Nursing care of the acute head injury: a review of the evidence

Abstract

This article aims to review the current evidence in relation to acute head injury care. Head injuries are a frequent cause of death and disability in western society with the first 72 h being an important period for prevention of further brain damage. The underlying physiology behind head injury and intracranial pressure will be discussed. The monitoring of intracranial pressure and implications for practice will be addressed. The specialized nursing care and drug therapy management that is necessary for acute head injury patients will be highlighted. Recommendations for practice will be given.

Comprehensive Overview of Nursing and Interdisciplinary Care of the Acute Ischemic Stroke Patient

“…Therefore, nurses need to evaluate each patient's physiological response to routine care. 187,188 Osmotic diuretics such as furosemide or mannitol can be used to treat cerebral edema. Intravenous mannitol (0.25 to 0.50 g/kg) administered over 20 minutes can be given every 6 hours.…”

Initial emergency nursing management of patients with severe traumatic brain injury: Development of an evidence-based care bundle for the Thai emergency department context

“…The BTF guidelines state that oxygen saturation should be measured and monitored continuously in the field with a pulse oximeter. 16 Hypoxaemia, defined as an oxygen saturation (SpO 2 ) less than 90%, should be avoided 16,19 in order to reduce the risk of cerebral hypoxia 12 and secondary brain injury due to ischaemia. An adequacy of ventilation is dependent not only on the ventilation rate, but also on the tidal volume, and the pressure under which the tidal volume is delivered.…”

“…Physician input into the care of patients with severe TBI is episodic and intermittent and it is emergency nurses who make decisions regarding type and frequency of physiological monitoring, cervical spine precautions, patient positioning, and urgent CT scan administration. 11,12 Third, there is known variation in Thai nurses' knowledge and care practices for patients with severe TBI. 13 Some elements of variation are placing patients at risk of harm particularly increased intracranial pressure and risk of secondary brain injury.…”

Importancia de la metodología enfermera en la mejora de la calidad de los cuidados en el paciente con traumatismo craneoencefálico grave. Revisión de la literatura

“…Numerosos estudios hacen referencia a la importancia de la atención al paciente con TCE grave por parte de un equipo multidisciplinar 13,14,30 , ya que éstos constituyen una causa importante de minusvalía neurológica 31 , que puede sobrellevar a diferentes grados de incapacidad durante muchos años, haciendo especial hincapié en los cuidados proporcionados por parte del personal de Enfermería 29,[32][33][34][35] .…”

“…La literatura revisada muestra cómo el empleo de unos cuidados individualizados y sistematizados mejoran la asistencia sanitaria en este tipo de pacientes y previenen la aparición de complicaciones 13,28,29,35 , cuáles son las respuestas humanas de los familiares de los pacientes ingresados en UCI 21,44,47 y cómo las enfermeras a través del proceso de cuidados y con el uso de un lenguaje estandarizado pueden evidenciar resultados 7,39,40 .…”