Citation

Allen KA. J. Neurosci. Nurs. 2016; 48(1): 15-27.

Affiliation

Questions or comments about this article may be directed to Kimberly A. Allen, PhD RN, at allenk@uic.edu. She is an Assistant Professor, Women, Children, and Family Health Science, University of Illinois, Chicago, IL.

Copyright

(Copyright © 2016, American Association of Neuroscience Nurses)

DOI

10.1097/JNN.0000000000000176

PMID

26720317

PMCID

PMC4698894

Abstract

Traumatic brain injuries (TBIs) in children are a major cause of morbidity and mortality worldwide. Severe TBIs account for 15,000 admissions annually and a mortality rate of 24% in children in the United States. The purpose of this article is to explore pathophysiologic events, examine monitoring techniques, and explain current treatment modalities and nursing care related to caring for children with severe TBI. The primary injury of a TBI is because of direct trauma from an external force, a penetrating object, blast waves, or a jolt to the head. Secondary injury occurs because of alterations in cerebral blood flow, and the development of cerebral edema leads to necrotic and apoptotic cellular death after TBI. Monitoring focuses on intracranial pressure, cerebral oxygenation, cerebral edema, and cerebrovascular injuries. If abnormalities are identified, treatments are available to manage the negative effects caused to the cerebral tissue. The mainstay treatments are hyperosmolar therapy; temperature control; cerebrospinal fluid drainage; barbiturate therapy; decompressive craniectomy; analgesia, sedation, and neuromuscular blockade; and antiseizure prophylaxis.

Language: en