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Secondary Brain Injury

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Secondary brain injury can occur within hours to days after the primary insult (Lump, 2014). The clinical indicators of secondary brain injury consist of increased intracranial pressure (ICP), hypotension, hypercapnia and hypoxia (Lump, 2014). Subsequently, it can potentially have vast impacts on the patient’s mortality and recovery rate (Salottolo et al., 2014). Performing neurological assessments such as GCS, pupillary and vital sign observation on TBI patients hold great importance as it detects early symptoms of secondary brain injury and provides information on the impairment of consciousness (Salottolo et al., 2014). Therefore, in order to provide high-quality holistic nursing interventions for patients in critical episodes, it is imperative to gain understanding of the use of intensive assessments.

GCS is a standardised assessment tool that has significant implications such as providing a baseline, detecting early signs of deterioration and evaluation of severity of the brain injury (Middleton, 2012). The three domains of GCS are eye opening, verbal and motor response. The eye opening reflects arousal levels originating from brainstem activity. The verbal component requires the use of cerebral cortex and reveals the patient’s awareness and orientation …show more content…

It is exemplified that herniation syndromes and increased ICP results in decorticate responses and progression to motionlessness (Maserati et al., 2016). Therefore, the decrease in motor subscore conveys valuable insight in the integrity of cerebral function and deficits in consciousness (Middleton, 2012). Therefore, gaining understanding into the significance of GCS is paramount as it provides a critical tool for measuring current neurological function and guides nurses to advocate and implement timely

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