Acceleration and Deceleration Injury (Nursing)

00:01 Okay, so this look kinda graphic, don't they? You've got a baseball bat.

00:05 Wham! That's an initial acceleration injury.

00:10 So something slams into the front of your head, you can see you've got the injury right there, and that's what the red spot is.

00:17 A moving object strikes a non-moving head.

00:20 Now, you've got the initial acceleration.

00:23 You can also have deceleration.

00:25 So you've got a moving person comes to a super abrupt to stop.

00:29 Like say, for example, in a car accident, You see that you have injury in the front of the brain and the back of the brain, because that brain is going to literally slosh around.

00:39 Remember, you've got cerebral spinal fluid that can act as a cushion under normal circumstances.

00:45 But if you're going to come to a quick or an abrupt stop, you're gonna have injury in the front and in the back, so they can have initial acceleration injury and deceleration injury.

00:56 Now we also call this coup-contrecoup.

00:59 So let's say if you're in a car and someone comes to a super quick stop, and you don't have your seat belt on, and you hit your head on the windshield.

01:06 That's considered the coup part of the injury.

01:09 Then you've end up flying backwards, right? Your brain will hit the back of your skull.

01:14 So, you have a brain injury on the opposite side of the brain.

01:18 Now it could also be this side or this side, but we just gave you an example of forehead to back of skull.

01:25 So, coup-contrecoup, coup-contrecoup.

01:30 It's just telling you, "Whoa, you got it on both sides." So, let's talk about acceleration/deceleration injuries a little more.

01:39 Now we've got tensile stress. This is a really weird thought.

01:43 But it's an overstretching of the brain and twisting of the tissues.

01:47 This comes if someone had to be moving at a pretty fast rate.

01:50 But just that tensile stress, that overstretching of your brain tissues can do some significant damage.

01:56 Compression is another way the brain can be traumatically injured.

02:00 That comes when you have any increased amount of pressure pushing on the brain.

02:05 Now that may be because you have a big bleed for some reason, the cerebral spinal fluid is not draining appropriately, so that's pressing on the brain, or the size of the brain tissue is changing, maybe have cerebral edema that could cause that compression, that extra pressure on the brain.

02:22 Now shearing is...

02:24 This one is even kind of hard to talk about.

02:27 But it's diffuse axonal injury.

02:30 It's the shearing and tearing of the brain's actual axons.

02:34 Those are the connecting nerve fibers in the brain.

02:37 So, this is incredibly traumatic.

02:41 You can see some really significant life altering responses to this type of injury.

02:46 So, tensile stress, you've got this overstretching and twisting of the tissue.

02:51 Compression, the pressure is getting bigger inside that skull, and then...

02:56 Shearing.

02:57 It's just when we say diffuse, it's all over.

03:00 That's what the word "diffuse" means, that axonal injury, because the shearing and tearing of the brain's axon.

03:07 Just almost think of it like pulling your brain apart.