TRAUMA TRAUMA involving the central nervous system can be life threatening.Even if not life threatening, brain and spinal cord injury may result in major physical and pychological dysfunction and can alter the patient’s life completely.neurologic trauma affects the patient, family, the health care system, and society asa whole because of its major sequelae and the costs of acute and long term care of the patients with trauma to the brain and spinal cord. CRANIOCEREBRAL TRAUMA or HEAD TRAUMA • Involves injury to the scalp, skull and brain tissues. TYPES OF BRAIN INJURY 1. CONCUSSIONS- jarring of the brain and its sudden, foreceful contact with the rigid skull. 2. CONTUSSION- bruising. A structural alteration characterized by extravasation of blood cells. 3. LACARATION-tearing of tissues caused by a sharp fragment or object. ASSESSESSMENT: Signs and symptoms of increased ICP CSF leakage from ears and nose Battle sign MANAGEMENT: Care of the client with IICP Monitor drainage from ears and nose Monitor for signs and symptoms of meningitis, atelectasis, pneumonia and UTI SPINAL CORD INJURY CAUSES: - falls - diving - vehicular accidents EFFECTS: - paralysis - loss of reflexes - loss of sensory function - loss of motor function
- autonomic dysfunction CERVICAL SCI - increase C4- fatal - quadriplegia - respiratory muscle paralysis - bowel and bladder retention THORACIC SCI - PARAPLEGIA - Poor control of upper trunk - bowel and bladder retention LUMBAR SCI - paraplegia - bowel and bladder retention SACRAL SCI - increased S2 - with retention and no ejaculation. - S2 and s4 - No erection and no ejaculation - Increased lesion- increased probability to perform sexually - Decreased lesion- decreased probability to perform sexually - Paraplegia - Bowel and bladder incontinence MANAGEMENT - respiratory function is the first priority esp. in cervical; SCI - immobilize in a flat firm surface - cervical collar if cervical injury is suspected - transport client as a unit - traction, cast, surgery