Nursing measures for head trauma

Everyone knows that hands and brain are the most important organs of the human body. Hands help us work, and the brain helps us think. The brain can be said to be the command organ of the body and is very important. However, in many cases, head injuries may occur due to external forces and other reasons. Once such symptoms occur, be sure to go to the hospital for treatment in time. The following is a brief introduction to the care measures for head injuries.

Scalp lacerations are mostly caused by sharp or blunt objects. The size and depth of the cracks vary, with neat or irregular wound edges, and are sometimes accompanied by skin contusions or defects. Because the scalp is rich in blood vessels, ruptured blood vessels are not easy to close on their own. Even small wounds can cause severe bleeding, and may even cause shock.

1. What is scalp hematoma?

Scalp hematomas are mostly caused by blunt trauma to the scalp and are classified according to the relationship between the various layers of the scalp in which they occur (Figure 4-1).

(1) Subcutaneous hematoma: Because the subcutaneous tissue is closely connected to the skin layer and the galea aponeurotica layer, the hematoma in this layer is not easy to spread and the range is relatively limited. The soft tissue around the hematoma is swollen and feels sunken when touched, which can easily be confused with a depressed fracture. Sometimes a skull X-ray is required to confirm the diagnosis.

(ii) Subgaleal hematoma: caused by rupture of small arteries or conducting vessels within this layer. The subgaleal layer is loose, and the hematoma can easily expand or even spread to the entire subgaleal layer, containing up to hundreds of milliliters of blood.

(III) Subperiosteal hematoma: It is often caused by skull deformation or fracture during blunt force trauma. This type of hematoma often occurs after ping-pong ball depressed fractures in infants and linear skull fractures in adults. Because the periosteum is firmly attached to the cranial sutures, the range of the hematoma often does not exceed the cranial sutures. In infants and young children, the periphery and periosteum of old hematoma may calcify or ossify, and even form bone cysts containing old blood.

Generally, smaller scalp hematomas do not require special treatment and can usually be absorbed on their own after about 1 to 2 weeks. Larger hematomas often require puncture and extraction while applying local compression and bandage, and can be cured after one or several treatments. If puncture treatment is ineffective, the hematoma does not disappear or continues to increase, an incision can be performed to remove the hematoma and stop the bleeding. For subperiosteal hematoma combined with skull fracture, attention should be paid to the possibility of concurrent intracranial hematoma. All infected hematomas require incision and drainage.

2. Scalp laceration

treat

In first aid, pressure bandage can be applied to stop bleeding. Clean the wound as soon as possible, remove foreign objects from the wound, stop bleeding, pay attention to skull fractures and meningeal injuries during the operation, and then suture the wound. For those with scalp tissue defects, subcutaneous release or flap transfer can be performed to repair them. For wounds that are more than 2 to 3 days old, it is also advisable to clean the wound, partially suture it, and add drainage.

3. Scalp avulsion

It is mostly caused by strong traction on the scalp, such as when a hair strand is caught in a rotating machine, causing part or all of the scalp to be torn off from under the galea aponeurotica or periosteum, resulting in severe injury, heavy bleeding, and easy shock.

treat

In first aid, cover the wound with sterile dressing and apply pressure to stop bleeding; at the same time, wrap the torn scalp with sterile gauze and keep it for later use, and try to clean and suture the wound within 12 hours. If the entire scalp is torn off, small vascular anastomosis and scalp replantation can be performed, or the torn scalp can be made into full-thickness or medium-thickness skin grafts and replanted. Small pieces of avulsion can transfer the scalp. For those with large areas of scalp, skull and meninges defects, the wound can be covered with the greater omentum with blood vessels, and skin grafting can be performed after granulation tissue grows. Wound infection or skin graft failure should be treated as general infected wounds. Later, holes deep to the skull plate can be made every 1 cm in the exposed area of the skull, or the outer skull plate can be chiseled off, and skin grafting can be performed after granulation tissue grows.

Nursing measures for head trauma

Although there are currently no obvious and serious symptoms of brain injury, as long as it is a head injury, neurological symptoms or intracranial hemorrhage may occur after a few hours, days, or even two or three months. The 72 hours is an important observation period. If you have the following symptoms, it is best to be hospitalized for observation and further treatment.

1. Feeling like vomiting or nausea.

2. Comatose or unable to be awakened.

3. Severe headache and dizziness.

4. Double vision and blurred vision.

5. Irregular pulse and breathing.

6. Restlessness and inattention.

7. Avoid drinking alcohol within two to three months.

8. Water intake should be about 80% of normal amount.

9. Do not take sleeping pills unless advised by your doctor.

10. For infants and young children, attention should be paid to whether there are any abnormalities in their activity and food intake.

11. Difficulty moving one limb, fatigue, bradykinesia or difficulty walking. For example: symptoms of cramps occur.

12. Rest quietly in bed, but the patient should be woken up once an hour during sleep to observe his or her state of consciousness.