Brain Injuries
Pay Attention
- Notice that an epidural hematoma is arterial blood that rapidly expands.Â
- A subdural hematoma is venous blood that slowly expands. It may take days for a subdural hematoma to be big enough to be symptomatic.Â
Brain Herniation
- Look for fixed and dilated pupils, which occur due to increased intracranial pressure as portions of the brain protrude into adjacent structures.
Reducing ↑ ICP
- HOB 30 Degrees
- Head Midline
- Osmotic agents such as Mannitol
- If herniation occurs, prepare client for surgery.
- Hyperventilation therapy: Maintain pCO2 30 to 35 mm Hg. Monitor for symptomatic respiratory alkalosis: lightheadedness, dizziness, confusion, anxiety, shortness of breath, chest pain, rapid heart rate, and tingling or numbness in the extremities
