July 15, 2021

July 15, 2021

1 Introduction | Definition

Today's
2 Types of Traumatic Injury

Agenda
Primary brain damage |
3 Secondary Brain damage

4 Causes | Signs and Symptoms

5 Caregiver's Responsibility
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Introduction

STATISTIC (Epidemiology)
Traumatic Brain Injury (TBI) is the leading
cause of death and disability in children and
adults from ages 1 to 44.
Every year, approximately 52,000 deaths occur
from traumatic brain injury.
Males are about twice as likely as females to
experience a Traumatic Brain Injury.
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Definition

Traumatic Brain Injury (TBI)

-is a non-degenerative, non-
congenital insult to the brain from an
external mechanical force, possibly
leading to permanent or temporary
impairment of cognitive, physical, and
psychosocial functions, with an
associated diminished or altered state
of consciousness.
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Types of

Traumatic

Brain Injury
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CLOSED BRAIN INJURY OPEN BRAIN INJURY

Without the skull being broken or Open or penetrating head injury

penetrated and the brain has not A TBI can be focal or diffuse,

been exposed meaning damage may be isolated

Eg: when the rapid movement of to one specific area of the brain in

the head backward and forward focal injuries or widespread in the

(acceleration-deceleration case of diffuse injuries

movement) causes the brain to

move inside the skull and slam
against its hard inner bone
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Primary and

Secondary

brain damage

Primary brain
damage
The 2 main mechanisms that cause primary injury are
contacted (eg, an object striking the head of the brain
striking inside of the skull) and acceleration-deceleration
Primary injury due to contact may result in injury to
the fracture to the skull, and surface confusions
Primary injury due to acceleration-deceleration
results from the unrestricted movement of the head
and leads to shear, tensile, and compressive strain
These forces can cause intracranial hematoma, diffuse
vascular injury, and injury to cranial nerves and the
pituitary stalk
July 15, 2021
Intracranial hematoma is the most common cause of
death and clinical deterioration after Traumatic Brain
Injury
Hematomas are categorized below:
EPIDULAR HEMATOMAS- these are usually caused by
fracture of the temporal bone and rupture of the middle
meningeal artery.
SUBDURAL HEMATOMAS- such hematomas are usually
caused by rupture of the bridging veins
SUBARACHNOID HEMATOMAS- these result from
damage to blood vessels in the posterior fossa stalk
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Secondary brain

damage

Secondary injury may occur hours or even days after the inciting traumatic event.

Injury may result from impairment in cerebral blood flow (CBF) after Traumatic Brain Injury

As a result of Inadequate perfusion, cellular pumps may fail, causing a cascade involving intracellular calcium and
sodium

Resultant calcium and sodium overload may contribute to cellular destruction

As the cascade continues, cells die, causing free radical formation, proteolysis, and lipid peroxidation

These factors can ultimately cause neuronal death

 Causes Signs and Symptoms

MILD TRAUMATIC BRAIN INJURY

EXTRACRANIAL CAUSES
Loss of consciousness for a few minutes
Failure of adequate cerebral perfusion from
memory or concentration problems
circulatory shock
headache
Failure of cerebral oxygenation from disturbance of
dizziness or loss of balance
pulmonary ventilation from:
nausea or vomiting
-aspiration, instability of chest wall (eg flat chest),
difficulty sleeping
neurogenic disturbances of ventilatory drive.

MODERATE TO SEVERE TRAUMATIC BRAIN INJURY

INTRACRANIAL CAUSES
loss of consciousness from several minutes to hours
A rise in ICP due to mass lesions and cerebral
slurred speech
oedema leading to falling in cerebral perfusion
inability to awaken from sleep
pressure and to herniation of the brain is a major
weakness or numbness in fingers and toes
factor in a poor outcome.
loss of coordination
Cerebral autoregulation impaired
persistent headache or headache that worsens
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'
Care giver s

Responsibility
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1. Assisting with
personal care

One of the biggest responsibilities of a caregiver is to assist

the older person with personal care. Some of the personal care
includes bathing, grooming, and dressing. There is a huge task
on the shoulders of caregivers to help the elderly with this
duties
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2. Food

preparation

The preparation of food is not limited to cooking alone.

Caregivers should be able to go beyond the mere preparation
of meals. The older person must be assured that you are there
for shopping of the food ingredients, arranging the food items
where they should be, and more.
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3. General health

care

Health is the most important aspect of aging. Older people,

at this point in their lives, do not prioritize any other thing above
their health. As such, your help comes in handy when it comes
to taking proper care of other people, especially when it
concerns their health in particular
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4. Mobility

Assistance

Even aging parents with mobility issues want to more about

it. They even love walking with their adult children or their
caregiver. Older people want to go out to see what is
happening. They think they must have missed a lot while
staying indoors for some time.
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5. Personal

supervision

Older parents usually act like babies as their ages increase. It

is no one's fault. That is how nature has been tailored. Their
body-like actions mean you will have to do some supervision
and give them orders to stick by. You are not meant to sound
arrogant or disobedient
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6. Emotional

support

More than being a caregiver, you have to be a reliable

companion. Seniors need people with whom they can stay,
people with whom they can discuss and laugh, and people with
whom they can share their deep feelings. It might be quite a
challenge if you have lots to do at home, especially if you are
rising a young family.
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7. Transportation

Older people need help when moving from one place to

another. Much of transportation has been covered in this
article. However, there is a little different here.
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8. Be the

mediator

The responsibility of a mediator is to be the person who

takes the position to pass information and feedback from one
individual to another. That is who you should be if you really
want to be impactful as a caregiver.
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9. Home

organization

Older people do not have the strength to clean homes and

arrange rooms the way you can. Therefore, organizing the
home of your aging parents becomes your responsibility. You
are tasked with general house cleaning and cleaning of a
specific part of the apartment like the toilet. You are also
responsible for cleaning house furniture and equipment.
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10. Handle a

crisis or medical

emergency

This is the scary part for some caregivers. However, there is

nothing to fear about an older person experiencing a medical
crisis. If you have been playing your role as a caregiver very
well, you wouldn't have to be terrified.
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11. -
Back up

caregiving

You might have to support another caregiver when they are

not available. You have to be ready to shoulder these
responsibilities even if you are acting as a backup to someone
else.
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!
Thank you

Have a great
weekend!