Assignment Title: Understanding Head Trauma and Glasgow Coma Scale (GCS)
Assessment
Course: Critical Care Nursing
Submission Date: 30-12-2024
Objective:
To gain a detailed understanding of head trauma and the Glasgow Coma Scale
(GCS) assessment
Expected Learning Outcomes:
By completing this case study, nursing students should be able to:
Accurately assess a patient using the Glasgow Coma Scale.
Identify critical nursing priorities in managing a patient with head trauma.
Understand the pathophysiology and management of epidural hematomas
Patient Information:
Name: Ali Ahmad
Age: 28 years
Gender: Male
Presenting Complaint: Unconscious after a road traffic accident (RTA)
Scenario:
Ali Ahmad was brought to the emergency department (ED) by ambulance after a
high-speed motor vehicle collision. Bystanders reported that the patient was
ejected from the vehicle and struck his head on the pavement. On arrival at the
scene, paramedics noted the following:
Airway: Patent but with snoring sounds.
Breathing: Shallow, respiratory rate 10 breaths/min.
Circulation: Weak, thready pulse of 120 bpm; BP 90/60 mmHg.
Disability (Neurological Assessment): Altered level of consciousness.
Paramedics stabilized his cervical spine, administered supplemental oxygen via a
non-rebreather mask, and transported him to the ED.
Emergency Department Findings:
The patient is unresponsive to verbal commands.
Pupils: Left pupil is dilated and sluggish to light; right pupil is normal.
Skin: Pale and clammy.
External injuries: A 5 cm laceration on the left temporal region with active
bleeding; bruising noted around both eyes (raccoon eyes).
No obvious limb fractures or deformities.
Neurological Assessment (GCS):
Evaluate Ali's GCS score based on the following observations:
1. Eye Opening (E): Does not open eyes, even to pain. (Score: __)
2. Verbal Response (V): No understandable words; only incomprehensible
sounds. (Score: __)
3. Motor Response (M): Withdraws arm in response to painful stimulus.
(Score: __)
Total GCS Score: ___
Clinical Management:
The attending physician orders the following interventions:
1. Intubation for airway protection.
2. CT scan of the head to assess for intracranial bleeding or skull fractures.
3. Fluid resuscitation with 0.9% saline to address hypotension.
4. Administration of IV mannitol to reduce intracranial pressure (ICP).
Questions for Nursing Students:
1. Glasgow Coma Scale Assessment:
a. Calculate Ali's GCS score based on the observations.
b. What does this score indicate about the severity of his head injury?
2. Immediate Nursing Priorities:
a. List the nursing interventions required to stabilize Ali in the ED.
b. How would you monitor for signs of increasing intracranial pressure?
3. Post-CT Scan Findings:
The CT scan reveals a left-sided epidural hematoma. Explain the
pathophysiology of this condition and why it is a neurosurgical emergency.
