : Intubation--RR<12,>24, low Vt increased resp effort Circulation: 18, 16 I .V . line, saline If low BP-HI unlikely radial absent BP<80, carotid <60 -CPR Abdomen, Pelvis, Thigh Foleys catheterSlide 5: GCS <8 ventilate ? Prevent hypoxic damage Resolves atelectasis Counteracts pulmonary edema Prevents aspiration Artifact free CT in restless patient Decreases ICP ( PaCo2 around 30 )Neurological exam: : Neurological exam: GCS mild 14-15, mod 9-13, severe <8 AVPU, pupils ( herniation), EOMS ( Br stem integrity),Motor. Local exam : ecchymosis –orbit,mastoid Any rhinorrhoea,otorrhoea. Mannitol 0.5-1.0 g/Kg if BP stable.Admit Whom?: Admit Whom? Altered sensorium Focal deficits Skull # Seizure, amnesia 30 mins Repeated vomiting ETOH Previous LOC, cranial surgeryLabs & Imaging: Labs & Imaging Once stable , investigate: Bloods, ABG, coag profile, Group, Xmatch CT Brain, Spine or Cx spine X ray CXR Seizure prophylaxis (Epsolin 1gm, Fosolin 1.5 Gm ) Spl Lines : CVP, ArterialSlide 9: Good documentation is essential after repeated clinical examination. I D marks List of injuries File x ray, CT, USG reports Consent for procedures and discuss with relatives – prepare them for the ordeal aheadSlide 10: Sub dural clotCranioplasty : CranioplastySlide 12: SUBDURAL HEMATOMAExtradural Hematoma: Extradural HematomaSlide 15: D E P R E S S E D #