Brain Injuries in case of Head Trauma-Signs

Signs of Brain Injury in case of head trauma:
-the patient suddently falls unconscious
-the eyes are closed
-pupils dilated
-the muscles are relaxed
-lost of reflexes
-sphincters are incontinent
-rapid and weak pulse
-subnormal temperature
-low blood pressure
-slow and shallow respiration
Uncomplicated cases usually recovers completely within minutes and rarely hours.
After recovery the patient still suffers from headache and amnesia.

In this case hospitalization and medical observation for at least 24 hours is needed.

Trauma Of The Eye- Ordinary Black Eye or a Subconjunctival Hemorrhage in case of fracture base of the skull

In case of head or face trauma,the injury signs can relieve a passible subconjunctival hemorrhage as result of a fracture base of the skull.

Subconjunctival hemorrhage happens if the orbital roof is fractured.
A subconjunctivated hemorrhage can be differentiated an ordinary black eye due just to a direct trauma to the eye.

Signs of an ordinary black eye:
-the bruise appears immediatly after trauma to the eye
-develops in the upper lid first
-has a tringular shape with its posterior borders seen and its base towards the cornea
-the occular mobility is not impaired
-proptasis does not occur.

Signs of a subconjunctival hemorrhage (so a skull fracture occured):
-develops hours after trauma
-no skin bruises
-develops in the lowest lid first
-has a triangular shape without posterior limits and its apex is toward the cornea
-occular mobility may be impaired
-proptosis occurs.

In case of base fracture of the skull appears a continuous salty taste and the blood extravation under the galea and in the lids (panda bear effect).

First aid management in case of severe trauma or multiple injuries SAVE LIVES! Learn how to give first aid

First aid management of the patient as emergency before hospital management:

1.Prevent asphyxia by the fallowing:
-keep patient airway
pull tangue
-if necessary insert air through mouth
-tilt the head to one side
-support the mandible forward
-clean any secretion.

2.Control of bleeding:
-pack the wound with textile and due local pressure to the bandage
-elevate the hurted part

3.Antishock measures: warm the trunk,elevation of lower part of the body,fluids.

4.Avoid any movement of the spine and splintage for any fracture: in case of cervical spine injury.

5.Immediatly transfer to the hospital !

Hospital management of the patient:

-section of blood,saliva and vomiting from the pharynx and oral cavity
-endotrocheal tube is inserted with mechanical ventilator in hypoventilation,hypoxia or comatosed patient
-oxygen by mask
-seal the wounds
-relieve pain by sedative.
-examination of all system of the body
-urgent investigations.

ACUTE APPENDICITIS-Causes ans Symptoms

Acute appendicitis is more common in males and usually occurs between 20-30 years,rare in old ages and in children below 5 years.

Predisposing Factors:

-Obstruction : it may be due to hard faeces,adhesions,kinking and parasites.
-Anatomical Factors: a narrow lumen and its wall is rich in lymphoid follicles.
-Septic Focus from which organisms are carried to the lymphoid follicles.
-Diet: High protein and low fibres diet predisposes to constipation,which leads to stasis of colon.
-Route of Infection: Usually from the lumen and rarely blood or lymphatic spread.
-Organisms: Usually E.Coli,streptococs.

Are known 2 types of appendicitis:

1.Acute obstructive appendicitis:(the most common).This produce ra[idly progressive severe inflammation that can lead to gangrene and perforation.
2.Acute Non-Obstructive Appendicitis:(less common).Produce mild slowly progressive inflammation.

Symptoms:

Usually is about a recent constipation or history of similar attacks.
Appear colicky pain in obstructive type and dull aching in non abstructive type.The pain become acute.
It is aggravated by movements or cough.
At first the pain is generalized abdominal and most marked around the umbilicus (both appendix and umbelicus are supplied by the 10th thoracic segment of the spinal cord).
Appears distension of appendix and visceral pain.
After 6-10 hours pain localises in the right inferior part of abdomen.
Appears nausea in non obstructive type and vomiting in obstructive type.Vomiting occurs once or twice only and if persistant it indicates complications.