First Aid
Head Injury
 

​Introduction:

Head injury is a common injury suffered by people of all age groups, especially children. Fortunately, most head injuries are mild, temporary, and curable without persisting health problems. Some head injuries may, however, affect the brain or the tissue surrounding it, resulting in long-term complications. 

Head injury: 
A head injury is any sort of injury to the brain, skull, or scalp. This can range from a mild bump or bruise to a traumatic brain injury.

Types of head injuries: 
  • Concussion: This is a jarring injury to your brain. Most of the time, people remain conscious. They may feel dazed and lose balance for a brief time. 
  • Brain contusion: This is a bruise of your brain. Minor bleeding in your brain causes swelling.
  • Skull fracture: This is a crack in the skull. Sometimes, the broken skull bones can cut into the brain. 
  • Hematoma: This is bleeding in your brain that collects and clots, forming a bump. A hematoma may not appear for a day or as long as several weeks.
Causes:
  • Falls (most common cause);
  • Exercising and sports-related accidents;
  • Physical assaults;
  • Traffic accidents.

Who is at highest risk?
  • Children;
  • The elderly;
  • Drug and alcohol users.

Symptoms:
  • Headache (following the head injury);  
  • Ringing in the ears; 
  • Vomiting and nausea;
  • Dizziness, and disorientedness;
  • Neck pain, or visual problems;
  • Swelling;
  • Loss of consciousness, usually for a short period of time (less than a minute).

When to call the ambulance and seek medical help:
  • Loss of consciousness;
  • Worsening headache;
  • Drastic changes in behavior (such as anger or confusion);
  • Trouble understanding, speaking or walking;
  • Impaired senses (such as hearing loss and vision impairment).
  • Recurrent vomiting;
  • Inability to remember incidents before or after the injury;
  • Weakness or numbness in the arms or legs;
  • Seizures;
  • Leaking of blood or a fluid from the ear or the nose.
  • Memory loss;
  • Problems breathing.

Treatment and first aid:
  • The treatment for head injuries depends on the injury severity. Most often, mild injuries do not require treatment. However, you should know the signs and symptoms that require medical attention.
  • If the head injury is severe, call the ambulance immediately.
  • If the injured person is bleeding, try to stop the bleeding by using gauze, or a clean cloth.
  • If the wound is open, do not touch or apply pressure on it. Cover or wrap the wound with a clean piece of gauze (bandage) instead.
  • If the person is vomiting while sitting, help them to lean forward. If the person is vomiting while lying down, roll their body to the side to prevent choking.
  • If the person is awake, instruct them not to move their head and neck. This can help prevent further damage to their spine and brain.
  • If the person is unconscious and breathing, try to stabilize their body. This includes keeping their neck and head in line with their spine.
  • If the person is unconscious and not breathing, begin the process of CPR (cardiopulmonary resuscitation).

Some symptoms may appear in the few days following discharge from hospital, such as:
  • Moderate headache;
  • Problems sleeping;
  • Poor appetite;
  • General exhaustion;
  • Problems focusing;
  • Bruises or mild scalp swelling;
  • Memory loss: the injured person may forget the events right before, during, and after the accident. Memory of these events may or may not come back after treatment.

The injured person should be readmitted to the ER in the following cases:
  • Persisting vomiting or nausea; 
  • Worsening headache;
  • Problems waking up;
  • Memory loss;
  • Dizziness or faintness;
  • Difficulty walking;
  • Troubles speaking;
  • Spasms or seizures;
  • Weakness or numbness in the arms or legs;
  • Neck spasm;
  • Dizzy or blurred vision;
  • Leaking of clear fluid from the ear or the nose; 
  • Change in behavior (especially in children).

General tips: Caring for a head injury after discharge from ER:
  • Take rest, keep at home, and stop any activity during the first 48 hours after injury.
  • Keep your phone at hand, to call the ambulance when need arises. 
  • Ask someone to keep by your side during the first 48 hours.
  • Don't go to school or work until after full recovery.
  • Avoid driving your car or bike immediately after injury.
  • Avoid medications (especially painkillers) unless prescribed by the doctor.
  • Talk with your doctor about exercising or practicing sports, such as football. In most cases, they are not recommended during three weeks after a head injury.
  • Eating and drinking are usually unrecommended during the first six hours after injury, unless otherwise prescribed by the doctor, following which, the injured person may eat and drink moderately.
  • Stop watching or using screens, as well as the activities requiring concentration.
  • Apply cold compresses to the swollen area, as recommended by the doctor, and avoid applying ice directly to the skin. 

After recovery:
Protect your head from other potential injuries, by wearing a helmet while exercising, or practicing such sports as cycling, etc.



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