so if you went into the ER with a hairline skull fracture and brain contusion would you be worried and/or need follow up (side note s/s of increased ICP= bad headache and intense nose bleeds)? i know nothing about these things i feel like...just wondering if any of you with ER preceptorships and/or jobs had any thoughts on the matter...let me know what you think!
-h
2 comments:
hmm...i'm not 100% sure what exactly your question is b/c my brain is swimming with all this nclex info and i'm just ridiculous right now...but i do know that some signs of increased ICP that go with a concusion are vomiting and decreased LOC.
I had multiple campers with this issue last week and it was a question i just had on my Nclex review test...
hope that helps some
Je'Nelle
Haley, I sure hope this is an hypothetical question or an NCLEX prep question...as an ER nurse imposter (which I am convinced IP stands for cause I still feel like a student in colorful scrubs, until I take and pass the test :)...We would want to know the mechanism of injury, what happened exactly, was there a loss of consciousness, did the pt regain consciousness and lose it again (characteristic, but not always present in epidural hematomas)? "Linear skull fractures are nondisplaced and assocatiated with minimal neurologica deficit. Supportive care is usually all that is required for optimal neurologic recovery" (Sheehy's Emergency Nursing Principles and Practice, p.255). Basilar skull fractures tend to be more serious and can result in periorbital ecchymoses (the raccoon eyes) and Battles's sign, along with CSF drainage from the nose or ears (depending on if the TM is intact or not)...there are many things to be seriuosly concerned about with head trauma...but we discharge each patient from the ER with instructions to follow up with their Primary Care Physician or to call or return for worsening symptoms. You can always call an ER and they can triage you over the phone to a degree, but if in doubt, get it checked out!! So in short, to answer your question...yes, follow up :)
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