Module 4: Pediatric Head Injuries

Slide 1 - Learning ObjectivesSlide 2 - Pediatric Head Injury - EpidemiologySlide 3 - Intracranial Pressure - PhysiologySlide 4 - Raised ICP - Brain HerniationSlide 5 - CPP - PhysiologySlide 6 - Head Injury - PathophysiologySlide 7 - Respiratory Failure in Head-Injured ChildrenSlide 8 - Signs and Symptoms of Head InjurySlide 9 - Glasgow Coma Scale (GCS)Slide 10 - Glasgow Coma Scale (GCS) in Infants and ChildrenSlide 11 - Classification of Head Injury (HI) by GCSSlide 12 - AVPU Pediatric Response Scale for DisabilitySlide 13 - Common Lesions After Head InjurySlide 14 - Subdural HematomaSlide 15 - Epidural HematomaSlide 16 - Intracerebral HematomaSlide 17 - Management of Head InjurySlide 18 - Hypotension Associated with Poor OutcomeSlide 19 - Management of Raised ICPSlide 20 - HyperventilationSlide 21 - Ventilation - RecommendationSlide 22 - Fluid Therapy for Head InjurySlide 23 - Sedation, Analgesia and ParalysisSlide 24 - Use of Paralytic AgentsSlide 25 - Positioning Tips to Reduce ICPSlide 26 - Temperature RegulationSlide 27 - Management of SeizuresSlide 28 - AnticonvulsantsSlide 29 - Anticonvulsant ProphylaxisSlide 30 - Hyperosmolar TherapySlide 31 - Ventricular Catheter/ Lumbar Drain for Draining CSF to Reduce ICPSlide 32 - Decompressive CraniotomySlide 33 - Barbiturate ComaSlide 34 - Summary of ICP ManagementSlide 35 - Non-Accidental Injury (Shaken Baby Syndrome)Slide 36 - Shaken Baby SyndromeFamily Risk FactorsSlide 37 - Bruises - Abuse or Accident?Slide 38 - Evaluation of Suspected AbuseSlide 39 - Evaluation of Suspected AbuseSlide 40 - Child Abuse - The Physician's RoleSlide 41 - Review: Question 1Slide 42 - Review: Question 2Slide 43 - Review: Question 3Slide 44 - Review: Question 4Slide 45 - Review: Question 5Slide 46 - Acknowledgments of 46

Management of Raised ICP

• Control the airway and give 100% oxygen
• Maintain BP and CPP
• Treat seizures
• Ensure adequate sedation, analgesia +/- paralysis
• Normalize temperature, glucose, chemistry
• Consider mannitol, hypertonic saline, furosemide
• Hyperventilation
  - Mild (PaCO₂ 30-35mmHg) for increased ICP
  - Transient (PaCO₂ < 30mmHg) for impending herniation
• Ventricular catheter for CSF drainage
• Decompressive craniotomy
• Barbiturate coma

Module 4: Pediatric Head Injuries

Hypotension Associated with Poor Outcome

Hyperventilation