Management of Head and Neck Injury

1159 Words5 Pages
In the case study provided, the 82 year old unconscious female needs an assessment and a differential diagnosis completed so that the paramedics know how to treat and to determine if the patient is time or transport critical. A differential diagnosis comes from the paramedics’ education and the patient’s history, current vitals signs, and pertinent knowledge gained from those at the scene. The paramedic must, after the differential diagnosis, have an understanding of the pathophysiological process and how this affects the patient. The patient has an Acquired Brain Injury (ABI), which is an injury occurring after birth (State Government of Victoria, 2013). The patient also has traumatic brain injury (TBI), which is caused by a physical force resulting in damage to the brain. One aspect of finding a differential diagnosis is an understanding of the mechanism and pattern of injury (MOI/POI). When looking at brain injuries the MOI/POI can be separated into two parts, primary and secondary injuries. Primary injury is the one that occurs at that moment of impact, i.e. the table that causes a visible hematoma (Rosenfeld, 2012). The secondary injury is the cascade of events and medical conditions, which can aggravate the primary injury (Hughes & Cruickshank, 2011). In this patients case it is the chronic subdural haematoma that has caused secondary conditions, such as Cushing reflex and this has caused the patient to become unconscious. Looking at the patients’ vital signs they are steadily deteriorating, and are worrying for an 82 year old female. The patients’ heart rate starts low but in the normal range however in the time of 15 minutes it drops to 54bpm, which is within the range of bradicardia (Curtis, Ramsden & Lord, 2011). T... ... middle of paper ... ...a Pty Ltd., (2014). Avapro HCT. Retrieved from https://www.mimsonline.com.au National Health Service (NHS)., (2013). Causes of subdural haematoma. Retrieved http://www.nhs.uk/Conditions/Subdural-haematoma/Pages/Causes.aspx Plaha, P., Malhotra, Dr., Heuer, Dr., & Whitfield, P. (2008). Management of Chronic Subdural Haematoma. Advances in Clinical Neurosceience (ANCR), 8 (5), 12-15. Retrieved from http://www.acnr.co.uk Professional Health Systems., (2014). Vital Signs Table. Retrieved from http://prohealthsys.com/site/resources/assessment/physical-assessment/vital-signs/vital_signs_table/ Rosenfeld, V.J., (2012). Practical management of head and neck injury. Chatswood, N.S.W : Elsevier Australia State Government of Victoria., (2013). Acquired brain injury. Retrieved from http://www.betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/Acquired_brain_injury?open
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