Head Injuries: First Aid Guide

Introduction

Head injuries are relatively common, and their severity may not always be immediately apparent to a first aider. It's crucial to handle them with caution due to the brain's sensitivity and the potential for spinal injury.

1. Suspecting Spinal Injury

Always consider the possibility of spinal injury when dealing with head injuries. Assess the injury's circumstances carefully.

2. Assessing Consciousness with AVPU

To gauge the patient's level of consciousness, use the AVPU scale:

• A - Alert: Are their eyes open, and do they respond to questions?
• V - Voice: Do they respond to voice or simple commands?
• P - Pain: Do they react to touch or pinching?
• U - Unresponsive: If they don't respond to voice or pain.

Record your findings and reassess to report any changes to their condition.

3. Activating Emergency Services

If you have any concerns or the head injury seems serious, activate the emergency services immediately. Head injuries can be severe.

4. Monitoring a Head Injury

A head injury might not have an obvious site. Monitor the patient carefully as they may act out of character, potentially being aggressive.

5. Recognizing Concussion

Concussion can result from head injuries. Symptoms can range from mild to severe, and emergency treatment may be necessary.

The common symptoms of concussion include:

• Nausea and loss of balance
• Confusion
• Memory difficulties
• Feeling dazed or stunned

6. Identifying Cerebral Compression

Cerebral compression involves pressure on the brain due to swelling or bleeding, and it's a severe condition. It can be caused by head injuries, strokes, brain tumours, or infections.

Signs and symptoms of cerebral compression include:

• Personality changes
• Deteriorating consciousness
• Slow and noisy breathing
• Intense headache
• Vomiting
• Drowsiness
• Unequal pupils
• Weakness or paralysis on one side of the body

7. Understanding Cerebral Contusion

Cerebral contusion involves brain bruising, occurring in 20-30% of serious head injuries. It results from damaged blood vessels and can lead to motor coordination, numbness, and memory problems.

8. Recognizing Skull Fractures

Skull fractures result from direct or indirect force, sometimes causing clear fluid or blood from ears and nose. Seek immediate medical attention in such cases.

9. Basic Treatment for Head Injuries

The general approach for head injuries is consistent:

• Consider potential spinal injury.
• Treat any bleeding.
• Activate emergency services.
• Lie the patient down with head and shoulders raised.
• Monitor breathing.
• Avoid giving food or drink.

10. Dealing with Helmets

If the patient is wearing a helmet (e.g., cycle, riding, or motorcycle helmet), leave it on unless it obstructs the airway or if they aren't breathing.

If helmet removal is necessary, do it slowly and carefully with two people. Note any marks on the helmet as they may provide insight into the injury.