First Aid Chapter 8 Head and Spine Injuries. Head Injuries: Scalp Wounds Bleeding scalp does NOT mean blood supply to brain is affected

First AidFirst Aid

Chapter 8

Head and Spine Injuries

Head Injuries: Scalp WoundsHead Injuries: Scalp Wounds

Bleeding scalp does NOT mean blood supply to brain is affected


What to Do: Control bleeding If you suspect a skull fx,

apply pressure around wound Keep head and shoulders elevated


DO NOT: Remove embedded object Clean the wound

if suspect skull fx.

Head Injuries: Skull FXHead Injuries: Skull FX

Hard to determine unless fx is obvious


Signs: Pain at the point of

injury Deformity of

skull


Signs: Bleeding

from ears or nose


Signs: Leakage of

clear pink tinged fluid (CSF) from ear or nose

CSF: Cerebral Spinal

Fluid


CSF:Drip onto cloth, if a pink ring forms around a blood tinged center, this is a positive “halo sign”


Signs: Discoloration

around eyes several hours after injury

Raccoon Eyes:


Signs: Discoloration behind an ear appearing several hour after injury

Battle’s Sign:


Signs: Unequal pupils Profuse scalp bleeding with broken skin


Signs: Penetrating

wound, impaled object


DO NOTStop the flow of blood or CSF from an ear or nose.

Increases pressure within the

skull


DO NOTRemove an impaled object

Stabilize object with

bulky dressings


DO NOTClean an open skull fx wound

Can cause

infection of the brain


What to Do:Monitor ABCs

Cover wound with sterile dressing

Stabilize neck against movement

Elevate head and shoulders

Apply pressure around wound edges.

Brain InjuriesBrain Injuries

Brain can bounce around inside skull if head is struck with sufficient force.

Brain InjuriesBrain InjuriesBrain will swell when injuredConfined inside skull

Little room to accommodate swelling


Pressure inside skull increases, interferes with brain functioning.

Brain InjuriesBrain InjuriesWhat to Look For:Level of Responsiveness – Awake, Alert, Oriented?Unresponsive, Confused or Disoriented?

Brain InjuriesBrain InjuriesWhat to Look For:Memory LossN/VHAVisual changesUnequal PupilsSeizures


What to Look For:

Paralysis, weakness or loss

balance

Blood or CSF from ears or nose

Combativeness


What to Do:

SMA

Stabilize head and neck

Monitor ABCs

Treat scalp wound or skull FX


What to Do:

Turn to side for vomiting

Slightly elevate head if possible

Monitor level of responsiveness

Brain InjuriesBrain InjuriesDO NOT

Stop flow of CSFElevate legsClean open skull Fx wound

Elevating legs

increases intra-cranial

pressure


NOT SURE?

Seek Medical Attention if the following signs appear within 48 hours after head injury:

Brain InjuriesBrain InjuriesSMA if:

Increase severity of headache

N/V lasting more than 2 hours

Drowsiness, confusion

Vision problems

Cannot use arms or legs

Slurred speech

Seizures

EYE InjuriesEYE Injuries

What to Do For Penetrating injuries:

SMA

Protect injured eye

Cover both eyes


What to Do For Blows to the eye:

Ice pack

SMA as needed


What to Do For Cuts of the eye and eye lid:

Bandage both eyes

SMA

EYE InjuriesEYE InjuriesWhat to Do For Chemical burns of the eye:Immediately flush with water for at least 20 minutesLoosely bandage with

cold, wet dressing

SMA

EYE InjuriesEYE InjuriesWhat to Do For Eye knocked out:AvulsedCover loosely with sterile dressing moistened with clean waterProject injured eyeCover undamaged eyeSMA

EYE InjuriesEYE InjuriesWhat to Do For Foreign Objects:

Try to flush out by rinsing gently

with warm water

Examine and remove if seen

NOSE InjuriesNOSE InjuriesNose Bleeds 2 types:

Anterior

Posterior

Front of nose. Most common. Blood comes out through one nostril

Back of nose. Massive bleeding backwards into mouth. Serious. SMA

NOSE InjuriesNOSE InjuriesNose Bleeds DO NOTTilt head backwardsProbe nose with applicatorMove head and neck if suspect spine injury

NOSE InjuriesNOSE InjuriesNose Bleeds Keep victim sitting

Keep head tilted slightly forward

Pinch soft parts of nose together for 5 minutesApply Ice pack prn

NOSE InjuriesNOSE InjuriesNose Bleeds SMA if:

