This will help maintain adequate brain perfusion. Assessment · Medical Management · Nursing Management · Care Coordination. On admission, a patient with severe TBI undergoes a brain CT scan. A follow-up scan is usually obtained within 24 hours as clinically indicated, for example, if the patient's neurological status changes or sudden ICP instability occurs.
In addition, many TBI patients require prolonged mechanical ventilation and may benefit from a tracheostomy. A tracheostomy helps reduce the risk of ventilator-associated pneumonia (VAP), as well as sucking secretions above the tracheostomy cuff, keeping the head of the bed at 30 degrees, and good oral care every 4 hours. Family members can spend endless hours at the bedside, watching anything that may indicate a change in the patient's condition. Prepare them for good days and bad days, and explain that patient progress can be slow.
Know that maintaining caregiver continuity can help build rapport with family members, whose coping skills may be impaired by fatigue, stress, fear, pain, anger, and frustration. As ordered, keep the head of the bed elevated at least 30 degrees with the patient's neck in neutral alignment, to promote venous drainage of the brain and reduce brain swelling. There are some common injuries of a patient with a head injury, including concussions, skull fractures, and scalp wounds. Focal contusions These injuries are often observed after falls and blows to the head when the brain tissue is bruised.
Search terms included nursing management, severe traumatic brain injury, severe brain injury, head injury, and treatment. In a closed or non-penetrating brain injury, the primary injury is the result of the direct impact of neuronal tissue against the skull or bone and the cutting of neurovascular structures due to rotational injury (see Mechanisms of head injury). Effective nursing management strategies for adults with severe traumatic brain injury (STBI) remain a notable problem and a difficult task for neurologists, neurosurgeons, and neuro nurses. Traumatic brain injury (TBI) is an injury that results from trauma to the head due to external physical forces.
The treatment of patients with TBI requires a multidisciplinary approach, close and frequent monitoring, and the judicious use of multiple treatments to reduce secondary brain injury and improve outcomes. The role of the nurse is extremely important because the skilled nurse cognitively manipulates many variables during a continuum of care and, if such tasks are performed skillfully and successfully, the incidence of secondary brain injury is reduced. The primary objective of nursing treatment in severe head injuries is to maintain adequate brain perfusion and improve cerebral blood flow to prevent cerebral ischemia and secondary brain injury. This article describes the types of brain injury and discusses the nursing care of patients with brain injury in the critical care setting, focusing on the management of elevated intracranial pressure.
Most patients with head injuries are treated in the emergency department; head injury is also often associated with other organ injuries.