In conclusion, more calories and protein can usually be administered continously via the TPN route to patients with acute brain injury. This is better than managing EN feedings by nasogastric routes. Nutritional assessment using traditional parameters is not useful in studying efficacy of nutritional support during the first 2 weeks after headinjury. Neurological recovery from headinjury occurs more rapidly in patients with better and earlier nutritional support.
The research results showed a description of life quality consisting of: the presence of grievances felt such as headache, blur vision, stiff, rigidity of movable organs, and forgetful. Thus, it needs an effort to minimize the symptoms caused by disorder in brain function. Impaired activity, rest and sleep is an effort that needs to be adjusted use. Taking treatment, conducting any activities, receiving family support, appealing to God, and to be thankful are the description of life quality that should be developed by the clients after treatment due to a moderate headinjury in facing any problems experienced. this effort should be constantly conducted by the clients so that they can adapt to the condition they face in orde to keep the quality of their life.
Headinjury is one of the main causes of deaths and disability in productive age group, most of which occurring due to traffic accidents. The impact of a headinjury may cause any disorder of body system as a whole from expiratory system, physical mobility disorder, to communicational ability. The clients may become angry, frustration, anxious, sad, depressed, of low sel-esteem, experience changes in body image, have a sense of powerless, or even a loss of weight. If the effort conducted is inappropriate, then it may produce a serious problem. Therefore, the researcher conducted a research on the description of the life quality of clients with moderate headinjury after treatment. The purpose of this research was to find out a description of the life quality of clients with moderate headinjury after a treatment and then return to community. This research was conducted by using a descriptive-qualitative method. Data was collected by an in-dept interview technique through open end questions. The sample collection technique used was a purposive sampling technique by choosing five clients with post-moderate headinjury. The research results showed a description of life quality consisting of: the presence of grievances felt such as headache, blur vision, stiff, rigidity of movable organs, and forgetful. Thus, it needs an effort to minimize the symptoms caused by disorder in brain function.Impaired activity, rest and sleep is an effort that needs to be adjusted use. Taking treatment, conducting any activities, receiving family support, appealing to God, and to be thankful are the description of life quality that should be developed by the clients after treatment due to a moderate headinjury in facing any problems experienced. this effort should be constantly conducted by the clients so that they can adapt to the condition they face in orde to keep the quality of their life. Thus, the role of nurses, family, and community can hopefully help supporting the efforts that clients conduct in keeping or increasing the quality of their life after treatment due to a moderate headinjury so that they may return to community.
Methods. This is a cohort study in patients with moderate-severe headinjury and suspected aspiration pneumonia treated in Neurosurgery Critical Care Unit, Hasan Sadikin Hospital, Bandung. There were 14 patients in 4 months study (April-July 2011). All patients were intubated and connected to ventilator, tracheostomy was performed when CPIS > 6. Tracheal secretion, thorax x-ray, temperature, leukocyte count, O2 saturation, blood gas analysis and sputum culture was investegated. T-Test and Pearson’s correlation was calculated and analyzed.
This study was an experimental study and was approved by the Ethics Committee of the Medical Faculty, University of North Sumatera. We evaluated 60 adults with severe traumatic brain injury in our hospital. Subjects were between 18-60 years old, had a severe headinjury based on Glasgow Coma Scale 3-8 with onset of accident within 48 hours before admission and had cerebral contusion as evidenced by head computed tomography, without any operative indication. Patients were excluded if they were pregnant, had history of anticoagulant use, history of neoplasm, and history of epilepsy.
Sampel yang digunakan dalam penelit ian ini berupa purposive sam ple, art inya sampel yang diambil dari populasi dengan krit er ia yang disesuaikan dengan t ujuan penelit ian. Pada penelit ian ini subyek yang digunakan adalah pasien yang t elah di diagnosis dengan cedera kepala sedang (M oderate HeadInjury) dan cedera kepala berat (Severe HeadInjury) yang dibaw a ke Emergensi Bedah Rumah Sakit dr. Hasan Sadikin Bandung pada kurun w akt u ant ara 1 Februari 2008 sampai dengan 30 April 2008 serta memenuhi krit eria sebagai berikut :
Moderate headinjury merupakan jenis cedera kepala yang penderitanya mengalami penurunan kesadaran yang signifikan (GCS 9-12). Kondisi ini menjadi salah satu stresor bagi keluarga mengingat selain klien yang mengalami penurunan kesadaran juga tindakan medis yang dilakukan tanpa informasi yang jelas menambah kecemasan keluarga. Dukungan emosional sangat penting untuk proses penyembuhan, dukungan ini berasal dari keluarga. Jika kecemasan keluarga berlanjut maka dukungan emosional pun akan terganggu dan mempengaruhi mempengaruhi proses penyembuhan klien.
