Head Injury

Clinical Features:

• Headache or “pressure” in head.
• Nausea or vomiting.
• Balance problems or dizziness, or double or blurry vision.
• Bothered by light or noise.
• Feeling sluggish, hazy, foggy, or groggy.
• Confusion, or concentration or memory problems.
• Just not “feeling right,” or “feeling down”.

Investigation:

• CT Scan of brain 
• CBC 
• Blood grouping & Rh typing
• RBS

Rx:

• Bed rest- Head raised 20 degree angle
  
• Diet : NPO - TFO
  
• 02 Inhallation - sos
  

1. Inf. Normal Saline(0.9%) (3L) (NOte : Never use DA fluid)

• I/V @ 30 d/min
  

2. Inj.Ceftron(ceftriaxone) (1gm)

• 1 vial IV -BD
  

3.  Inj. Torax (ketorolac)(30mg)

• 1amp... I/M... BD/TDS
  

4.Inj. Esonix (Esomeprazole)(40mg)

• 1 vial I/V  -BD
  

5. Inj. Roxadex(Dexamethasosne)(5mg)

• 1 ample ....IV....... TDS
  

If convulsion:

Inj. Barbit(phenobarbitone)(200mg/1ml)

• 1 amp I/M stat & sos
  

OR

Inj.Iracet (500mg)(levetiracetum)

• 1 vial I/V stat

Special note:

 If cut injury: 

Inj. TT(tetanus vaccine)

• 1 ample I/M stat 

inj.TIG/Vaxitate IG (tetanus immunoglubolin)

• 1 ample .....I/M stat
  

If Unconscious:

•  NG feeding,
• Catheteriazation.

 If vomiting: 

Inj. Anset(Ondansetron) (8mg)

• 1amp I/V TDS/ SOS

 If P/R bleeding, from nose, ear: 

Inj. Xamic(Tranexamic acid)(500mg/5ml)

1 ample  l/V   stat

If pt restlessness : 

Inj. Halopid (haloperodol)(5mg/ml)

• 1 ample I/M stat 

Inj.Perkinil (procyclidine)(10mg/2ml)

• 1amp I/M stat 

Discharge of Head injury:

1. Tab.Denver(200mg)

• 1+0+1……….7 days
  

2. Tab.Acifix(20mg)

• 1+0+1……….10 days
  

3. Tab.Rolac(10mg)

• 1+0=1………...3 days
  

4. Tab.Barbit (30mg)

• 1+0+1 ……..6 months
  

5. Tab.Dextor(0.5mg) 

• 5+5+5.(after meal)…….5 days

then

• 4+4+4(after meal)……5 days

then

• 3+3+3(after meal)……5 days

then

• 2+2+2(after meal)…….5 days

then

• 1+1+1(after meal)……....5 days

Advice :

• 1. Bed rest 
• 2. Take medicine regularly