Head Injury
See also Fractures: I. Fractures of the
Skull.)
Head injuries, common in traffic accidents, in falls, and in incidents of violence, are generally more serious in childhood because the child's skull is weaker, and the likelihood of fracture greater. However, severe damage to the brain or hemorrhage may occur even when no fracture exists. Symptoms of drowsiness or loss of consciousness (even for a short period) should be taken to indicate that some degree of cerebral concussion has occurred. The severity of the concussion can be roughly judged by the duration of unconsciousness. Other symptoms of head injury with concussion include severe headache, nausea and vomiting, and shock. If the skull has been fractured, there may be external bleeding from the nose, ears, or mouth. In cases where bleeding occurs inside the skull the victim may have a short lucid interval or may remain unconscious until the pressure on the brain has been relieved by surgery.
WHAT TO DO
1. Keep the victim lying down and covered with blankets or coats to conserve his body heat and thus reduce the danger of shock.
2. Try to obtain a physician's services before the patient is moved from the site of the accident.
3. If there is strangling, gently turn the victim's head to one side so that the mucus or blood or vomitus may escape from the corner of his mouth, reducing interference with breathing.
4. If there is bleeding from the scalp, cover the wound with a: clean cloth held gently in place by a bandage. Avoid undue pressure over the scalp wound because of possible skull fracture.
5. If an ice bag is available, place it next to the victim's head.
6. When the victim must be moved, do it with the least possible movement of his body and with the victim lying flat.
7. Observe the victim of a head injury closely for at least twenty-four hours. Make note of any deepening of his
stupor or return to unconsciousness after he has once been conscious. Advise the doctor of any such change, for this may indicate a hemorrhage inside the skull.
PRECAUTIONS
1. Do not permit the victim of a head injury to sit up or walk around. In his confused condition he may insist on
walking, but this should be prevented.
2. Do not try to rouse the victim of head injury from his unconsciousness.
3. Do not give any alcoholic drink or stimulant.
4. Give no sedative or pain reliever, not even aspirin, to a head-injury victim not fully conscious.
5. Do not leave the victim unattended.
6. Do not restrain the victim too much. If he wishes to lie on his side, let him do so. Excessive restraint often
causes violence.
