TBI
BY GHITA HAJJAMI
TBI
TBI= Mild traumaitc injury
Traumatic brain injury (TBI) is a nondegenerative,
noncongenital insult to the brain from an external mechanical force,
possibly leading to permanent or temporary impairment of cognitive,
physical, and psychosocial functions, with an associated diminished
or altered state of consciousness.
Definition:
MECHANISM OF ACTION OF
MILD TRAUMATIC INJURIES
• 1.
Trauma
• 2. Impaired neuronal communication
• 3. Brain metabolic imbalance
• 4. Excessive inflammation
POSSIBLE CAUSES
OF TBIS
• Falls
• Vehicle-related collisions
• Violence: gunshots, domestic
violence, child abuse, assaults
• Sports injuries: Concussions
• Explosiive blasts and other combat
injuries
• TBIs can also results from penetrating
wounds, severe blows to the head,
falls, and bodily collisions
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Headache
. Balance and sleep impairements
Behavioral changes
Psychological symptoms ( anxiety, Depression…)
Dizziness
Concentration Deficits
Confusion
Blurred vision
Light and Sound Sensivity
Fatigue
SYMPTOMS OF MILD TBI
Nausea
Amnesia
Loss of consciousness
SEVERE TBI COMPLICATIONS ( ALTERED CONSCIOUSNESS)
. Moderate to severe traumatic
brain injury can result in prolonged
or permanent changes in a person's
state of consciousness, awareness
or responsiveness. Different states
of consciousness
• Coma
• Vegetative state: Widespread
damage to the brain that can
result in a vegetative state
• Minimal conscious state: A
minimally conscious state is a
condition of severely altered
consciousness but with some
signs of self-awareness or
awareness of one's
environment.
• Brain death: No measurable
activity in the brainstem.
Irreversible.
SEVERE TBI
COMPLICATION PART 2
•
Seizures
•
Hydrocephalus: Fluid buildup in the brain
•
Blood vessels damages
•
Vertigo
•
Cognitive problems: Difficulty speaking/understandingwriting,
inability to organize ideas and thoughts.
•
Social problems: Dysarthria
•
Behavioral changes: self-control, risky behavior
•
Emotional changes: anger, insomnia, irritability…
•
Sensory problems: double vision, bitter taste, blind spots…
•
Degenerative brain diseases: Parkinson’s, Alzheimer’s…
DIAGNOSTIC TOOLS
• 1. Glasgow Coma Scale: 15-point test helps emergency
medical workers assess the initial severity of a brain injury
by checking the ability to follow directions and move their
eyes and limbs. The coherence of speech also provides
important clues.
• 2. imaging Tests: Computerized tomography (CT) scan, Magnetic
resonance imaging (MRI).
• 3. Intracranial pressure monitor
• 4. Questions
TREATMENTS
• Mild Injury: Rest, over the counter pain killers (tylenol), close monitoring, limit physical and cognitive
activities.
• Medications: Diuretics, Anti-seizures drugs, Coma-inducing drugs…
• Surgeries: Craniotomy…
• Rehabilitation: PT, OT, Social worker, Rehabilittion Nurse, TBI nurse specialist…
• Coping and support: support group, write things down…
NURSING ASSESSMENTS
•
Assessments
1. Disturbance in level of consciousness from slightly drowsy to unconscious.
2. Headache, vertigo, agitation, and restlessness.
3. Cerebrospinal fluid leakage at ears and nose, which may indicate skull fracture.
4. Contusions about eyes and ears indicating skull fractures.
5. Irregular respirations
6. Cognitive deficit
7. Pupillary abnormality
8. Sudden onset of neurologic deficits
9. Otorrhea indicating posterior fossa skull fracture
10. Rhinorrhea indicating anterior fossa skul fracture
NURSING INTERVENTIONS
1. Maintain ICP monitoring, as indicated, and report abnormalities.
2. Maintain patent airway; assist with intubation and ventilatory assistance is needed.
3. Turn the patient every 2 hours and encourage coughing and deep breathing.
4. Apply firm pressure over puncture site for subdural trap and observe for drainage and
dressing.
5. Suction the patient as needed.
6. Institute measures to prevent increased ICP or other neurovascular compromise.
7. Feed the patient as soon as possible after a head injury and administer histamine-2 blockers
to prevent gastric ulceration and hemorrhage from gastric acid hypersecretion.
8. If the patient is unable to swallow, provide enteral feedings after bowel sounds have
returned.
9. Elevate the head of the bed after feedings, and check residuals to prevent aspiration.
10.Monitor respiratory rate, depth, and pattern of respirations.
1. Traumatic Brain Injury Nursing Management – Rnpedia
2. Traumatic brain injury - Symptoms and causes - Mayo
Clinic
3. Traumatic brain injury - Diagnosis and treatment - Mayo
Clinic
4. Lecture 8 - Sport Concussions.pdf
Sources