Perspective - Journal of Intensive and Critical Care Nursing (2022) Volume 5, Issue 4
Evidence for care of patients with severe traumatic brain injury with specific elements of emergency nursesSahaja Gettri*
Lakshya- A Society For Public Health Education And Research, Pune, India
- *Corresponding Author:
- Sahaja Gettri
Lakshya-A Society For Public Health Education And Research
E-mail: [email protected]
Received: 07-Jul-2022, Manuscript No. AAICCN-22-78181; Editor assigned: 08-Jul-2022, PreQC No. AAICCN-22-78181(PQ); Reviewed: 21-Jul-2022, QC No AAICCN-22-78181; Revised: 09-Aug-2022, Manuscript No. AAICCN-22-78181(R); Published: 12-Aug-2022, DOI:10.35841/aaiccn-5.4.118Citation: Gettri S. Evidence for care of patients with severe traumatic brain injury with specific elements of emergency nurses.. J Intensive Crit Care Nurs. 2022;5(4):118
ICU survivors, Nursing, Severe traumatic brain injury, Emergency nursing.
Maintain airway and ventilation. Keep the cerebral perfusion pressure constant. Secondary injuries can be avoided by identifying and treating hypoxia, hypercapnia, or hypoperfusion. An adequate airway is always the first priority in any emergency. The nurse is responsible for cleaning the patient's mouth, inserting an oral airway, assisting with intubation, oxygen therapy, and continuously evaluating the patient's respiratory system. Serious or catastrophic brain injuries may necessitate emergency care, such as surgery to remove blood clots and relieve brain pressure. Minor head injuries will be treated and monitored based on their symptoms, which may include headache pain medication as well as nausea and vomiting medications.
A mixed medical-surgical strategy is now used in the intensive care unit to treat severe traumatic brain injury (TBI). The goal of treatment is to prevent further brain damage and to improve circumstances for brain recovery. TBI is commonly regarded and treated as a single clinical entity, despite the fact that it is a syndrome composed of a variety of lesions that may necessitate distinct therapies and physiological aims. Because of advancements in monitoring and imaging, it is now possible to pinpoint particular processes of brain damage and target treatment to individuals or subsets of patients. Targeted treatment is especially important for the elderly, who now account for a growing proportion of TBI patients, because their preinjury comorbidities and therapies necessitate specific management tactics . Progress in monitoring and understanding the pathophysiological mechanisms of TBI could revolutionise present intensive care unit management, allowing for focused interventions that could ultimately improve results .
Traumatic brain injury (TBI) manifests itself in a variety of ways, ranging from slight changes in awareness to a relentless vegetative condition and death. In the most severe form of TBI, a diffuse sort of inflammation and edoema affects the entire brain. Depending on the degree of the injury, treatment options range from daily cognitive therapy sessions to major surgery such as bilateral decompressive craniectomies. Guidelines for the optimal care of TBI have been established, but they must be considered in the context of the scenario and cannot be employed in every particular circumstance. We described the present state of TBI treatment in clinical practise and basic research in this review study .
We have provided a brief summary of the many subtypes of traumatic injuries, optimal medical therapy, non-invasive and invasive monitoring techniques, and surgical interventions that may be required in specific cases. We have reviewed the major advances in basic science in the hunt for TBI therapy techniques. We also reviewed the future direction of TBI treatment development from an experimental standpoint .
We have provided a brief summary of the many subtypes of traumatic injuries, optimal medical therapy, non-invasive and invasive monitoring techniques, and surgical interventions that may be required in specific cases. We have reviewed the major advances in basic science in the hunt for TBI therapy techniques. We also reviewed the future direction of TBI treatment development from an experimental standpoint. A variety of biomarkers are currently at or nearing the stage of formal clinical validation for their diagnostic and prognostic utility in the treatment of TBI of varying severity, including concussions. TBI biomarkers have the potential to be used as a theranostic tool to aid in drug development and treatment monitoring .
Therapeutic hypothermia (TH) and targeted temperature management (TTM) have been investigated in a range of preclinical and clinical settings for severe (TBI). Mild reductions in brain temperature after moderate to severe TBI improved histopathological outcomes and reduced neurological impairments, according to early preclinical investigations. Reduced post-traumatic temperature has also been shown in studies to reduce several secondary injury processes such as excitotoxicity, free radical production, apoptotic cell death, and inflammation. Furthermore, whereas post-traumatic temperature rises exacerbated subsequent damage processes, successful use of TTM techniques in injured patients to lower fever burden appears to be helpful. While TH has been evaluated effectively in a number of single institution clinical TBI studies, bigger randomised multicenter trials have failed to show the benefits. The use of TH and TTM for TBI treatment is evolving, and several criteria, including patient selection and TH timing, appear to be crucial in effective trial design. It is clear that using TH and TTM techniques to treat severely damaged individuals is a critical therapeutic issue that necessitates additional basic and clinical study. Current research is looking into different cooling tactics such as pharmacologically induced hypothermia and combining TH or TTM procedures with more specific neuroprotective or reparative treatments. The purpose of this publication is to outline the preclinical and clinical research emphasising the role of brain temperature in modulating secondary injury pathways and improving traumatic outcomes in severely injured individuals .
Although TBI-related fatality rates reduced between 1997 and 2007, disability for TBI survivors continue to have a direct and indirect impact on our society's economic and human integrity. The severity and cause of the damage influence the degree of disability, but physical and mental problems can persist for years after the accident .
The pathophysiology of moderate to severe TBI, its consequences, and potential to enhance patient outcomes through the use of acute care and rehabilitation modalities are discussed in this article. To address the various obstacles faced by TBI survivors and their families, including considerable financial and emotional burdens, a concerted effort is required to assist afflicted children in effortlessly transitioning from acute care to long-term rehabilitation.
- Stocchetti N, Carbonara M, Citerio G, et al. Severe traumatic brain injury: targeted management in the intensive care unit. Lancet Neurol. 2017;16(6):452-64.
- Galgano M, Toshkezi G, Qiu X, et al. Traumatic Brain Injury: Current Treatment Strategies and Future Endeavors. Cell Transplant. 2017;26(7):1118-30.
- Wang KK, Yang Z, Zhu T, et al. An update on diagnostic and prognostic biomarkers for traumatic brain injury. Expert Rev Mol Diagn. 2018;18(2):165-80.
- Dietrich WD, Bramlett HM. Therapeutic hypothermia and targeted temperature management in traumatic brain injury: Clinical challenges for successful translation. Brain Res. 2016;1640(Pt A):94-103.
- Popernack ML, Gray N, Reuter-Rice K. Moderate-to-Severe Traumatic Brain Injury in Children: Complications and Rehabilitation Strategies. J Pediatr Health Care. 2015;29(3):e1-7.