RESUMO
Pneumocephalus, air in the cranial cavity, is a common occurrence following cranial surgery. However, tension pneumocephalus, accumulation of air trapped in the cranial cavity causing a mass effect and abnormal neurological signs, is uncommon. Knowledge about conditions that contribute to tension pneumocephalus, a potentially fatal complication, including the related signs and symptoms, is imperative. Immediate collaboration with a physician allows for timely treatment and patient recovery. Treatment measures include preoperative teaching, immediate removal of intracranial air, supine positioning, administration of 100% oxygen, repair of the bony and dural defect, and, if indicated drain placement into the air cavity, temporary tracheotomy, and antibiotics.
Assuntos
Pneumocefalia , Especialidades de Enfermagem/métodos , Educação Continuada em Enfermagem , Humanos , Masculino , Pessoa de Meia-Idade , Pneumocefalia/etiologia , Pneumocefalia/enfermagem , Pneumocefalia/terapiaRESUMO
The rigid cervical collar has been a great addition to the successful management of cervical spine injuries. But the collar has been known to offer a false sense of security in terms of totally preventing additional and further spinal cord compromise and damage. Also, with increased length of collar wear, there is development of skin pressure points and ulcer formation, possible delay in weaning from a ventilator, potential for exposure to transmission of blood-borne diseases. Photographs are used to demonstrate examples of related skin breakdown, show proper collar fit, present the result of ineffective cervical immobilization, and show how to stabilize the head and neck during a collar change. These problem areas are addressed with the dos and don'ts for nursing management.