Concussion tx

dont know about all cases but can speak of mine. hit hard on the head, didnt go to er for 24 hours. was still dizzy. got scanned, basic neuro exam (had had a full one 3 days earlier). discharged same day.

This is not going to help you with your assignment. It might help you get an "A", but using my and everybody else's posts aren't going to help you get what they're trying to teach. That being said, here you go....

IVF are definitely going to be hooked up. Depending on age, probably 100+ml/hr. Neuro checks are also a must. q15 or so is sufficient for the first hour or two if it's not a severe injury.

Speaking from a Trauma standpoint, two large bore IV 18g or higher are usually placed.

CT of the head to rule out hematoma would be high on the list.

The patient would almost definitely be sent to an ICU if the LOC was 20+ minutes. USUALLY LOC is much less than this. For a LOC that is >20min then you typically may have other side effects (no respirations, etc) that would have not enabled him to drive the patient to the ER... He instead would have had to wait for EMS while doing rescue breathing...

Lasting effects depend on severity of injury. If it's a simple concussion then expecting excessive veritgo and nausea and vomiting is more than likely. Scopalamine patch, Zofran, and Morphine would be probably the basics... If hematoma is present, possible hematoma evacuation, skull plate removal for pressure relief, and/or placement of burholes to check for ICP may be completed. If this is the case, also, the patient will probably be intubated and mildly sedated with something such as propofol - this makes it easier to bring the patient out of sedation to being interactive in

Depending on how the person fell, usually they just don't hit ONE thing, so other body parts may hurt. 2 or 3 view xrays may also be in order to extremities, possibly abdominal and chest to rule out anything else more severe.

The patient may be kept NPO until the AM in case of nausea and/or waiting for a followup CT of the head 24 hours out. If everything is fine, the patient may go home in a day or two.

Finally you may be able to put a scalp lac in there somewhere that needs sutures? Complete with irrigation of the wound and everything else that is involved with this type of injury (lido, etc)

Just a side note. Gallows humor for this kind of patient. Morbidly funny but true.

When alert the patient will have repetitive questioning. Where am I, what happened, how did I get here, and maybe a few others. They usually "reset" themselves and start all over every 30 to 60 seconds. If family is at the bedside they'll go through stages (probably you too). 1st answering the questions, 2nd finding it a bit frustrating and at the same time funny, 3rd ready to strangle the patient if they ask just one more time. It's all normal, predictable, enjoy the fact that you can leave the room, the family can't.

2 months after my concussion (mild to moderate, no LOC. I was unable to recall my address, photophobia and unable to walk straight) I was still feeling drepressed and sad because I was still having co-ordination problems and disorientation. It was all gone by the end of the 3rd month, but it made me realize that it is not just in the first couple of days after the head trauma that people feel miserable.

I humbly admit I'm in the presence of true genius.

Lunah, I'm going to use that idea. Thanks.