{"id":4961,"date":"2014-01-01T21:02:45","date_gmt":"2014-01-01T21:02:45","guid":{"rendered":"http:\/\/phosdev.com\/todaysveterinarypractice\/?p=4961"},"modified":"2022-02-16T19:06:40","modified_gmt":"2022-02-16T19:06:40","slug":"nursing-care-triage-for-head-trauma-patients","status":"publish","type":"post","link":"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/emergency-medicine-critical-care\/nursing-care-triage-for-head-trauma-patients\/","title":{"rendered":"Nursing Care & Triage for Head Trauma Patients"},"content":{"rendered":"

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Oriana D. Scislowicz, BS, LVT<\/span><\/em><\/p>\n

This article covers the gamut from triage and emergency assessment, initial stabilization, physical examination, diagnosis, surgical and\/or medical therapy, and monitoring of the patient.<\/span><\/p>\n

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Although animals with head trauma are frequently presented to emergency hospitals, veterinary teams at general practices encounter these patients as well. Therefore, understanding triage and emergency assessment and treatment of head trauma is important for every veterinary professional in practice.<\/span><\/p>\n

TYPES OF HEAD TRAUMA<\/b><\/span><\/h2>\n

Head trauma often results from falls, gunshot wounds, car crashes, and altercations with other animals.<\/span><\/p>\n

When assessing a head trauma patient, it is helpful to understand the differences between primary<\/i> and secondary<\/i> head injuries.<\/span><\/p>\n

Primary head trauma<\/b><\/span> immediately follows impact and consists of direct damage to the brain parenchyma, such as contusions, lacerations, and diffuse axonal injury. There also may be damage to blood vessels in the brain, which can cause subsequent intracranial hemorrhage and vasogenic edema (Table 1<\/b>).<\/span><\/p>\n

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Secondary injuries<\/b><\/span> result from increased intracranial pressure\u2014the pressure exerted within the skull by hemorrhage and swollen brain tissue\u2014that causes further damage by stimulating various biochemical pathways. The primary mediators that become involved in this injury include nitric oxide, glutamate, and oxygen free radicals.<\/span>1<\/sup><\/span><\/p>\n

When inflammation and bleeding occurs within the brain, cerebrospinal fluid\u2014the fluid that bathes the spinal column and brain\u2014and intracranial venous blood are directed out of the skull and back into the body in order to compensate for the other space occupying lesions. If the body has already exhausted all of its compensatory mechanisms and intracranial pressure continues to rise, intracranial hypertension can develop.<\/span>2<\/sup><\/span><\/p>\n

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INITIAL STABILIZATION<\/b><\/span><\/h2>\n
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  1. <\/b>Stabilize the ABCs <\/b><\/span>(airway, breathing, and circulation)\u2014the most important step upon a head trauma patient\u2019s admittance to the hospital. Ensure that the airway is patent by:<\/span>\n