Head & Neurological Injuries

A head injury may consist of one or a combination of the following conditions: a concussion, a cut or bruise of the scalp, or a fracture of the skull with injury to the brain and the blood vessels of the scalp.

The damage can range from a minor cut on the scalp to a severe brain injury which rapidly causes death. Most head injuries lie somewhere between the two extremes.

Usually, serious skull fractures and brain injuries occur together; however, it is possible to receive a serious brain injury without a skull fracture. The brain is a very delicate organ; when it is injured, the casualty may vomit, become sleepy, suffer paralysis, or lose consciousness and slip into a coma.

All severe head injuries are potentially life-threatening. For recovery and return to normal function, casualties require proper fi rst aid as a vital first step.

Signs & Symptoms

A head injury may be open or closed. In open injuries, there is a visible wound and, at times, the brain may actually be seen. In closed injuries, no visible injury is seen, but the casualty may experience the same signs and symptoms. Either closed or open head injuries can be life threatening if the injury has been severe enough; thus, if you suspect a head injury, evaluate the casualty for the following:

  • Current or recent unconsciousness (loss of consciousness)
  • Nausea or vomiting
  • Convulsions or twitches (involuntary jerking and shaking)
  • Slurred speech
  • Confusion
  • Sleepiness (drowsiness)
  • Loss of memory (does casualty know his own name, where he is, etc.)
  • Clear or bloody fluid leaking from nose or ears
  • Staggering in walking
  • Dizziness
  • A change in pulse rate
  • Breathing problems
  • Eye (vision) problems, such as unequal pupils
  • Paralysis
  • Headache
  • Black eyes
  • Bleeding from scalp/head area
  • Deformity of the head

General Considerations

The casualty with a head injury (or suspected head injury) should be continually monitored for the development of conditions which may require the performance of the necessary basic lifesaving measures, therefore be prepared to:

  • perform the basic lifesaving measures.
  • treat as a suspected neck/spinal injury until proven otherwise [see: Spinal Injuries].
  • place a dressing over the wounded area — DO NOT attempt to clean the wound.
  • keep the casualty warm
  • seek medical aid

DO NOT attempt to remove a protruding object from the head.

DO NOT give the casualty anything to eat or drink.

Care of the Unconscious Casualty

If a casualty is unconscious as the result of a head injury—He may lose his sensitivity to pain or ability to cough up blood or mucus that may be plugging his airway. An unconscious casualty must be evaluated for breathing diffi culties, uncontrollable bleeding, and spinal injury.

Breathing

The brain requires a constant supply of oxygen. A bluish (or in an individual with dark skin will be grayish) color of skin around the lips and nail beds indicates that the casualty is not receiving enough air (oxygen). Immediate action must be taken to clear the airway, to position the casualty on his side, or to give artifi cial respiration. Be prepared to give artificial respiration if breathing should stop. [see: Restore Breathing]

Bleeding

Bleeding from a head injury usually comes from blood vessels within the scalp. Bleeding can also develop inside the skull or within the brain. In most instances bleeding from the head can be controlled by proper application of the field first aid dressing.

WARNING! DO NOT attempt to put unnecessary pressure on the wound or attempt to push any brain matter back into the head (skull). DO NOT apply a pressure dressing.