NERVOUS SYSTEM PROBLEMS CHAPTER 8 To assess the victim’s condition quickly & calmly To carry out any treatment necessary to improve the victim’s condition To comfort and reassure the victim To protect the victim from further injury To look for & treat any injuries associated with the condition To call 911 for emergency help if you suspect a serious illness or injury To be aware of your own needs

The Nervous System Body’s information- gathering storage & control system Brain, spinal cord & network of nerves that carry electrical impulses between the brain & the body Two main parts 1.Central Nervous System (CNS) 1.Brain & spinal cord 2.Peripheral Nervous System 1.Nerves Autonomic (involuntary) System Controls body functions= digestion, HR & breathing

Central Nervous System (CNS) Contains billions of interconnected nerve cells (neurons) Enclosed by three membranes called meninges Cerebrospinal fluid- flows around the brain & spinal cord Shock absorber Provides oxygen & nutrients Removes waste products 1.Brain: 1.Cerebrum- thought, sensation & conscious movement 2.Cerebellum- movement, balance, posture 3.Brain stem- controls basic functions (breathing) 2.Spinal cord- convey signals between the brain and peripheral nervous system

Peripheral Nervous System Consists of two sets of paired nerves: 1.Cranial nerves (12) 2.Spinal nerves (31)

Autonomic Nervous System Some of the cranial nerves & several spinal nerves Concerned with vital body functions Breathing HR Two parts: 1.Sympathetic 1.Releases hormones that raise HR & reduce blood flow to the skin & intestines 2.Parasympathetic 1.Releases hormones with a calming effect

Impaired Consciousness Conscious= fully aware & awake Unconscious= unresponsive to any stimulus Impaired consciousness= anything less than fully conscious AVPU Scale- used to assess conscious levels A- alert V-voice P- pain U- unresponsive Make a note of your findings at each assessment

Causes of Impaired Consciousness Structural damage to the brain Head injury Brain tumor Lack of nutrients (oxygen & glucose) reaching the brain Stroke Shock Fainting Heart attack 1.AVPU; if person is “groggy” support in comfortable resting position; call Unconscious= assess for normal breathing; begin CPR if not breathing; record vital signs; treat any injuries

Head Injury All head injuries are potentially serious May produce concussion Clear/ watery blood leaking from the ear/ nose & bruising around the eyes & ears= SERIOUS injury Aims: Address & monitor victim Caution: Support victim’s head (risk of cervical injury) Unconscious & not breathing CPR Conscious sit down in comfortable position Cold compress for head Monitor condition for 24 hours Call 911 if: confused, headache, double vision (diplopia), vomiting

Recognizing a Potentially Serious Head Injury Increasing drowsiness Worsening headache Confusion/ strange behavior/ loss of memory/ vomiting Weakness in an arm, leg or speech difficulties Dizziness, loss of balance, or seizures Visual problems Blood/ clear fluid Breathing problems

Concussion Produces temporary disturbance of normal brain activity Should be monitored & advised to obtain medical help Always suspect cervical injury Mechanism: Blow to the head which “shakes” the brain within the skull

Compression of the Brain Build-up of pressure usually caused by a head injury or: Stroke Infection Brain tumor Swelling VERY serious; usually requires surgery

Seizures in Adults Convulsion; consists of involuntary contractions of many muscles in the body due to a disturbance in the electrical activity of the brain Usually result in loss/ impairment of consciousness Most common cause= Epilepsy Other causes: Head injury Brain- damaging disease Shortage of oxygen/ glucose Poisons (alcohol/ drugs)

Epileptic Seizures Recurrent, major disturbances of brain activity Sudden or dramatic Following sequence is common: Rigid; arching back Breathing may become difficult (cyanosis) & face/ neck may become red & puffy Convulsion movements begin; saliva may appear; blood may appear Possible loss of bladder control Muscles relax & breathing becomes normal Afterwards victim may feel tired and fall into a deep sleep May have brief warning period (aura) Strange feeling or particular smell/ taste 1.Make space around victim; ask bystanders to move away; remove potentially dangerous items; note time the seizure started 2.Protect victim’s head from objects; loosen tight clothing around neck 3.When convulsions have ceased- check ABCs- place in recovery position 4.Monitor/ record vital signs

Absence Seizures Mild form of epilepsy Small seizures during which they appear distant & unaware of their surroundings Tend to affect children more than adults Unlikely to be any convulsive movements or loss of consciousness Full seizure may follow Recognition: Sudden “switching off” (blank stare) Slight/ localized twitching of the lips, eyelids, head or limbs 1.Help victim sit down in quiet place- make space; remove dangerous items 2.Talk to victim calmly 3.First episode= send to hospital

Seizures in Children Often a result of high temperature Throat infection Ear infection Always seek medical advise for the child to rule out ay serious condition 1.Place pillows/ soft padding around the child- DO NOT restrain child in any way 2.If caused by fever- cool by removing clothes/ bedding 3.Maintain an open airway-recovery position 4.Monitor/ record vital signs

Spinal Injury Most serious risk associated with spinal injury is damage to the spinal cord Loss of power/ sensation below injured area Spinal cord/ nerve root can suffer temporary damage if pinched by displaced/ dislocated discs or by fragments of broken bone Spinal cord partly/ completely severed damage may be permanent Most important indicator is MOI Suspect injury if abnormal forces have been exerted on back/ neck Must avoid unnecessary movement of head, neck and spine

Spinal Injury Any of the following incidents should alert you to a possible spinal injury: 1.Falling from a height 2.Falling awkwardly 3.Diving into a shallow pool 4.Falling from a horse 5.Football tackle or misplaced hit 6.Sudden deceleration 7.A heavy object falling 8.Injury to the head

Stroke Is a medical emergency that occurs when the blood supply to the brain is disrupted 3 rd most common cause of death in the US Majority caused by a clot in the blood vessel that blocks the flow of blood to the brain Use the FAST guide: F- facial weakness A- arm weakness S- speech problems T- time to call 911

Stroke 1.Look at the victim’s face- ask him to smile 2.Ask victim to raise both arms 3.Find out if he can speak 4.Call for emergency help 5.Keep victim comfortable and supported 6.Monitor/ record vital signs