Brain hemorrhages

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Specializes in ICU.

I am writing about a case study and need to know the difference between an arterial versus venous bleed concerning head injuries in toddlers. If anyone has any info, please let me know ASAP

Here is the case study:

T.S. is a 3 y.o. female brought to the ED after falling while on the playground. Her parents are concerned because she hit her head and she has not bee "acting right" after the fall.

At this time, T.S. appears to be sleeping in her mother's arms. While performing VS, the RN notices that T.S. is difficult to arouse. Her vitals are: BP 80/55, HR 110, RR 24, T 98, O2 sat 96% (all WNL for a 3 y.o.)

A CT of the head is performed and it is noted that she has a "bleed" in her head.

After the CT, T.S. vomits 3 more times and is now lethargic. Her VS are: BP 70/40, HR 120, RR 14, T 98. :)

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Specializes in midwifery, NICU.
I am writing about a case study and need to know the difference between an arterial versus venous bleed concerning head injuries in toddlers. If anyone has any info, please let me know ASAP :)

Great big stuff to ponder. am thinking, but dont honestly know if I can help. Good luck, if I come across anything, will let you know!

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wouldn't an arterial bleed present w/more abrupt, traumatic onset?

whereas a venous bleed could ooze for much longer time, producing different s/s...

leslie

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Specializes in Neurological/Trauma ICU.

I work with adults so I don't know if the bleeds in children are exactly the same in timeline and effects (symptoms). Subdural bleeds are venous and so take a while to accumulated and produce symptoms. Epidural and Subarachnoid bleeds are arterial and changes are very quick. With epidural, they can have a period of normalcy after the initial injury, and then when the blood accumulates, they drop their LOC.

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Specializes in ICU.
I am writing about a case study and need to know the difference between an arterial versus venous bleed concerning head injuries in toddlers. If anyone has any info, please let me know ASAP

Here is the case study:

T.S. is a 3 y.o. female brought to the ED after falling while on the playground. Her parents are concerned because she hit her head and she has not bee "acting right" after the fall.

At this time, T.S. appears to be sleeping in her mother's arms. While performing VS, the RN notices that T.S. is difficult to arouse. Her vitals are: BP 80/55, HR 110, RR 24, T 98, O2 sat 96% (all WNL for a 3 y.o.)

A CT of the head is performed and it is noted that she has a "bleed" in her head.

After the CT, T.S. vomits 3 more times and is now lethargic. Her VS are: BP 70/40, HR 120, RR 14, T 98. :)

It is a different ball game when you talk of children as the compliance in the head is different. But by 3 years old (correct me if I am wrong) the suture lines in the skull should be closed and the cranial vault should be fairly rigid.

Leslie was right - venous, in general are slower but your scenario does not say what kind of bleed and you can have rapidly accumulating bleeds whether they be venous or arterial. If this is for undergraduate studies I would think what they want is ASSESSMENT of the deteriorating status.

Google Adelaide coma scale to get some paediatric appropriate scales and information

http://www.medal.org/visitor/www/Active/ch17/ch17.01/ch17.01.02.aspx

http://209.85.173.104/search?q=cache:VfnfDwYA9xwJ:www.nottingham.ac.uk/paediatric-guideline/recdoc.pdf+adelaide+coma+scale&hl=en&ct=clnk&cd=8&gl=au&client=firefox-a

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