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Head Injuries

What head injury can include

  • Soft tissue (cuts, abrasions, bruises) — high blood supply, bleeds heavily
  • Bone fractures — facial bones, skull base, skull vault
  • Intracranial — concussion, contusion, haemorrhage
  • Combined

Mild head injury signs

  • Headache
  • Nausea, vomiting
  • Dizziness
  • Brief loss of consciousness with memory gap
  • Confusion

SEVERE head injury signs (call 112)

  • Drowsiness
  • Progressive consciousness loss → unconsciousness
  • Speech problems
  • Paralysis of one or more limbs
  • Seizures of face/limbs
  • Loss of vision or hearing

Skull base fracture — classic signs

  • CSF or blood from nose or ears
  • Raccoon eyes (periorbital haematoma)
  • Battle's sign (bruising behind the ear)
  • Altered consciousness

Concussion

Brief loss of consciousness with short memory gap, often with nausea, vomiting, repeating the same questions. Caused by impact, jolt, or fall.

Knocked-out adult tooth

  • Rinse the mouth with cool, clean water
  • Place moist gauze where the tooth was, patient bites down
  • Visibly dirty tooth: hold by the CROWN (not root), rinse gently with bottled water
  • Do not scrub or touch the bloody root
  • Store the tooth in: patient's saliva, cow's milk, or wrapped in food film with saliva
  • See a dentist immediately
  • Milk teeth: no preservation needed

First aid for head injury

  • VODDO
  • Call 112
  • Unconscious + breathing → recovery position OR maintain airway with OPA
  • Others → flat on back, secure C-spine
  • Full body assessment
  • Sterile cover for wounds
  • Continuous monitoring of consciousness and breathing
  • SAMPLE

Always think about the C-spine

High-energy mechanism + head injury = suspect cervical spine injury until proven otherwise.

Head Injuries