00:01
Okay, head injury this comes up,
pretty much every scenario, every exam
will have something on head injury.
00:08
So standard scenario,
bruising of the
left side of face,
faded the hemi-pelvis,
parallel region,
drop in GCS, high potency.
00:21
Okay?
What are causes of reduced GCS?
One is head injury, fine.
00:28
Anything else?
Shock?
Yeah, very good.
00:32
I truly, did morphine you mean.
00:35
Okay?
Yeah, take that.
00:38
Hypoxia.
00:41
Alcohol? Yeah, you're right.
00:44
That will be there, but these are
the common ones, the important ones,
head injury, subdural,
extradural, shock, hypoxia,
due to respiratory depression,
due to a head injury,
facial fractures,
pneumothorax, haemothorax,
flail chest,
your opiates as well, fine.
01:02
Why is a patient drowsy in
an any situation, in an any?
Alcohol.
01:09
Okay.
01:10
Drugs, very good.
01:11
So, hypoglycemia is a
common stone then alcohol,
drugs and again opiate overdose.
01:17
Okay?
Now, make sure that in the exam,
always remember hypoxia
and hypoglycemia.
01:25
Sometimes, they ask what is
the single most common thing?
What is the most..
01:28
What is the most likely
cause of confusion?
Certainly, we know we always think
of slightly more complex things
but they're asking
hypoglycemia, it is so common.
01:37
In a post operative
patient as well,
hypoglycemia is one of the
commonest cause of confusion.
01:44
Okay,
indications for CT in an adult.
01:47
So starting indications,
that's based on
the NICE guidelines
and this is what is
asked the exam as well.
01:56
Pretty much logical things, I don't think
there is anything which is not logical,
you know, if you just look at
it, you'll understand,
there's nothing you have missed.
02:19
Okay.
02:26
Okay, the question here
normally what is asked is,
what is the most appropriate
investigation in a
60 year old or 70 year old
patient presenting with
head injury,
but got a GCS of around 14, 15?
Would you go for a
skull x-ray or for a CT?
That's where the you
need to be careful.
02:47
Elderly patient reduced
GCS and if they have any,
anything, any of
these, coagulopathy or
even one of these
features, always go for CT.
03:01
Because your skull x-ray like so it's
probably not going to show anything.
03:04
Okay?
Symptoms of raised ICP?
Okay, headache.
03:15
Yeah, what's it called?
Hypertension bradycardia.
03:22
So, headache, nausea, vomiting,
reduced level of consciousness,
and then your question reflects,
but that will be
at a later stage.