Presented by Qassim AL-abody Master in adult nursing Head injury Presented by Qassim AL-abody Master in adult nursing

Definition Is any sort of injury to brain, skull, or scalp. This can range from a mild bump or bruise to a traumatic brain injury. Head injuries may be either closed or open.

Major types of head injuries Hematoma A hematoma is a collection, or clotting, of blood outside the blood vessels. It can be very serious if a hematoma occurs in the brain. The clotting can cause pressure to build inside the skull, which causing can lose consciousness or result in permanent brain damage.

2. Hemorrhage A hemorrhage is uncontrolled bleeding. There can be bleeding in the space around the brain, which is a subarachnoid hemorrhage, or bleeding within the brain tissue, which is an intracerebral hemorrhage. The severity of intracerebral hemorrhages depends on how much bleeding there is, but over time any amount of blood can cause pressure to build.

3. Concussion :- A concussion is a brain injury that occurs when the brain bounces against the hard walls of the skull. Generally speaking, the loss of function associated with concussions is temporary.

4. Edema :- Any brain injury can lead to edema, or swelling 4. Edema :- Any brain injury can lead to edema, or swelling. Many injuries cause swelling of the surrounding tissues, but it’s more serious when it occurs in the brain. The skull can’t stretch to accommodate the swelling, which leads to a buildup of pressure in the brain. This can cause the brain to press against the skull.

5. Skull fracture Unlike most bones in the body, the skull doesn’t have bone marrow. This makes the skull very strong and difficult to break. A broken skull is unable to absorb the impact of a blow, making it more likely that there will also be damage to the brain.

6. Diffuse axonal injury A diffuse axonal injury, or sheer injury, is an injury to the brain that doesn’t cause bleeding but does damage the brain cells. The damage to the brain cells results in them not being able to function and can also result in swelling, causing more damage.

Causes of head injury 1- Motor vehicle accidents 2- Falls from high 3- Physical assaults 4- Sports-related accidents

Signs and symptoms of head injury 1- a headache 2- a spinning sensation 3- mild confusion 4- nausea 5- temporary ringing in the ears 6- a loss of consciousness 7- seizures

7. vomiting 8. balance or coordination problems 9 7. vomiting 8. balance or coordination problems 9. serious disorientation 10. an inability to focus the eyes 11. abnormal eye movements 12. a loss of muscle control 13. a persistent or worsening headache 14. memory loss 15. changes in mood

Diagnosis test for head injury clinical feature physical examination laboratory study e.g. blood test head X-ray CT –SCAN MRI

Management of head injuries Medicine treatment 1. Mild injury Mild traumatic head injuries usually require no treatment other than rest and over-the-counter pain relievers to treat a headache. A person with a mild traumatic head injury usually needs to be monitored closely at home for any persistent, worsening or new symptoms.

2. Immediate Emergency care:- for moderate to severe traumatic head injuries focuses on making sure the person has an adequate oxygen and blood supply, maintaining blood pressure, and preventing any further injury to neck. People with severe injuries may also have other injuries that need to be addressed

B. Medications: use medications to limit secondary damage to the brain immediately after an injury may include: Diuretics. These drugs reduce the amount of fluid in tissues and increase urine output. Diuretics, given intravenously to people with traumatic brain injury, help reduce pressure inside the brain. Anti-seizure drugs. People who've had a moderate to severe traumatic brain injury are at risk of having seizures during the first week after their injury. An anti-seizure drug may be given during the first week to avoid any additional brain damage that might be caused by a seizure. Additional anti-seizure treatments are used only if seizures occur.

. Coma-inducing drugs. Use drugs to put people into temporary comas because a comatose brain needs less oxygen to function. This is especially helpful if blood vessels, compressed by increased pressure in the brain, are unable to deliver the usual amount of nutrients and oxygen to brain cells.

C. Surgery: Emergency surgery may be needed to minimize additional damage to brain tissues. Surgery may be used to address the following problems Removing clotted blood (hematomas). Bleeding outside or within the brain can result in a collection of clotted blood (hematoma) that puts pressure on the brain and damages brain tissue? Repairing skull fractures. Surgery may be needed to repair severe skull fractures or to remove pieces of skull in the brain. Opening a window in the skull. Surgery may be used to relieve pressure inside the skull by draining accumulated cerebral spinal fluid or creating a window in the skull that provides more room for swollen tissues.

Pertussis (Also known as whooping cough or 100-day cough) is a highly contagious bacterial disease. Initially, symptoms are usually similar to those of the common cold .This is then followed by weeks of severe coughing fits, following a fit of coughing, a high-pitched whoop sound or gasp may occur as the person breathes in. The coughing may last for 10 or more weeks

Causes and Incubation period of pertussis The time between exposure and the development of symptoms is on average 7–14 days (range 6–20 days), rarely as long as 42 days. Pertussis is caused by the bacterium Bordetella pertussis. It is an airborne disease which spreads easily through the coughs and sneezes of an infected person

Signs and symptoms paroxysmal cough Fever, vomiting after coughing. subconjunctival hemorrhages, Sneezing, or a runny nose. Urinary incontinence Vertebral artery dissection Hernias Pneumothorax. Cyanosis Rib fractures

Treatment of pertussis 1. Following the schedule for giving antibiotics exactly as prescribed. 2. Treatment underlying cause such as cough and fever 3. Keeping the home free from irritants – as much as possible – that can trigger coughing, such as smoke, dust, and chemical fumes. 4. Using a clean, cool mist vaporizer to help loosen mucus and soothe the cough. 5. Practicing good hand washing. 6. Encouraging patient to drink plenty of fluids, including water, juices, and soups, and eating fruits to prevent dehydration (lack of fluids).

7. Report any signs of dehydration to doctor immediately. These include Dry and sticky mouth, Sleepiness or tiredness, or thirst. Decreased urination, few or no tears when crying, Muscle weakness, headache Dizziness or lightheadedness. 8. Encouraging the patient to eat small meals every few hours to help prevent vomiting

Complications of pertussis 1. Dehydration or weight loss due to feeding difficulties in infant 2. Abdominal hernias 3. Pneumonia 4. Slowed or stopped breathing 5. Bruised or cracked ribs 6. Seizures 7. Brain damage