Change of Consciusness Level Through Oxygen Supply in Head Injury

K. Khoiriyah, Hendi Ardiananto
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Abstract

Head injury is one of the main causes of death and disability in the productive age group and most occur due to traffic accidents. Patients with a head injury can experience permanent damage to brain tissue or secondary injuries such as brain ischemia due to hypoxia, hypercapnia, hyperglycemia or electrolyte imbalance, even respiratory failure and heart failure. The head injury patients are initially examined using a standardized scoring system to assess the consciousness level of patients with impaired consciousness, namely the Glasgow coma scale (GCS). One of the possible treatments for decreasing intracranial pressure (ICP) and cerebral perfusion managements to position the patients with a head elevation of 15˚-30˚. This treatment aimed  to increase venous drainage from the head and to reduce systemic blood pressure that may be compromised by cerebral perfusion pressure. This study aimed to determine the effect of giving oxygen through a simple mask and the 30˚ head elevation position to the changes of the consciousness level for the patients witha head injury in the emergency department at Dr. Kariadi Hospital, Semarang. This study was quasi-experimental research without control with pre-test and post-test one-group design with used a sample of 23 respondents. The instrument used an observation sheet containing the GCS examination results and analyzed using the Wilcoxon test. Based on the results of the bivariate analysis using the Wilcoxon correlation test, a p-value of 0,000 <0,05 was obtained so it could be concluded that the H0 is accepted. Therefore, giving oxygen through simple masks and patient positioning with 30˚ head elevation affect the consciousness level of head injury patients at Dr. Kariadi Hospital, Semarang.
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供氧对颅脑损伤患者意识水平的影响
头部受伤是生产年龄组死亡和残疾的主要原因之一,大多数是由交通事故造成的。头部受伤的患者可能会经历脑组织的永久性损伤或继发性损伤,如缺氧、高碳酸血症、高血糖或电解质失衡引起的脑缺血,甚至呼吸衰竭和心力衰竭。对头部损伤患者进行初步检查,使用标准化评分系统评估意识受损患者的意识水平,即格拉斯哥昏迷评分(GCS)。降低颅内压(ICP)和脑灌注管理的可能治疗方法之一是定位头部抬高15˚-30˚的患者。这种治疗旨在增加头部静脉引流,降低可能被脑灌注压损害的全身血压。本研究旨在探讨三宝朗Dr. Kariadi医院急诊科颅脑损伤患者在简易面罩和头部抬高30˚位置给氧对其意识水平变化的影响。本研究为准实验研究,无对照,采用前测和后测单组设计,共23人。该仪器使用包含GCS检查结果的观察表,并使用Wilcoxon试验进行分析。根据Wilcoxon相关检验的双变量分析结果,p值为0000 < 0.05,因此可以认为H0是可以接受的。因此,在三宝朗Dr. Kariadi医院,通过简单的面罩给氧和患者头部抬高30˚的体位会影响头部损伤患者的意识水平。
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