Welcome to our video series
on the Central Nervous System.
And this one, I'm going to introduce you
to Traumatic Brain Injuries.
Now, first of all, let's start
with a basic definition.
A head injury is any trauma.
Okay, so they can range
from very mild to severe.
But we're talking about
any trauma to the scalp,
the skull, or the brain.
So the injury might be
a minor bump
or it could be a serious brain injury.
So when you hear us talk
about head injuries,
keep that in mind.
This could be like
a really stressed out mom
whose little one fell
and bumped their head
and they have a scalp laceration
or this could be a very serious
life-altering brain injury.
Covers the whole spectrum
when we say head injury.
Now the CDC, that's usually
who we go to for definitions,
defines a traumatic brain injury
as a disruption
in the normal function of the brain.
It can be caused by a bump,
blow, or jolt to the head,
or even a penetrating head injury.
Okay, now we're getting more serious.
And a traumatic brain injury
is going to disrupt
the normal function of your brain.
See, that's one
of the most difficult things
about traumatic brain injuries
after they've recovered.
People may look completely
functioning on the outside,
but they're not quite right
and able to make
like high-level executive decisions.
I had a really good friend
whose husband had a traumatic brain injury.
and it was very difficult
after he went home
because you couldn't see any scars,
you couldn't see any sign
of his brain injury,
but he would forget things like
he'd leave the kids at daycare,
or he wouldn't remember
where he parked his car,
so it was very difficult
to kind of work through those things,
because it was very frustrating
for him as a patient
and very difficult for the family.
So keep in mind,
traumatic brain injuries
are not just traumatic
for the patient,
they're also traumatic
for the family.
And they all need
a lot of care and counseling
as they work through this process.
But in order for it to be a TBI,
we have to have some type of disruption
in their normal function of the brain.
Now there are lots
of possible causes of TBI
and you guys
that are heading for ER,
you're going to hear
the craziest stories
of what people do
and what they experience.
But let's talk about
some of the basic ones.
The causes could be a violent blow
or jolt to the head or body.
There could be an object
that penetrates the brain tissue
like a bullet,
or maybe even their own skull
that's been shattered.
Okay, so when you're thinking about
there's got to be some trauma to the head.
Now it might penetrate,
it might not.
Just the actual bouncing
or moving of the head inside your skull,
your brain moving around
the side your skull
can cause a traumatic brain injury,
or something can actually go
through the skull like a bullet,
or if I've suffered
a big traumatic blow to my head,
pieces of the skull
can also damage my brain.
So, for example, someone's
in a motor vehicle accident
or they're shot,
a firearm-related injury,
or they fall and bump their head,
and that happens particularly
with our elderly patients.
Now the saddest one is if someone
has experienced child abuse,
or is may be attacked or beaten up.
There can be sports-related injuries.
this has been a huge topic of discussion
for football players,
American football players
and head injuries.
Also, there's recreational accidents.
People fall off four-wheelers
or they, you know,
they can bump into rocks,
or they do all kinds of things,
a large amount and variety
in the recreational accidents category.
But one thing you can be sure of
that any one of these things
is an opportunity
for a patient to experience
a traumatic brain injury.
We've got a note for you there.
"Alcohol makes everything worse!"
It impairs judgment
and really makes it difficult
to assess any neuro changes
if someone is also intoxicated.
So, let's start with a question.
What is the cause of death from a TBI?
Now this might sound kind of morbid.
But as nurses, you have to learn
to be always anticipating
for any patient that you see,
for any diagnosis
that you're interacting with.
As a nurse your job is think,
to know what is the worst
possible case scenario,
and then watch for any signs,
because you want to recognize early.
What's going on with that patient?
When you start seeing early signs,
you can intervene
and help really advocate
and take the best, most safe
and effective care of your patient.
So, that's why you'll hear us
ask questions like this:
What is the problem with a TBI?
What could possibly cause death?
Well, if the patient dies
initially after the injury,
it might be from the direct trauma
to the brain tissue,
or it could because
of a massive hemorrhage
and the patient ends up in shock.
This could be like the brain herniation.
That means when the brain tissue,
there's such pressure inside the skull
from swelling or extra bleeding
that it causes that brain tissue
to shift and squish
through the holes in your skull,
and you end up
cutting off blood supply.
You can also have
That means for whatever reason,
the brain did not receive
enough oxygen to stay functioning.
Just like if a patient
has a heart attack.
Because you know the blood supply--
There's something that clots off
the blood supply to the heart,
so it doesn't get enough oxygen,
and that heart tissue dies.
Same thing can happen
in your brain.
So when you see
that means for whatever reason,
oxygenated blood supply
was cut off to the brain tissue,
and that's what caused death.
So, if the patient dies pretty close
to the time they experience injury,
those are usually the most common reasons
why the patient would die.
Now if the patient
dies longer after injury,
it might be because
of multi-system failure.
They take such a big trauma
that it overwhelms the body.
But you try and try and try,
you have that patient in critical care,
but they just can't recover
from that injury,
and, eventually, they end up
in multi-system failure.
It's really a difficult experience
both for healthcare deliverers
and for the patient's families,
because they have that hope,
and then, gradually, you see
the systems one by one shut down.
So, initially, if it's going to be
a relatively short time that they survive,
we're looking at brain herniation,
We've got hemorrhage or shock.
But if it's a longer time
that they survive,
they're really at risk
for multi-system failure.