Cushing’s Triad (later s/s of increased ICP)
- widened pulse pressure (increasing SBP)
- bradycardia
- decreased respirations
- suspect SCI if brady
- suspect neuro shock if hypotensive
Epidural hematoma
rapid onset
- unresponsive, lucid period, second unresponsiveness
Uncal herniation
- ipsilateral pupil dilation
- contralateral hemiparesis (weakness on the opposite side as the injury)
Shaken impact syndrome
- subdural hematoma (SDH)
- retinal hemorrhage
- posterior rib fractures
Concussion treatment
- no NSAIDs or aspirin
- no narcotics
- Tylenol only
Diffuse Axonal Injury (DAI)
- hyperthermia
- HTN
- profuse sweating
- deep prolonged coma
- posturing
- monitor for diabetes insipidus - increased urine output
Ruptured Globe
- tear drop shaped pupil
Orbital wall fracture
- pain & limited upward gaze
- pressure on CN IIs
LeFort Maxillary Fractures
I - free floating maxilla, lip laceration
II - pyramidal shaped fracture, nasal fracture
III - craniofacial separation, severe swelling, decreased LOC
Tracheobronchial (laryngeal) injury
clothesline type injury
- Hamman’s sign (crunch with heartbeat)
- SQ emphysema
- dysphonia (hoarseness)
- stridor
- increasing hematoma = respiratory distress
Horner’s syndrome s/s
**occurs with high cervical fractures PAM ipsilateral triad of: - ptosis (eyelid drooping) - anhydrosis (no sweating) - miosis (constricted pupil)
Incomplete cord injury- anterior cord syndrome s/s
- *most common
- motor loss
- spares vibration and proprioception (awareness of movements)
Incomplete cord injury- central cord syndrome s/s
increased deficit in upper extremities vs lower extremities
Incomplete cord injury- Brown- Sequard Syndrome s/s
- *most common in penetrating trauma
- ipsilateral motor function loss
