By Grace-Anne Krapez

PDHPE Preliminary Course 2008Assessment task # 4

FIRST AID

Head injury is a trauma to the head which can include the skull and brain and can cause death, or lifetime impairment. Head injuries include:

• Minor lacerations and bruises

• Scalp wounds

• Skull fractures

• Bleeding within the skull or brain

• Concussion

Concussion is normally caused by trauma to the head which causes the brain to be shocked and traumatised inside the skull. A temporary impairment of brain function can result from this and usually only lasts for a short amount of time.

                                                               

Types of head injuries include: •Scalp wounds•Fractured skull/ Cerebral compression

Scalp Wounds

When wounds occur on the scalp, there is usually heavy bleeding due to the rich blood supply of the scalp. In the case of this injury, the wound should be treated in the same manner as normal wound care. There is a chance that there is a head injury present so the first aider needs to be aware of this possibility while observing signs cautiously.

Fractured Skull/ Cerebral compression

Trauma to the head can result in bleeding within the head and/or a skull fracture. The brain can become compressed which can affect the function of the brain and could consequently cause brain damage. Internal bleeding and brain compression can result from a fracture to the skull as well as leakage of the fluid that surrounds the brain.

There are many signs and symptoms which can detect if an individual is suffering from a head injury. These include:• Possible period of unconsciousness• Headache• Nausea and vomiting• Reduced level of consciousness• Visual problems• Numbness, tingling• Paralysis• Convulsions• Discharge of fluid from ears, nose or mouth• Bruising around the eyes or behind the ears• Bleeding into the whites of the eyes• Unequal or slow responding pupils• Change to normal breathing patterns• Breathing stops

A victim suffering from concussion may experience:• A brief period of unconsciousness• Dizziness• Nausea, vomiting• Headache• Blurred vision• Confusion, loss of short term memory

If the concussion is only mild, these signs and symptoms should resolve quickly.

In the primary management of head injuries, the first aider must consider the possibility of a spinal injury. The first aider who arrives at the scene of a head injury should support the head before commencing DRABCD.

DRABCD stands for: • Danger• Response• Airway • Breathing• Compressions• Defibrillation

As well as conducting DRABCD, management of the victim should be carried out by following the steps considering whether the victim is responsive or unresponsive. The DRABCD and the steps of management of the head injury are explained on the following two slides.

If responsive:

• Keep the victim still and reassure them• Continually monitor the vital signs• Seek medical advice if skull or cerebral compression in suspected

• In the event of discharge from the ear, do not plug the ear but cover lightly with a sterile pad, allowing the ear to drain• Provide supplemental oxygen is able

If unresponsive:

• Conduct a Primary Survey• Call an ambulance urgently• Provide supplemental oxygen if able

Danger- Check for any dangers in the environment to yourself, the bystanders and the casualty. If there are any dangers present, they must be removed if it is safe for the first aider to do so.

Response- Ask the casualty if they are okay and try to get a response from them by squeezing their shoulders or shouting at them.Conduct COWS to initiate response. Instruct bystanders to call for an ambulance and any other services that may be needed, for example, the fire brigade.

Airway- Check and clear the airway by positing the casualty on their back and tilting the head back slightly while supporting the head to check for anything obstructing the airway and if so, clearing it. The first aider should look, listen and feel for signs of life.

Breathing- If there are no signs of life the head and jaw should be supported and two rescue breaths should be given.. If there are signs of life, the casualty should be placed in the lateral position to ensure the airway stays clear.

Compressions- 30 compressions should be completed for every two breaths. This should be continued until medical aid arrives.

Defibrillation- If a defibrillator is available, attach to the victim and follow the prompts.

•Able publishing (2007). Personal Development, Health and Physical Education. First Aid. Pp 4-7

• Lippmann, J. and Natoli, D. (2006). First Aid. Royal Lifesaving Australia

• NHS. (2007). Head injury (online)

http://www.nice.org.uk/CG56 Retrieved 22.8.08

• Better Health Channel. (2008) Head Injuries- First Aid (online)

http://www.betterhealth.vic.gov.au/BHCV2/bhcarticles.nsf/pages/Head_injuries_first_aid?Open Retrieved 27.8.08