Predicting short-term outcome in comatose head-injured children

While planning patient care strategies for the critically head-injured child, anticipation of complications and expected outcomes are important nursing considerations. This research study followed 30 comatose children retrospectively during their hospitalization for severe head injury. Ten prognostic indicators (age, sex, type of injury, Glasgow Coma Scale total, motor response, pupillary response, oculocephalic reflex, corneal reflex, gag reflex, and ventilatory status) were analyzed for their relationship to the subsequent development of diffuse cerebral swelling, duration of coma, and mortality. Only the corneal reflex was significantly related to all three of the short-term complications (p greater than 0.05). Age category was shown to be related to both diffuse cerebral swelling and duration of coma (p greater than 0.05), identifying children between 11 and 15 years of age at greatest risk for these life-threatening complications. Knowledge of the probable clinical course of a head-injured child aids the nurse in developing care plans and supporting family members.