Neurotrauma: Managing Patients with Head Injuries is a
comprehensive, holistic, evidence-based approach to the primary,
secondary and tertiary care of a person with neurotrauma.
Using a patient-centred needs approach to enhance the quality of
care of head injured patients, family and carers, this
multidisciplinary book enables the reader to apply the
knowledge, skills and attitudes learned to the practice of
neurotrauma in all settings. It explores:
* Anatomy and physiology of the brain
* Pharmacology for neurotrauma patients
* Assessment of the patient with neurotrauma
* Management of neurotrauma in a range of settings including at
the scene, in the emergency department, and at the hospital
* Neuro-rehabilitation
* Community care
* Nursing management of the patient
This practical resource includes activities, exercises, and
ethical and legal considerations throughout, making it ideal
reading for all staff working in neuroscience, emergency, critical
and rehabilitation settings.
Autorentext
Dr Nadine Abelson-Mitchell is Senior Lecturer in the School of Nursing and Community Studies at the University of Plymouth. She is the partnership link for the neuroscience programme and is Appointed Honorary Nurse Consultant to Rowans Rehabilitation Unit, Plymouth teaching PCT.
Zusammenfassung
Neurotrauma: Managing Patients with Head Injuries is a comprehensive, holistic, evidence-based approach to the primary, secondary and tertiary care of a person with neurotrauma.
Using a patient-centred needs approach to enhance the quality of care of head injured patients, family and carers, this multidisciplinary book enables the reader to apply the knowledge, skills and attitudes learned to the practice of neurotrauma in all settings. It explores:
- Anatomy and physiology of the brain
- Pharmacology for neurotrauma patients
- Assessment of the patient with neurotrauma
- Management of neurotrauma in a range of settings including at the scene, in the emergency department, and at the hospital
- Neuro-rehabilitation
- Community care
- Nursing management of the patient
This practical resource includes activities, exercises, and ethical and legal considerations throughout, making it ideal reading for all staff working in neuroscience, emergency, critical and rehabilitation settings.
Inhalt
Preface xi
Dedication xii
Acknowledgements xiii
Contributor Details xiv
Abbreviations xviii
List of Tables and Figures xx
Section 1 Foundations for Practice 1
Introduction 1
1 The Patient's Journey 3
Nadine Abelson-Mitchell
Introduction 3
Care pathways: policies and guidelines 4
Integrated care pathways 4
2 Philosophy 6
Nadine Abelson-Mitchell
Introduction 6
Conclusion 9
3 The Needs Approach Model 11
Nadine Abelson-Mitchell
Introduction 11
What is a need? 11
Structure of the Needs Approach Model 11
Use of the model 12
Assessing the patient's needs 12
Planning 13
Goal setting 14
Implementation 14
Evaluation 14
Risk 14
The miraculous recovery 23
Nursing diagnosis 26
Conclusion 28
4 The Patient Matters 31
Nadine Abelson-Mitchell, an anonymous carer and Sue Mottram
The patient 31
Family and carers 31
Conclusion 37
5 Multidisciplinary Management 38
Nadine Abelson-Mitchell and Katie Searle
Introduction 38
Staffing 39
Speech and language therapy services 40
6 Physiotherapy 43
Jude Fewings
Introduction 43
Respiratory care 43
Positioning 43
Musculoskeletal integrity and neuromuscular status 44
Summary 44
Rehabilitation and motor control theories 45
Posture and seating 45
Conclusion 46
7 Neuropsychology 47
Michelle Smith
Introduction 47
What is clinical neuropsychology? 47
Who is a clinical neuropsychologist? 47
What is the role of the clinical neuropsychologist in the management of TBI? 47
Neuropsychological functions 47
The patient's neuropsychological journey 49
Additional factors influencing neuropsychological functioning 50
Other issues and considerations 51
8 Social Considerations 52
Judi Thomson and Anthony Gilbert
The role of the social worker 52
Social issues 54
Conclusion 56
9 Occupational Therapy 57
Danielle Williams
Section 2 Pre-requisite Knowledge 61
Introduction 61
10 Epidemiology 63
Nadine Abelson-Mitchell
Introduction 63
Severity of injury 63
Hospital attendance 64
Incidence 64
Prevalence of head injury 64
Age distribution 65
Gender distribution 65
Race and ethnicity 65
Mechanism of injury 65
Seasonal variation 66
Predisposition 66
Use of alcohol 66
Head injury mortality 66
Conclusion 66
11 Prevention of Head Injuries 68
Nadine Abelson-Mitchell
Introduction 68
Recommendations 68
Road traffic accidents (RTAs) 69
Action regarding the use of prescription, over the counter and illicit drugs 70
Prevention of sports injuries 71
Care of older people 71
Interpersonal violence 71
Conclusion 72
12 Applied Anatomy and Physiology 74
Nadine Abelson-Mitchell
Introduction 74
The nervous system 74
The scalp 74
The skull 75
Structure of the brain 84
Additional concepts related to neurophysiology 102
Acid-base balance 102
Summary 105
Conclusion 106
13 Investigations 108
Nadine Abelson-Mitchell
14 Pharmacology for Neurotrauma Patients 126
Nadine Abelson-Mitchell and Penny Franklin
Introduction 126
Anaesthetic agents 127
Analgesics 127
Diuretics 127
Anti-epileptic drugs 127
Anticoagulants 127
Antiemetics 127
Laxatives 127
Conclusion 127
15 Applied Microbiology 129
Nadine Abelson-Mitchell
Introduction 129
Meningitis 129
Encephalitis 130
Brain abscess 131
Conclusion 133
Section 3 Features of Neurotrauma 135
Introduction 135
16 Classification of Traumatic Brain Injury 137
Zuhair Noori and Nadine Abelson-Mitchell
Introduction 137
Primary and secondary brain injury 137
Open and closed head injury 139
Conclusion 140
17 Raised Intracranial Pressure 141
Nadine Abelson-Mitchell
Introduction 141
Definition 141
Cause of increased intracranial pressure 141
Diagnosis 141
Investigations 142
Treatment 142
Management of the patient 142
Conclusion 143
18 Assessment of the Patient with Neurotrauma 144
Nadine Abelson-Mitchell
Introduction 144
General principles 144
Neurological observations 146
Vital signs 151
Recording the observations 152
Undertaking a comprehensive CNS examination 152
Recording the assessment 160
Conclusion 160
Section 4 Management of Neurotrauma 161
Introduction 161
19 Management of Neurotrauma at the Scene 163
Henry Guly
Introduction 163
Severe and moderate head injury 163
Airway with cervical spine protectio…