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Head injuries


Head injuries include damage to the scalp, skull or brain, which may be caused by trauma of varying degrees. Traumatic brain injury is the most serious form of head injury. Common causes include motor vehicle accidents, falls and injuries caused by objects or people.

Because the brain is the control organ for the whole body, any head injury is potentially dangerous and always needs medical attention.

Concussion
Concussion is a condition caused by an injury to the head, characterised by headache, confusion and amnesia (loss of memory).

Signs and symptoms of concussion
The effects of concussion can appear immediately or soon after the event and urgent medical attention should be sought.

Signs and symptoms include:
  • Temporary loss of consciousness
  • Confused - altered conscious state
  • Loss of memory (may only be temporary)
  • Nausea and vomiting
  • Inappropriate behaviour
  • Visual disturbances - blurred vision
  • Headache
  • Dizziness
  • Oversensitivity to light (photophobia)

Fractured skull

A fractured skull is a break in the continuity of the bones of the skull, usually the result of a direct force.  The fracture may cause cerebral compression, a build up of pressure inside the brain, which is caused by the swelling or rupture of blood vessels.



Image above:  Altered pupil appearance

Signs and symptoms of a fractured skull
  • Obvious skull deformity and/or head wound
  • Headache
  • Altered level of consciousness
  • Drowsiness, vagueness or memory loss
  • Agitation, irritability
  • Lack of coordination, loss of limb power, slurred speech
  • Bleeding into the eyes
  • Bruising around the edges of the eyes
  • Bleeding from the nose and/or ears
  • Bruising behind the ears
  • Seizures
  • Loss of cerebro-spinal fluid from the ears and/or nose (straw-like colour)
  • Pupil abnormalities, eg one pupil may be dilated and the other may be constricted or pupil reaction may be sluggish to light

Management of head injuries


From a first aid perspective, all head injuries are managed the same way:
  • DRSABCD
  • Seek urgent medical aid — call Triple Zero (000) for an ambulance
  • Immobilise the neck. Never move the casualty unless absolutely necessary
  • Control any bleeding
  • Cover open wounds
  • If bleeding from the ear, position the casualty with the bleeding ear down to allow drainage
  • Place a pad lightly over the bleeding ear

If the casualty is conscious, position them:
  • Flat with head raised to 30°, or in a semi-sitting position with the head and neck supported
  • Monitor and record vital signs every 15 minutes (pulse, breathing, level of consciousness and pupil reaction)

NOTE:  Any person with a head injury is presumed to have neck or spinal injury until proved otherwise