First Aid for Head Injuries

Definition of Head injury: A head injury is any trauma that leads to injury of the scalp, skull, or brain. These injuries can range from a minor bump on the skull to a devastating brain injury.

Head injuries can cause damage to the:
1) Scalp - such as a minor bump on the head or scalp wound that bleeds
2) Skull - such as a skull fracture (a break or crack in the bone that surrounds the brain)
3) Spinal fluid in the brain
4) Brain itself such as: a concussion, a contusion (the brain tissue is bruised), or a hematoma (blood collects in an area of the brain from a broken blood vessel). Blood from broken vessels may seep into the brain even though there may not be any visible bumps, cuts or bruises. The blood has nowhere to go because skull bones don't expand. This puts pressure on the vital areas of the brain. Bleeding in the brain often starts within the first 24 hours after a head injury and can last for three days or longer. It is very important that you watch for signs and symptoms of a serious head injury during the first 24 hours. Functional outcome is better in children. 77 % of adults & 62 % children who develop hematoma have a skull fracture.

Suspect head injury if:
1. Patient is unconscious or loosing consciousness
2. Has fallen from a height
3. Has been in a motor vehicle collision
4. Has received blow to head, spine or pelvis
5. Has straw colored fluid coming from mouth, nose and ears.
6. Presume neck injury in victims with head injury in all unconscious patients

Test for normality:
• Balance – should be able to stand straight away and walk without swaying, heel to toe
• Orientation – must be able to give their name, age, address, day of the week, where they are
• Memory – should remember how the accident occurred, what happened afterwards.

Signs and Symptoms of head injuries that alert the need for medical care include: 1) Loss of consciousness, confusion, drowsiness
2) Inability to move any part of the body or weakness in an arm or leg
3) Dent, bruise, cut or blood on the scalp
4) Severe headache
5) Stiff neck
6) Vomiting
7) Blood or fluid that comes from the mouth, nose or ear
8) Loss of vision, blurred or double vision, pupils of unequal size
9) Convulsions
10) Palpable Depression
11) visual problems
12) bleeding from eyes, ears or mouth
13) change in behavior (sleep, irritability, lethargy)
14) fluid draining from nose
15) repeated vomiting
16) irregular breathing or heart rate
17) child under the age of two
18) person under the influence of alcohol or other drugs
19) possible child or domestic abuse
20) If yes to any of the previous, seek medical attention.

What is First-aid? First aid is the provision of initial care for an illness or injury. It is usually performed by a lay person to a sick or injured casualty until definitive medical treatment can be accessed.

Do's for head injuries:• Allow for free breathing by cleaning the nose and mouth. Loosen the clothes if possible.
• Turn the patient to his side, so that the oral secretions and vomit (if any) will drool out easily.
• Check for breathing and pulse. If no breathing, open airway by pulling down the jaw and give mouth to mouth assisted breathing. If no pulse, start CPR (cardiopulmonary resuscitation).
• Immobilize and Stabilize the victim:
o Immobilize the victim's head and neck in the position in which they were found. Place rolled towels, articles of clothing, etc. on both sides of the head and neck Tie and wrap in place, but don't interfere with the victim's breathing.
o If necessary, use your hands, one on each side of the victim's head to keep the head from moving.
o Roll the victim on his or her side as mentioned above. This position will allow any vomit to drain and keep the airway open
• Control bleeding:
o Control bleeding by putting pressure around the edges of the wound, not on the wound unless you suspect of fracture. Make a ring pad (shaped like a doughnut) with a narrow bandage or narrow, but long strips of cloth. Start with one end of the narrow bandage and wrap it around all four fingers on one hand until you form a loop. Leave a long strip of the bandage material to weave in and around the loop so it doesn't ravel. Use this ring pad to apply pressure around the edges of the wound.
• Don't wash the wound or apply an antiseptic or any other fluid to it.
• If blood or pink-colored fluid is coming from the ear, nose or mouth, let it drain. Do not try to stop its flow.
• Head and shoulders slightly elevated: Lift the victims head and shoulder, if neck or spinal injury is not suspected.
• Call for Ambulance.
• Apply an ice pack to the injured area to reduce swelling or bruising. Change it every 15 to 20 minutes for an hour or two. Do not put ice directly on the skin. To make an ice pack:
• Put ice cubes into a plastic bag with a little cold water and seal it. Wrap it in a clean towel and apply to the bump or bruise.
• Cover an open cut with gauze and first aid tape or a band-aid.

Don’ts for head injuries:• Do not move head alone separate from body and twist the neck
• Do not plug the bleeding ear or nose for stopping secretions.
• Do not pour water into the mouth.
• Do not give the victim anything to drink or eat.
• Do not elevate the victim's legs.
• Do not leave the victim unattended.
• Don't move the victim unnecessarily.
• Keep unnecessary people away.

Prevention of Head injury: Ways to prevent head injuries:
• Wear a helmet when biking, horseback riding or boxing. Insist that your child does, too.
• Use child safety seats and/or seatbelts in any car, van or truck.
• Teach your child:
• To stop and look both ways before crossing a street.
• About the dangers of running into the street without first looking.
• Not to bang his or her head against something hard during a temper tantrum.
• Don't leave a child alone in a shopping cart. When available, use carts with seatbelts or child safety seats.
• Don't leave a child alone on a high place like a sofa, changing table or bed.
• Take caution yourself when climbing ladders or walking on the roof, etc.
• Install window locks or guards on windows on upper floors.
• Place a sturdy gate at the top of the stairs.
• Lock the door to the basement.
• Keep stairs free of clutter.

Lastly, if any of these problems occur within 72 hours of a head injury:• Headache that lasts longer than one or two days or gets worse with time
• Inability to move arms or legs, weakness in limbs
• Blurred or double vision, pupils of unequal size
• Slurred speech
• Convulsions
• Drowsiness or it is hard to awaken the victim
• Memory loss, confusion, disorientation
• Nausea, vomiting, dry heaves