Head trauma professional#

The degree of brainstem neurological function and.The level of consciousness: Glascow Coma Scale (GCS) 1-15 a patient with any score less than 7 or 8 is considered to be in coma.The decision to proceed with surgical treatment of the gunshot wound is based on the following factors:

If blood pressure and oxygenation can be maintained, an urgent CT scan of the head is obtained. Gunshot wound head trauma patients are aggressively resuscitated upon initial arrival at the hospital. If the victim survives the initial insult, the issue becomes the increasing pressure inside the skull.

A bullet trajectory through key blood vessels in the brain can result in rapidly expanding blood clot in the brain that can critically compress the important brain tissue resulting in immediate death at the scene. However, a similar bullet passing downward from the left frontal lobe tip toward the temporal lobe and brainstem is likely to be devastating, because it passes through eloquent brain tissue and is likely to injure important vascular structures inside the head. A bullet wound going through the right frontal lobe tip toward the forehead and well above the base of the skull is likely to cause relatively mild clinical damage, because it passes through no vital brain tissue or vascular structures. These include the caliber of the gun, size and speed of the bullet, the trajectory and site of the injury. Both bleeding and damage from this pressure wave results in brain swelling, which can also lead to death.Ī number of factors determine the extent of damage caused by a gunshot wound. When the projectile itself goes through the brain, there is injury from both the direct penetration of the brain and from transmission of a pressure wave from the high-velocity (greater than 2,000 feet/second) projectile traveling through the brain tissue. An injury in which the projectile enters and exits the cranium is referred to as a perforating wound. CHOP is not responsible for any errors or omissions in the clinical pathways, or for any outcomes a patient might experience where a clinician consulted one or more such pathways in connection with providing care for that patient.A wound in which the projectile enters the cranium, but does not exit, is referred to as a penetrating wound. CHOP does not represent or warrant that the clinical pathways are in every respect accurate or complete, or that one or more of them apply to a particular patient or medical condition.

Head trauma professional#

These clinical pathways are intended to be a guide for practitioners and may need to be adapted for each specific patient based on the practitioner’s professional judgment, consideration of any unique circumstances, the needs of each patient and their family, and/or the availability of various resources at the health care institution where the patient is located.Īccordingly, these clinical pathways are not intended to constitute medical advice or treatment, or to create a doctor-patient relationship between/among The Children’s Hospital of Philadelphia (“CHOP”), its physicians and the individual patients in question.

The clinical pathways are based upon publicly available medical evidence and/or a consensus of medical practitioners at The Children’s Hospital of Philadelphia (“CHOP”) and are current at the time of publication. Use of this site is subject to the Terms of Use. ©2022 by Children's Hospital of Philadelphia, all rights reserved. If you have questions about any of the clinical pathways or about the process of creating a clinical pathway please contact us.