🥊Approximately half of severely head-injured patients will need surgery to remove or repair hematomas (ruptured blood vessels) or contusions (bruised brain tissue). Disabilities resulting from a TBI depend upon the severity of the injury, the location of the injury, and the age and general health of the individual. Some common disabilities include problems with cognition (thinking, memory, and reasoning), sensory processing (sight, hearing, touch, taste, and smell), communication (expression and understanding), and behavior or mental health (depression, anxiety, personality changes, aggression, acting out, and social inappropriateness). More serious head injuries may result in stupor, an unresponsive state, but one in which an individual can be aroused briefly by a strong stimulus, such as sharp pain; coma, a state in which an individual is totally unconscious, unresponsive, unaware, and unarousable; vegetative state, in which an individual is unconscious and unaware of his or her surroundings, but continues to have a sleep-wake cycle and periods of alertness; and a persistent vegetative state (PVS), in which an individual stays in a vegetative state for more than a month.
🤺Anyone with signs of moderate or severe TBI should receive medical attention as soon as possible. Because little can be done to reverse the initial brain damage caused by trauma, medical personnel try to stabilize an individual with TBI and focus on preventing further injury. Primary concerns include insuring proper oxygen supply to the brain and the rest of the body, maintaining adequate blood flow, and controlling blood pressure. Imaging tests help in determining the diagnosis and prognosis of a TBI patient. A blood test to evaluate mild traumatic brain injury in adults was approved by the U.S. Food and Drug Administration in February 2018. People with mild to moderate injuries may receive skull and neck X-rays to check for bone fractures or spinal instability. For moderate to severe cases, the imaging test is a computed tomography (CT) scan. Moderately to severely injured patients receive rehabilitation that involves individually tailored treatment programs in the areas of physical therapy, occupational therapy, speech/language therapy, physiatry (physical medicine), psychology/psychiatry, and social support.
⚽TBI SYMPTOMS
Symptoms vary greatly depending on the severity of the head injury, but may include any of the following:
- Vomiting
- Lethargy
- Headache
- Confusion
- Paralysis
- Coma
- Loss of consciousness
- Dilated pupils
- Vision changes (blurred vision or seeing double, not able to tolerate bright light, loss of eye movement, blindness)
- Cerebrospinal fluid (CSF) (which may be clear or blood-tinged) coming out of the ears or nose
- Dizziness and balance problems
- Breathing problems
- Slow pulse
- Slow breathing rate, with an increase in blood pressure
- Ringing in the ears or changes in hearing
- Cognitive difficulties
- Inappropriate emotional responses
- Speech difficulties (slurred speech, inability to understand and/or articulate words)
- Difficulty swallowing
- Body numbness or tingling
- Droopy eyelid or facial weakness
- Loss of bowel control or bladder control
If a TBI is suspected, call 911 immediately or take the person to an emergency room.
🏒MEDICAL TREATMENT
At the present time, there is no medication or "miracle treatment" that can be given to prevent nerve damage or promote nerve healing after TBI. The primary goal in the ICU is to prevent any secondary injury to the brain. The "primary insult" refers to the initial trauma to the brain, whereas the "secondary insult" is any subsequent development that may contribute to neurological injury. For example, an injured brain is especially sensitive and vulnerable to decreases in blood pressure that might otherwise be well tolerated. One way of avoiding secondary insults is to try to maintain normal or slightly elevated blood pressure levels. Likewise, increases in ICP, decreases in blood oxygenation, increases in body temperature, increases in blood glucose and many other disturbances can potentially worsen neurological damage. The prevention of secondary insults is a major part of the ICU management of head-injured patients.
Various monitoring devices may assist health care personnel in caring for the patient. Placement of an ICP monitor into the brain itself can help detect excessive swelling of the brain. One commonly used type of ICP monitor is a ventriculostomy, which is a narrow, flexible, hollow catheter that is passed into the ventricles, or fluid spaces in the center of the brain, to monitor ICP and to drain CSF if ICP increases. Another commonly used type of intracranial pressure monitoring device involves placement of a small fiberoptic catheter directly into the brain tissue. Additional catheters may be added that measure brain temperature and brain tissue oxygenation. Placement of an oxygen sensor into the jugular vein can detect how much oxygen in the blood is arising from the brain and can indicate how much oxygen the brain is using. This may be related to the degree of brain damage. Many other monitoring techniques are currently under investigation to see if they can help to improve outcome after head injury or provide other critical information about caring for TBI patients.
Buy and use helmets or protective head gear approved by the American Society for Testing and Materials (ASTM) for specific sports 100 percent of the time. The ASTM has vigorous standards for testing helmets for many sports; helmets approved by the ASTM bear a sticker stating this. Helmets and head gear come in many sizes and styles for many sports and must properly fit to provide maximum protection against head injuries. In addition to other safety apparel or gear, helmets or head gear should be worn at all times for:
- Baseball and Softball (when batting)
- Cycling
- Football
- Hockey
- Horseback Riding
- Powered Recreational Vehicles
- Skateboards/Scooters
- Skiing
- Wrestling
Head gear is recommended by many sports safety experts for:
- Bull riding
- Martial Arts
- Pole Vaulting
- Soccer
- Vintage Motor Sports
- Supervise younger children at all times, and do not let them use sporting equipment or play sports unsuitable for their age. Do not let them use playgrounds with hard surface grounds.
- Follow all rules and warning signs at water parks, swimming pools, and public beaches.
- Do not dive in water less than 12 feet deep or in above-ground pools. Check the depth and check for debris in the water before diving.
- Wear appropriate clothing for the sport.
- Do not wear any clothing that can interfere with your vision.
- Do not participate in sports when you are ill or very tired.
- Obey all traffic signals and be aware of drivers when cycling or skateboarding.
- Avoid uneven or unpaved surfaces when cycling, skateboarding, or in-line skating.
- Perform regular safety checks of sports fields, playgrounds and equipment.
- Discard and replace sporting equipment or protective gear that is damaged.
- Never slide head-first when stealing a base.
- Wear a seatbelt every time you drive or ride in a motor vehicle.
- Never drive while under the influence of drugs or alcohol or ride as a passenger with anybody else who is under the influence.
- Keep firearms unloaded in a locked cabinet or safe, and store ammunition in a separate, secure location.
- Remove hazards in the home that may contribute to falls. Secure rugs and loose electrical cords, put away toys, use safety gates, and install window guards. Install grab bars and handrails if you are frail or elderly.
BLOGGER: Egypt Assanti
ESD Baroness
{aka} Big Sister Southern Heat 🏉
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