Emergency care for various head injuries

Most if not all head injuries are potentially dangerous because the head houses the brain which is the central hub of the nervous system and any injury to the head could possibly result in irreversible damage to the brain and its underlying tissue. If not immediately and properly treated, injuries that seem minor could turn out to be life threatening if not cared for accordingly.

Head injuries come in many forms and the most common ones include open scalp wounds, penetrating skull fractures and brain trauma. Although spinal injuries are generally classified belonging to the neck and back, it can also present in several head-injured victims due to its close proximity especially cervical spine related injuries.

Emergency care for various head injuries

Care for Scalp Wounds

The scalp (the portion of the head where the hair is attached to the skin) contains numerous blood vessels, therefore any cut or wound can cause severe bleeding. Although a bleeding scalp may not directly affect the blood supply to the brain nevertheless it should be properly treated to prevent infection. To care for scalp wounds do the following:

  1. Apply a clean cloth or preferably a sterile dressing to the wound and direct pressure to help control bleeding.
  2. Keep the victim’s shoulders and head slightly elevated to help stabilize bleeding if there is no spinal injury suspected.
  3. Seek medical care for further evaluation and management.

Skull fractures

Any significant force or blow to the head can cause a fracture to the skull. Any skull related fracture occurs when part of the skull is broken.

Recognizing skull fracture

Signs and indications of a skull fracture include the following:

  • A break or deformity of the skull
  • Moderate to severe pain at the point of injury
  • Drainage of clear of bloody fluid from the nasal orifice or ears.
  • Loss of responsiveness
  • Heavy scalp bleeding (exposure of the skull and brain tissue)

Care for Skull Fracture

  1. Check for responsiveness and breathing. Initiate CPR if necessary.
  2. Control any bleeding by applying direct pressure using a sterile or clean dressing around the edges of the wound and not directly on it to avoid further injury.
  3. Immobilize the head and neck, asses for possible neck injury.
  4. Call emergency care services or rush the victim to the hospital.

Brain Injuries

The brain despite being protected by the skull can sustain significant injury if the force applied is more than what the skull can withstand. A temporary disturbance of brain activity is known as a concussion. Most concussions are basically mild which people can fully recover. Most concussions do not involve hemorrhage under the skull or swelling of the brain tissue.

Signs of Brain injury

  • Amnesia
  • Confusion
  • Slurred speech
  • Inability to walk properly
  • Loss of responsiveness
  • Incoherent disposition
  • Headache, dizziness and nausea within minutes or hours of injury

Care for brain injuries

  1. Check for responsiveness and breathing. Provide necessary and appropriate care.
  2. Immobilize the head and neck for a suspected spinal injury.
  3. Control bleeding by applying a clean cloth or sterile dressing and direct pressure if there is an open wound and active bleeding.
  4. If the victim vomits, place the roll the victim to his/her side to keep airway pate and clear.
  5. Call for emergency medical services for further evaluation and management

Reference:

Alton, T. et al (2012). First Aid, CPR and AED Standard 6th Ed. Jones & Bartlett Learning

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