Bleeding does not stop

Suspect posterior nose bleed

Suspect broken nose

Victim has high B/P or is taking Anticoagulants (blood thinner)

Dental InjuriesDental InjuriesKnocked-Out Tooth Rinse mouth and use gauze to control bleedingFind tooth, handle by crown, not rootPlace back into socket if possibleSee Dentist

crown

root

Dental InjuriesDental InjuriesKnocked-Out Tooth

DO NOTPlace tooth in water, alcohol, Betadine, mouth wash, skim milk, or milk by-productsScrub toothRemove partially extracted tooth

Dental InjuriesDental InjuriesToothache Rinse mouth with warm waterUse dental floss to remove

trapped foodSoak cotton ball in oil of cloves and place on toothAnalgesicSee Dentist

Dental InjuriesDental InjuriesToothache

DO NOTPlace analgesic tablet directly on tooth

Wait to see dentist if there is pus or

facial swelling

Spine InjuriesSpine InjuriesWhat to Look For:Head injuriesPainful, limited or no movement in arms or legsLoss of bowel or bladderDeformity of head or neck

Spine InjuriesSpine InjuriesPedal Pushes

Hand Squeezes

Have victim push foot against your hand

Have victim squeeze your hand

Spine InjuriesSpine InjuriesAsk:

Pain?

Can you move your hands and fingers?

Can you move your feet and toes?

Spine InjuriesSpine InjuriesIf unresponsive:Test response by pinching arm, hand and leg, foot

Spine InjuriesSpine InjuriesWhat To Do:Monitor ABCs

Stabilize against movement –

Hold head between hands and arms or use objects to

stabilize

Spine InjuriesSpine InjuriesDO NOT:

Move the victim unless ABSOLUTELY necessary

Learning Activities 8Learning Activities 8

1. 1. For a suspected skull fx, For a suspected skull fx, press around the wound not press around the wound not directly on itdirectly on it. .

Yes

Head Injuries


2. 2. DO NOT removed DO NOT removed impaled objectsimpaled objects. .

Yes

Head Injuries


3. 3. Head injury victims should Head injury victims should be checked for possible be checked for possible spine injury spine injury . .

Yes

Head Injuries

Learning Activities 8Learning Activities 8ScenerioScenerio: : Carpenter fell from ladder. Responsive Carpenter fell from ladder. Responsive

now but was motionless for a few now but was motionless for a few minutes. C/o severe HA and dizziness. minutes. C/o severe HA and dizziness.

Swelling on back of head. What to do?Swelling on back of head. What to do?

Monitor ABCs

Stabalize head and neck

Assess level of responsiveness

If bleeding, apply pressure around wound

Elveat head if possible


1. 1. After blow to eye, apply After blow to eye, apply ice pack for about 15 ice pack for about 15 minutesminutes. .

Yes

Eye Injuries


2. 2. Tears are sufficient to Tears are sufficient to flush chemicals from flush chemicals from the eyethe eye. .

No

Eye Injuries


3. 3. Use a clean damp Use a clean damp cloth to remove object cloth to remove object from surface of eyefrom surface of eye. .

Yes

Eye Injuries


Flush with water for at least 20 minutes

SMA

Scenario: Car battery explodes. Battery cap flies off. Battery acid splashes into Sam’s eye. What to do?


1.1. Preserve a knocked out tooth in alcohol or mouth wash.

No

Dental Injuries


2.2. Scrub knocked-out tooth before going to dentist.

No

Dental Injuries


3.3. Sometimes a knocked-out tooth should be reinserted.

Yes

Dental Injuries


Rinse mouth

Stop socket bleeding

Handle tooth by crown

Reinsert tooth

Scenario: Mike (age 20) was struck in mouth. Spit out 2 front teeth. What to do?


1.1. DO NOT move and stabilize against movement a victim with a suspected spine injury .

Yes

Spine Injuries


2.2. Inability to move fingers and or feet may indicate a spine injury .

Yes

Spine Injuries


3.3. A head injury may be a reason to suspect a spine injury .

Yes

Spine Injuries


Monitoe ABCs

Stabalize head and neck against movement

Wait for EMS

Scenario: A car hits concrete median. You completed scene survey. Driver C/O numbness and loss of feeling in both legs. What to do?

First Aid KitsFirst Aid KitsItem Quantity

Paper or

Styrofoam cup 1

Documents

First Aid Chapter 8 Head and Spine Injuries. Head Injuries: Scalp Wounds Bleeding scalp does NOT mean blood supply to brain is affected