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. The evidence obtained from 38 reviewed publications on the management of patients with STBI is beneficial to all neuronurses who care for patients with STBI. This descriptive synthesis adds to the scientific evidence in the field of nursing care. Nursing care for patients with TBI starts from initial management to rehabilitation care.
The main objectives of pre-hospital treatment are to prevent hypoxia and hypotension, since these systemic aggressions lead to secondary brain damage. When assessed before hospital admission, saturation. Upon 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 bedside, observing 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. However, be careful when explaining such a “wake-up assessment” to family members; inform them that the patient does not actually wake up and return to a pre-injury condition. In 1995, BTF developed the first BIT management guidelines based on the recommendations of an international panel of experts. For patients who have a low risk of intracranial injury, there are two externally validated rules about when to get a CT scan of the head after a traumatic brain injury.
A patient with traumatic brain injury may require surgery to stop bleeding or create more space in the skull for the inflamed brain. Patients with a GCS less than 9 often require mechanical ventilation, tracheostomy, and a feeding tube. The objectives of the study are to analyze relevant research and available clinical studies that demonstrate nursing management strategies for adults with STIs and to synthesize available evidence based on the review. Focal contusions: These injuries are often seen after falls and blows to the head when the brain tissue is bruised.
Therefore, serum electrolytes and osmolality should be monitored regularly, and the nurse is particularly alert to the development of sodium imbalances. Effective nursing management strategies for adults with severe traumatic brain injury (STBI) remain a notable problem and a difficult task for neurologists, neurosurgeons and neuronurses. Traumatic brain injury is a major public health problem, accounting for thousands of revenues each year and costing the health system billions of dollars. A male patient is admitted to your ward after a traffic accident and has suffered a head injury.
As the volume and condition of the patient's blood pressure stabilize and intracranial hypertension is resolved, the need for aggressive volume management and vasoactive drugs decreases; gradually, these interventions are eliminated. Secure all devices and equipment and keep them out of sight and reach of the patient; even a seemingly simple device can pose a danger to a confused or agitated patient. A list of justified indications and scientific grounds for nursing management of these patients is constantly evolving. ICU nurses play a vital role in managing these patients; from providing basic medical care, monitoring, DVT, and ulcer prophylaxis to monitoring the patient for complications.