Exam (elaborations) Close Head Injury Case Study

Closed head injury Scenario Y.W. is a 23-year-old male student from Thailand studying electrical engineering at the university. He was ejected from a moving vehicle, which was traveling at 70 mph. His injuries includ ...

Closed head injury Scenario Y.W. is a 23-year-old male student from Thailand studying electrical engineering at the university. He was ejected from a moving vehicle, which was traveling at 70 mph. His injuries included a severe closed head injury with an occipital hematoma, bilateral wrist fractures, and a right pneumothorax. During his neurologic intensive care unit (NICU) stay, Y.W. was intubated and placed on mechanical ventilation, had a feeding tube inserted and was placed on tube feedings, had a Foley catheter placed, and had a central venous catheter (CVC) inserted for medication administration. 1. Differentiate between primary and secondary head injury.  A primary head injury means tissue damage resulting from the traumatic impact and can include the scalp, skull, or brain tissue itself. On the other hand, Secondary head injury is an event that complicates the primary head injury and causes further damage resulting in a worse outcome and increased risk of death. They include intracranial hemorrhage, cerebral edema, increased ICP, ischemic brain injury and infection. 2. Why is increased intracranial pressure (ICP) clinically important? Normal ICP is 10-15 mm Hg.  A sustained increased ICP of greater than 15 mm HG means decreased blood flow to the brain tissue and decreased O2 delivery. If sustained it can lead to brain anoxia, atrophy, herniation, and death. 3. Identify at least six signs and symptoms of increased ICP.  altered or decreased LOC  restlessness  drowsiness  worsening headache  blurred vision  weakness or sensory motor changes  nausea and vomiting  widened pulse pressure