Posted by BRAINY GROUP on May 31, 2001 at 14:27:09:
the management of head injury
Options
a) CT scan
b) neck collar
c) MRI
d) skull Xray
e) discharge home with head injury instructions
f) admit overnight for observation
g) suction of skull vault
h) antibiotics
i) intracranial pressure monitoring
1. following an alcoholic binge a 36 year old male falls and comes to Casualty with a cut in his temporal region his Glasgow Coma Scale is normal and his neck is cleared by the orthopedic SHO .
2. An 8 year old boy falls off a swing at his school. He is brought to Casualty by one of his teachers. He has a bruise over his right eye but the examination is otherwise normal. He is fully conscious with no history of blackouts since the accident. A skull Xray is performed, which is normal.
3. A young woman is involved in an RTA and is brought in with a Glasgow Coma Scale of 6 . A CT scan shows evidence of diffuse cerebral oedema but no evidence of haemorrhage. She has bilateral papilledema.
4. A young man is involved in a fight and suffers a blow to the back of the head. A skull Xray reveals a depressed fracture of the occiput. His Glasgow Coma Scale on admission is 14 but falls rapidly within an hour .
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