Head Injury

What are the signs and symptoms of Head Injury?

How will you maintain a head injury chart based on the vital signs?

Write the nursing management of an adult male unconscious patient

admitted with head injury.

Symptoms

Localized pain - persistent in fractures

LOC - Loss of Consciousness

Altered sensorium and behaviour

Giddiness

Vomiting

Persistent severe headache

Bleeding from the ears, nose and throat

Signs

Bleeding under the conjuntiva

Ecchymosis over the mastoid (Battle's sign)

Watery discharge mixed with blood from the ear or nose - CSF - otorrhoea - rhinorrhoea

- blood stain surrounded by a yellowish stain = "halo" sign.

In severe injuries like contusion of the brain -

patient lies motionless

faint pulse

shallow respiration

cool pale skin

involuntary evacuation of bladder and bowel

aroused with effort but soon slips back into unconsciousness

blood pressure and temperature subnormal - picture like shock

in chronic subdural haematoma - fluctuating consciousness - projectile vomiting

Nursing Management of an adult unconscious patient (male) with head injury

Maintain the vital signs chart
Maintain airway - position to drain oral secretions -
head of the bed elevated by 30 degress - to decrease ICP
effective suctioning of the airway - the endotracheal tube etc.
guard against aspiration and respiratory insufficiency
blood gas analysis
monitor mechanical ventilation
monitor fluid and electrolyte balance
promote adequate nutrition
prevent injury from agitation during recovery - padded limb parts - padded rails etc.
minimize environmental stimuli - avoid noise - visitors - speak calmly
take measures to prevent bed sores
condom drainage for urine