Karen’s Free Health and Fitness Tips

The tragic accidental death of respected actress Natasha Richardson has brought attention to how a bumped head might seem minor enough, but can turn out to be a life threatening brain injury.

Just as Natasha reportedly did, it’s common for someone who’s had a fall or been in a car crash to seem perfectly lucid just after the impact, only to deteriorate rapidly later on.

“A patient can appear so deceivingly normal at first,” said Dr. Carmelo Graffagnino, director of Duke University Medical Center’s Neurosciences Critical Care Unit. “But they actually have a brain bleed and as the pressure builds up, they’ll experience classic symptoms of a traumatic brain injury.”

You may have heard this called “talk and die” syndrome.

The fall doesn’t have to be all that bad. Natasha fell on a beginner ski slope and didn’t seem to hit her head on anything. You don’t have to see external injury to have injury to your brain. She was able to talk and joke with her ski instructor after the fall, and rejected medical care.

The onset of symptoms can be anywhere from five minutes to three hours after the accident - for Natasha it was two and half hours before she complained of the headache that brought an ambulance to her hotel.

After a person has been in a car accident, they are understandably in shock. Car accidents happen quickly, oftentimes before either party had time to react. For those who have been injured in a car accident, most of the trauma often ends up being in the head and neck, although cars with airbags are supposed to protect on impact.

Once the initial shock is over, it is time to get the extent of the injuries checked out via a CT scan. In order to understand what getting a CT scan means, it is important to understand the basic idea behind x-ray technology. Obviously, a doctor cannot look at a person’s bones just on site. Rather, the doctor needs the patient to get an x-ray.

The same thing goes for a CT scan, which is a more advanced form of x-ray technology. While an x-ray can see the bones, a CT scan can see the bones and the tissue in a far more detailed manner. This can be of help to a car accident injury victims, because head traumas can result in brain damage or clots, which this kind of scan can detect.

The most notable reason they exist in the first place is VTOL or VerTOL capability, which stands for Vertical Take-Off and Landing. Although helicopters were invented in the 20th century, the idea was firstly thought out by Leonardo da Vinci in the 15th century, which he defined as ‘air screw’. Helicopters ability to fly and land vertically, eliminates the need for a runway like in a winged aircraft. This particular feature enables the helicopters to hover and access many impossible areas.

Helicopters as air ambulances have greatly increased the percentage of severely injured victims that being saved because of the lifesaving equipment prepared on the helicopters and the aerial speed generated by the helicopters to get to the nearest health care facility. The universal flight capability of a helicopter makes them favorable among many military transports and emergency services. The most iconic helicopter is the Bell Huey, designated UH-1 “Iroq” which serves as the main transport aircraft during the Vietnam War in the 60’s. This helicopter was the star of many popular Vietnam War themed movies such as Tour of Duty and We Were Soldiers. Apart from serving its purpose as a light assault platform, they were mainly responsible as a “Medivac” or Medical Evacuation, much like an air ambulance helicopter, except with bullets flying past (and through) them.

The main goal for treatment of cardiogenic shock is reestablishing myocardial circulation, minimize heart muscle damage, and improve the pumping function of the heart. First-line treatment can utilize antishock trousers which compress the legs and shunt blood flow to the vital organs. Metallic PET film blankets can be used to reflect the patient’s body heat to keep the patient warm (Wikipedia, 2008).

If a structural disorder is causing cardiogenic shock, they are repaired surgically. These may include septal rupture or dysfunction of the valves. Thrombosis of the coronary arteries is treated usually with angioplasty or stenting, coronary artery bypass grafting, or thrombolysis. Arrhythmias are treated medically or with cardioversion if indicated (Weil, 2007). Shock resulting from an acute myocardial infarction is usually treated with fluids if the CVP is low. If a pulmonary artery catheter is not in place, often small boluses of fluid (250 mL to 500 mL) are given to see if the patient’s vital signs improve. This is done with care, while frequently auscultating the lungs and looking for signs and symptoms of fluid overload. Vasopressors may also be instituted to maintain adequate blood pressure (Weil, 2007).

Head injury can be a linear skull fracture which is a common injury that is found especially in children. It is a simple break in the skull that follows a somewhat straight line. It can occur after a minor head injury and is not that serious unless there is an additional injury to the brain.

Head injury can also be a depressed skull fracture. A depressed skull fracture is common after forceful impacts by blunt objects-most commonly, hammers, rocks and other heavy but fairly small objects. This type of injury can cause dents in the skull bone and may be fatal and require surgery.

Then there is the basilar skull fracture. A head injury that is a fracture of the bones that form the base of the skull. It is a result of a severe blunt head trauma of significant force. This injury may cause infection as the fracture allows air or fluid inside to enter the skull. Surgery may or not be necessary unless other injuries are involved.

These are just the types of head injuries, but there is only one type of modern alternative medicine that can help cure it. It is hyperbaric oxygen treatment. Hyperbaric oxygen treatment is an FDA approved treatment and already being used by over 400 facilities in the U.S.

The nutritional support in critically ill patients can be explained in 2 ways

1. Enteral Nutrition

2. Parenteral nutrition

It is worth remembering that enteral nutritional is always the preferred route. The reason is clear.

1. Enteral nutrition helps mucosal integrity and thereby it minimizes the risk of bacterial colonization.

2. Reduces gastro-intestinal bleeds

3. Sepsis and its complications are reduced.

There has been an extensive study done on the role of aminoacids and fatty acids but the conclusions have been inconclusive.

Now lets talk about the 2.Parenteral nutrition

If the enteral nutrition is not applicable or worse has failed then parenteral nutrition is the way to go.

But remember that its costly affair and not many patients may be able to afford it especially if you are a doctor in the third world country.

Problems with parenteral nutrition {complications}

1. Catheter related sepsis

2. Intestinal mucosal atrophy

3} Standard solutions related problems.

Apart from Nutritional support lets consider the other support a critically ill patients need.

1. Ventilatory Support

Modes-Controlled mandatory ventilation

—Synchronized intermittent mandatory ventilation

—Positive pressure ventilation and

Having a baby that is admitted into the neonatal intensive care unit, or NICU, can be an overwhelming event. Infants are admitted into the NICU for a broad spectrum of illnesses, diseases, conditions, as well as prematurity. A team of neonatologists, neonatal nurse practitioners, and specialized neonatal nurses provide the most advanced and critical care for these neonates.

Parents with a baby in the neonatal intensive care unit must first understand the reason why their infant is in a critical care unit. While many mothers may know of a certain condition or anomaly ahead of time, there are many times that a mother will unexpectedly go into labor, delivering a preterm infant, or have a baby with a condition, illness, or anomaly that is completely unexpected.

Regardless of how and why the infant came into the NICU, it can be a tough ordeal for any parent. Remember that the NICU staff is not only there to care for the infants, but to help parents through the ordeal as well. A mother or father should remember to ask any and all questions they have, as it is very important they completely understand the condition of their baby.

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