Definition

Head Injury

Any kind of damage to the scalp, skull, or brain is collectively referred to as a "head injury." A bump or a
bruise on the head all the way up to a severe brain damage can fall under this category. Concussions,
fractures of the skull, and wounds to the scalp are all examples of common head injuries. The severity of
your head injury as well as the circumstances that led to it will determine the range of possible
repercussions and treatments. Closed or open head trauma are both types of head injuries. An injury to
the head that does not involve the breaking of the skull is referred to as a closed head injury. An open
head injury, also known as a penetrating head injury, is one in which something penetrates both the
scalp and the skull and makes its way into the brain. It is not always easy to determine the severity of a
brain injury simply by looking at it. Some very mild head injuries cause a significant amount of bleeding,
but some significantly more serious injuries don't bleed at all. It is essential to take any kind of brain
injury seriously and have it checked out by a medical professional right away.

Reference: Head Injury: Types, Causes, and Symptoms ([Link])

Spinal cord Injury

Damage to any part of the spinal cord or nerves at the end of the spinal canal (cauda equina) is what is
referred to as a spinal cord injury. This type of injury frequently results in permanent changes in the
patient's level of strength, sensation, and other body functions below the site of the injury. If you just
had an injury to your spinal cord, it is possible that you feel as though your entire life has been turned
upside down. It is possible that you will experience mental, emotional, and social repercussions as a
result of your injuries.

Reference: Spinal cord injury - Symptoms and causes - Mayo Clinic

Nursing Intervention

Head Injury

 Assess neurologic and respiratory status to monitor for the sign of increased ICP (Increased
intracranial pressure) and respiratory distress.
 Have to monitor and record major symptoms and intake and output, increased intracranial
pressure, hemodynamic variables, cerebral perfusion pressure, specific gravity, laboratory
studies, and pulse oximetry to detect early signs of compromise.
 Observe for the sign of increasing increased intracranial pressure (ICP) to avoid treatment delay
and prevent neurologic compromise.
 Assess for CSF leak as evidenced by otorrhea or rhinorrhea. Cerebrospinal fluid (CSF) leak could
leave the patient at risk for infection.
 Assess for pain. Pain may cause anxiety and increase increased intracranial pressure (ICP).
  Check a cough and gag reflex to prevent aspiration.
 Have to check for different symptoms of diabetes insipidus (High urine output, low urine specific
gravity) to maintain hydration.
 Administer I.V fluids to maintain hydration.
 Administer oxygen to maintain position and patency of endotracheal tube if present, to
maintain the airway and hyperventilate the patient, and to lower increased intracranial pressure
(ICP).
 Provide suctioning; if the patient is able, assist with turning, coughing, and deep breathing to
prevent pooling of secretions.
 Maintain position, patency, and low suction of NGT to prevent vomiting.
 Maintain seizure precautions to maintain patient safety.
 Administer medication as a prescription to decrease increased intracranial pressure (ICP) and
pain.
 Allow a rest period between nursing activities to avoid the increase in increased intracranial
pressure (ICP).
 Encourage the patient to express feeling about changes in body image to allay anxiety. Provide
appropriate sensory input and stimuli with frequent reorientation to foster awareness of the
environment.
 Provide means of communication, such as a communication board to prevent anxiety.
 To prevent tissue damage, provide eye, skin, and mouth care.
 Turn the patient every 2 hours or maintain in a rotating bed if condition allows preventing skin
breakdown.

Reference: Important Nursing Management of Head Injury Patient ([Link])

Spinal Injury

 Assess respiratory function by asking the patient to take a deep breath. Note the presence or
absence of spontaneous effort and quality of respirations (labored, using accessory muscles).
 Auscultate breath sounds. Note areas of absent or decreased breath sounds or development of
adventitious sounds (rhonchi).
 Note the strength or effectiveness of the cough.
 Observe skin color for developing cyanosis, and duskiness.
 Assess for abdominal distension and muscle spasm.
 Monitor and limit visitors as indicated.
 Monitor diaphragmatic movement when the phrenic pacemaker is implanted.
 Maintain patent airway: keep head in a neutral position, elevate the head of the bed slightly if
tolerated, and use airway adjuncts as indicated.
 Assist the patient in “taking control” of respirations as indicated. Instruct in and encourage deep
breathing, focusing attention on steps of breathing.
 Reposition and turn periodically. Avoid and limit prone position when indicated.
 Encourage fluids (at least 2000 mL per day).

Reference: 12 Spinal Cord Injury Nursing Care Plans - Nurseslabs

Head Injury