Unintentional Injuries
 Used to refer to injuries that were unplanned
 Common:
o Falls - second most common
o Burns
o Drownings
o 
Motor vehicle accidents
 Head injuries
o Any trauma to the scalp, skull, or
brain
o Injury may be minor bump on the
skull/serious brain injury
o Either closed or open (penetrating)
o Skull fracture - a break in a bone
surrounding the brain
 Linear (most common)
 Depressed fractures (skull
has been pushed in)
 Diastatic fracture (break
occurs in more than one of the
bones in the skull connected
together)
 Basilar fractures (most
uncommon and appear at the base
of the skull and can risk damage to
the spinal cord
o *location of suture lines of skull*
o Subdural Hematoma
 Collection of blood
(associated with traumatic brain
injury)that gathers between the
inner layer of the dura mater and
arachnoid mater of the meninges
surrounding the brain
o Epidural Hematoma
 Bleeding between tough
outer membrane covering the brain
(dura mater) and the skull
 Dx: CT scan or MRI
 Tx: urgent surgery
(Craniotomy or burr hole)
 Without tx, death occurs
o Concussion
 Mild traumatic brain injury
(TBI)
Occur after an impact to your
head or after a whiplash-type injury
that causes your head and brain to
shake quickly back and forth
 Altered mental
state=unconscious
 Dx: MRI scan and CT scan of
brain
 Tx: electroencaphologram
(monitors brain waves)
 *etiology of coup and
contrecoup injury*
 ICH (Intracerebral
hemorrhage)
 Bleeding in the brain
tissue itself
 Life threatening
stroke
 Brain deprived of O2
and blood supply
o Brain Contusion
 Tearing or laceration of brain
tissue
 "bruising on the brain"
 Tx: aims to prevent swelling
 Prevention
hypotension (low BP),
hyponatremia (insufficient
sodium), hypercapnia
(increased CO2 in blood)
 Surgery may be necessary;
requires intensive care and close
monitoring
o o
Coma
 Unresponsive/unconsciousne
ss from which a child cannot
roused
 Stupor (grogginess from
which a child can be roused) may
occur in children after severe head
trauma
o NURSING PROCESS
 Immediate assessment
 Neurologic
assessment
 VS, Pupils, LOC,
motor function
 Glasgow Coma
Scale
 Immediate management
 Neck stabilization,
head elevated (45 degrees)
 CT scan/MRI
 Central nervous or
arterial line; steroids
 For coma:
 Obtain history
immediately; inspect
complete...
 Therapeutic Techniques
 Abdominal trauma
o Injury to the abdomen
o Symptoms
 abdominal pain, tenderness,
rigidity, and bruising of the external
abdomen
o complications
 Drowning
 Poisoning
 Burns
 Assessment:
Respiratory system
  Rate and quality of
respiration
 Any sound of obstruction
 Cyanotic? (color)
 Oxygen hunger
(restlessness)
o Cardiovascular system
 Color
 Evident/signs of bleeding
 Pulse rate (increases)
 Blood pressure (decreases)
 Feeling of apprehension
o Nervous system
 Level of consciousness
 PERRLA