Fri 30th Aug 2013
Session 2 / Talk 4
11:10 – 11:25
BROOKLYN 3
STUDENTS
Anna JACQUES
Natasha COVIC
ABSTRACT
At Auckland City Hospital in 2004, 200 traumatic brain injury cases presented in the hospital, 83% of these patients
survived due to effective treatment (Kejriwal & Civil, 2009). Traumatic Brain Injury (TBI) is a common
psychopathology encountered in the radiographic clinical setting. The severity of the TBI varies between patients
and the severity is indicated by the Glasgow Coma scale (GCS) (Rotheray, et al., 2011) . Those with more severe
TBl's commonly present in the resuscitation room in the emergency department with a GCS of less than eight (Office
of Communications and Public Liaison, 2012) . Although the scale is able to provide objective information about
their responses, the nature of the condition is usually unpredictable.
As radiographers, it is common to be involved in the patient's journey from their initial presentation in the
emergency department through to their follow up routine x-rays at a later date. The questions to be addressed in
this presentation are; how are we able to support the patient's successful recovery and how can we meet the
patient's needs in the x-ray department?
These questions will be explored through the humanistic psychological theory of Maslow's hierarchy of needs
(1954). In this twelve-minute presentation, each of the needs, defined by Maslow including; physiological,
psychological and self-actualization needs, will be investigated and related back to management of the patient in the
radiology department.
Although we may have a small overall influence on a patient's recovery, optimizing physiological and psychological
support in this environment may aid in the patient reaching Maslow's stage of self-actualization.
Separate Video File
Psychopathology
Traumatic brain Injury
What is a psychopathology?
“A study of mental disorders; another name for
abnormal psychology” (Colman, 2001, pg. 601)
Traumatic Brain Injury (TBI)
Trauma:
“injury that results when energy is transferred
from the environment to human tissue” (Emergency
Nurse Association, 2005, pg. 599)
Mechanisms:
-Open Head injury
-Closed Head injury
-Deceleration injury
(Traumatic Brain Injury, n.d)
Glasgow Coma Scale (GCS)
A scale that determines the neurological level of
consciousness of a person through evaluation of
motor, visual and verbal response.
Each category is rated out of 5
– Fully conscious person = 15
– Brain dead = 3
(Traumatic Brain Injury, n.d)
TBI
Mild
GCS 13-15
Symptoms:
Headache
Confusion
Light headedness
Ears ringing
Moderate
GCS 8-13
&
No conscious response
Worsening headache
Vomiting and Nausea
Convulsions/ seizures
Slurred speech
Loss of co-ordination
(Office of Communications and Public Liaison, 2012)
Severe
GCS <8
(Office of Communications and Public Liaison, 2012)
TBI
Patient Demographics:
(Schatz, n.d.)
(Kejriwal &
Civil, 2009)
MASLOW’S (1954) HIERACHY OF NEEDS
(The McGraw-Hill Companies, 2011)
(The McGraw-Hill Companies, 2011)
Fundamental Needs
Physiological needs
Nature of the Condition
- Consciousness
- Assistance in fulfilling basic needs
(Gentleman, Dearden, Midgley, & Maclean, 1993)
Treatment
- Airway, breathing, circulation
- Surgery
Management in Radiography Department
- Portable/Mobile CXR
- CT studies
- Careful handling – Bone flap, other injuries
(The McGraw-Hill Companies, 2011)
Fundamental Needs
Safety needs:
Nature of the Condition
-Disorders of Memory
-Disorders of Attention
-Disorders of Language
(Granacher, 2003)
Treatment
- Reassurance
- Acceptance of loved ones
Management in Radiography Department
-Regular CXR
-Encouragement and acceptance
-Keeping the patients dignity in tact
-Be aware of aggression and uncooperativeness
(The McGraw-Hill Companies, 2011)
Psychological needs
Belongingness and Esteem:
Nature of the Condition
-Apathy
-Agitation & frustration
-Depression
-Diminished self awareness
-Impulse control
(Walter, Angelle, Margaret, & Karen, 2005)
Treatment
-Pharmacological vs. Non-pharmacological
(Walter, Angelle, Margaret, & Karen, 2005)
Management in Radiography Department
- Encouragement
- Be accepting
- Keeping the patients dignity in tact
(The McGraw-Hill Companies, 2011)
Self actualization
Self-actualization traits:
-Being self-accepting of who they are
-“look at life objectively” (McLeod, 2007, para. 14)
-Deep appreciation of simple aspects of life
Personal Experience
(The McGraw-Hill Companies, 2011)
REFERENCES
Bullock, R., Chesnut, R., Ghajar, J., Gordon, D., Hartl, R., Newell, D., et al. (2006). Surgical Management of TBI. Neurosurgery , 1-3.
EdVisions. (2010). Belongingness. Retrieved August 10, 2012, from The Hope Survey: http://www.hopesurvey.org/what-were-measuring/belongingness
Emergency Nurse Association. (2005). Sheehy's Manual of Emergency Care. Missouri: Elsevier Mosby.
Gentleman, D., Dearden, M., Midgley, S., & Maclean, D. (1993). Guidelines for resuscitation and transfer of patients with serious head injury. Education and
Debate , 547-552.
Granacher, R. (2003). Traumatic Brain Injury: Methods for Clinical and Forensic Neuropsychiatric Assessment. London: CRC Press.
Kejriwal, R., & Civil, I. (2009). Time to definitive care for patients with moderate and severe traumatic brain injury—does a trauma system matter? The New
Zealand Medical Journal , 122, 40-46.
McLeod, S. (2007). Maslow's Hierarchy of Needs. Retrieved August 17, 2012, from Simply Psychology: http://www.simplypsychology.org/maslow.html
Office of Communications and Public Liaison. (2012, June 14). NINDS Traumatic Brain Injury Information Page. Retrieved August 10, 2012, from National
Institute of Neurological Disorders and Stroke: http://www.ninds.nih.gov/disorders/tbi/tbi.htm#What_is
Rotheray, K., Cheung, P., Cheung, C., Wai, A., Chan, D., Rainer, T., et al. (2011). The Glasgow coma scale (GCS) was originally described in trauma patients
and is a tool which allows standardized recording of a patient's level of consciousness. Resuscitation , 86-89.
Schatz, P. (n.d.). Traumatic Brain Injury Demographics. Retrieved August 10, 2012, from Schatz: http://schatz.sju.edu/neuro/epidem/demograph.html
The McGraw-Hill Companies. (2011). Theories of Development. Retrieved August 10, 2012, from Higher Education: http://highered.mcgrawhill.com/sites/dl/free/0073370428/666687/Crandell9e_ch02.pdf
Traumatic Brain Injury. (n.d). What are the Causes of TBI? Retrieved August 10, 2012, from Traumatic Brain Injury:
http://traumaticbraininjury.com/understanding-tbi/%20what-are-the-causes-of-tbi/
Walter, H., Angelle, S., Margaret, S., & Karen, H. (2005). Rehabilitation for Traumatic Brain Injury. New York: Oxford.
Weiten, W., Dunn, D., & Hammer, E. (2012). Psychology Applied to Modern Life. Belmont: Wadsworth.
Zollman, F. (2011). Manual of Traumatic Brain Injury Management. New York: Demos Medical Publication.