| What should you attempt to maintain the PTs ETCO2 values ? | 35-45 mmHg |
| to address hypoxemia and hypotension, hyperventilate PT ETCO2 values at | 30-35 mmHg |
| some signs of cerebral herniation | Deteriorating GCS <9 with any of the following - dilated/ unreactive pupils, asymmetric pupillary response, asymmetric motor response or motor exam extension posturing or no response |
| if ETCO2 monitoring is unavailable how any bpm should you hyperventilate an adult that is showing hypoxemia and hypotension | approx. 20 bpm |
| if ETCO2 monitoring is unavailable what bpm should you hyperventilate an child that is showing hypoxemia and hypotension | approx. 25 bpm |
| if ETCO2 monitoring is unavailable how many bpm should you hyperventilate an infant <1yr that is showing hypoxemia and hypotension | approx. 30 bpm |
| GCS | Glasgow Coma Scale |
| lowest score a PT can get on the GCS | 3 |
| most common head # | Linar # at 80% |
| halo sign | blood mixed w/CSF from nose, mouth, ears |
| what is the wave the a bullet causes | cavitational wave |
| Retroauricular Ecchymosis | blood pooling below ear |
| Epidural Hematoma | bleeding between mater and skull, involves arterial bleed, ICP builds up quickly |
| Subdural Hematoma | More common - bleeding w/in meninges, usually venous bleed, complaints of focal symptoms , occurs above pia mater |
| Intracerebral Hematoma | Rupture blood vessel w/in brain, presentation similar to stroke |
| DAI | Diffuse Axonal Injury (stretching or tearing of nerve fibres w.subsequent axonal damage) |
| Hallmark of Concussion | They only improve |
| Retrograde amnesia | forgetting events prior to incident |
| Anterograde amnesia | forgetting events post incident |
| Reduced levels on CO2 in CSF | cerebral vasoconstriction - results in cerebral anoxia |
| As CO2 levels rise in CSF | cerebral arteries dilate - encourage blood flow - reduce hypercarbia |
| Already high ICP | causes classic hyperventilation and hypertension |
| Severe Diffuse Axonal Injury | Brainstem injury, significant mechanical disruption, high mortality rate |
| Presentation of Severe Diffuse Axonal Injury | prolonged unconsciousness, cushings reflex, decorticate or decerebrate posturing |
| if a PT responds with painful stimuli , confusion and localizes to pain ... what level of GCS would they be | 11 |
| If a PT responds with verbal stimuli, inappropriate words and abnormal flexion what level of GCS would they be | 9 |
| if the PT has spontaneous eye response, is oriented but has no motor functions what level of GCS would they be | 10 |
| if the PT responds to painful stimuli, uses uncomprehending sounds and has abnormal extension what GCS level would they be | 6 |
| what is the highest level of GCS can a PT get | 15 |
| Herniation | portion of the brain structure pushed through opening (foramen magnum), pressure on upper brain (vomiting, decreased LOC, pupil dilation), pressure on medulla oblongata ( disturbs respiration, BP, HR) |
| Cushing's Reflex | increasing BP, slowing pulse rate, erratic/irregular respirations |
| what kind of posturing would be present with an upper brainstem compression | decorticate posturing |
| what kind of posturing would be present with an middle brainstem compression | decerebrate posturing |
| PT is on spinal board with no indicated SMR and is conscious elevate the head ___ degrees | 30 |
| What is the best predictor for head injury | LOC |
| Apply constant pressure to the soft parts of the nares for ? minute intervals | 5 |
| can you remove a foreign object from eye | yes, only if the object is not on the cornea and is visible, accessible and easily removed |
| Hyphema | Blunt trauma to the anterior chamber of the eye, blood in front of iris or pupil |
| what medication is used for head injuries | Mannitol (Diuretic) |