The elevation of body temperature among patients with headinjury may lead to increase total metabolism of the body. Such situation may worsen the patient condition, prolonged length of stay and increase risk of death. Cooling methods using wet blanket and cold-pack have been commonly adopted to reduce the body heat. However no empirical studies have proved these methods are effective to reduce high temperature of patients with headinjury. This non-paired comparative study seeks to examine the difference of those two methods towards body temperature involving 24 patients with headinjury that recruited using consecutive sampling technique. Results indicated that there is no significant difference of the temperature decrease after wet blanket and cold-pack application (p= 0,371). However, cold-pack still can be used as an alternative compress beside wet blanket application.
Rather maintaining adequate airway patency, suctioning may pose risk of developing diminished oxygen saturation among patient with severe headinjury. Patients may also experience intra cranial pressure (ICP) and airway trauma. Therefore, providing appropriate pressure of suction machine is needed to overcome those problems particularly to reduce risk of diminished oxygen saturation. This quasi-experimental study aimed to determine differences in oxygen saturation among patients with headinjury after suctioning with three different pressures: 100 mmHg, 120 mmHg and 150 mmHg. The study design used one group pretest and post-test without control that performed with repeated measurements. Findings suggest higher pressure of suctioning tends to decrease their oxygen saturation. Results are expected to provide best practice to conduct suctioning for patients with severe headinjury and maintaining oxygen saturation after hyper oxygenation action.
Background and Objective: Headinjury in pregnancy can increase the risks of mortality and morbidity, both for the mother and fetus. Common complications are including death, shock, intrauterine bleeding, intrauterine fetal death, fetal trauma, placental abruptio and, uterine rupture. Motor vehicle accident, falls, assault and gunshot wound are the primary cause of injury. Treatment and recognition of this cases are unique, even though the main target are early evaluation and resuscitation of the mother and afterward, the fetus. Tococardiography monitoring, ultrasound, and head CT Scan can be perform with or without craniotomy and caesarean section.
Management of penetrating brain injury focusing solely on headinjury should be avoided. Instead, a thorough review by primary and secondary survey of advance trauma life support (ATLS) is highly recommended. Radiology should be performed after the patient is stable. Computer tomography- scan (CT-scan), Skull X-ray anteroposterior (AP) and lateral are the most common and useful tools to evaluate gunshot headinjury. The addition of CT 3D, CT angiography, and digital subtraction angiography (DSA) provide a reasonable initial assessment when available. The gunshot wounds can be treated using medication and by surgery. The purpose of medication is to decrease intracranial pressure (ICP) by preventing brain edema (head elevation 30–45°, hyperventilation PaCO 2 = 30–35
trained medical records personnel. We selected 450 cases of all data (962 patients) who had headinjury were eligible subjects. Subjects were eligible to analysis conducted 450 patients who had headinjury. Number of subjects who diagnosed headinjury were 125 patients (27. 8%) in Koja hospital, 122 patients (27.1%) in Sumber Waras hospital and 203 patients (45.1%) in Dr. Kariadi hospital. Headinjury classification based on the tenth revision of International Classification of Diseases (ICD 10) include S00, S01, S02, S03, S04, S05, S06.0, S06.3, S06.4, S06.5, S07, S08, S09 codes. 7 The severity of headinjury assessed using Glasgow Coma Scale (GCS). Patient had severe headinjury which was GCS score of 3 9, moderate headinjury 10 12 score and mild headinjury 13 15 score. GCS was a quantitative scale to assess level of consciousness and neurological disorders. Those are three aspects included the reaction of eyes opening, verbal responses and the motor response. 8 The poten sial risk factors for this study were sociodemo graphic characteristics (gender, age, education, occupation and mode of payment) and charac teristic of accident that consists of the time of injury, type of accident, current activity, mode of transport to hospital, state of referral, suspec ted alcohol or addictive narcotic use, type of medical treatment.
In this study, some outliers were found in serum Bcl-2 concentration measurement data, which deviated from standard deviation. The outliers might be caused by polymorphism of the Bcl-2 gene. In one study, there was a correlation between genotype Bcl-2 with global function after headinjury. From that finding it was known that there are allele variants for rs17759659 and rs1801018 with worse outcome [Glasgow Outcome Scale (GOS) and Disability Rating Scale (DRS)], higher mortality rate, and lesser Neurobehavioral Rating Scale-Revised (NRS-R). In contradiction to that finding, homozygote allele wild type for rs7236090 and homozygote variants from rs949037 correlates with better outcome (GOS and DRS). These results supported the chance of, genetic polymorphism especially genetic variance in Bcl-2 gene for prosurvival proteins which could affect the outcome of headinjury.