Category: First Aid

Removing the dressing

This is the part that gives people the most trouble, but it doesn’t have to.

The dressing is designed to remain firmly adhered to your skin (but not the wound), and has a strong adhesive quality on both the hydrocolloid and the film surrounding it. Pulling at this dressing, will cause quite a bit of pain, and can cause the skin to redden and disrupt the wound healing process. To avoid this discomfort, follow these simple directions.

1. Hydrocolloids and the film around them have elastic qualities. You may have noticed this when applying the dressing, the components stretch easily. This is important for the removal of the dressing.

2. Instead of pulling in the opposite direction, which will cause severe pain and skin reddening, pull the ends outwards, in a forward direction away from the hydrocolliod. The purpose is to stretch them like an elastic, or rubber band. While it may pull a little (if the film is stuck to hair), the film and hydrocolloid should lift from the skin pretty easily. The more you stretch it, the easier it will come off. The dressing should not stick to the actual wound.

As mentioned above, the wound generally does not need to be cleaned again, unless dirt enters the wound before a fresh dressing is applied. Occasionally the hydrocolloid will leave some residues behind near the wound. These residues may be gently washed off before the applying the new dressing to continue optimal healing conditions.

Those pesky fraying edges…

These dressing are strong adherents but they are not immune to developing raised edges, which will collect dirt, dust, and other fibers. To keep the dressing neat, carefully trim off any raised edges with a pair of fine, sharp small scissors. The dressing does not need to be removed, and edges can be clipped until you get near the hydrocolloid in the center, or near where the wound exudates (fluid) has extended.

Other important notes about Hydrocolloids:

If you’re changing the dressing more than once a day, or very frequently, you may need a higher strength dressing, and should consult your doctor who may recommend a hydrocolloid paste or powder, and a different solution altogether. Do not use these products (pastes or powders) without consulting a doctor first to make sure they are appropriate.

If your wound is showing signs of possible infection or has already become infected do NOT use these dressings! Their safety has not yet been proven on clinically infected wounds

In a study that involved laceration, abrasion and small operating incision patients, a hydrocolloid dressing was compared with a non-adherent dressing. The results were as follows. Although the healing time was the same for both groups, the patients using the hydrocolloids won out overall. Those using the hydrocolloids experienced less pain, and were able to carry out normal daily activities (such as bathing) without disturbing the wound or the dressings.

Definitions:

Heat rash — also known as prickly heat and miliaria — isn’t just for babies. Heat rash affects adults, too, especially during hot, humid weather.

Heat rash develops when blocked pores (sweat ducts) trap perspiration under your skin. Symptoms range from superficial blisters to deep, red lumps. Some forms of heat rash feel prickly or intensely itchy.

Heat rash usually clears on its own. Severe forms of heat rash may need medical care, but the best way to relieve symptoms is to cool your skin and prevent sweating.

Miliaria rubra (A), one type of heat rash, appears as red clusters of small blister-like bumps that can produce intense itching. Miliaria crystallina (B), another type of heat rash, appears as clear, fluid-filled bumps that produce no other signs or symptoms.

Symptoms:

Adults usually develop heat rash in skin folds and where clothing causes friction. In infants, the rash is mainly found on the neck, shoulders and chest. It can also show up in the armpits, elbow creases and groin.

Heat rash usually heals by cooling the skin and avoiding exposure to the heat that caused it. See your doctor if you or your child has symptoms that last longer than a few days, the rash seems to be getting worse, or you notice signs of infection, such as:

• Increased pain, swelling, redness or warmth around the affected area.

• Pus draining from the lesions.

• Swollen lymph nodes in the armpit, neck or groin.

• A fever or chills

Causes:

Heat rash develops when some of your sweat ducts clog. Instead of evaporating, perspiration gets trapped beneath the skin, causing inflammation and rash.

It’s not always clear why the sweat ducts become blocked, but certain factors seem to play a role, including:

• Immature sweat ducts. A newborn’s sweat ducts aren’t fully developed. They can rupture more easily, trapping perspiration beneath the skin. Heat rash can develop in the first week of life, especially if the infant is being warmed in an incubator, is dressed too warmly or has a fever.

• Tropical climates. Hot, humid weather can cause heat rash.

• Physical activity. Intense exercise, hard work or any activity that causes you to sweat heavily can lead to heat rash.

• Overheating. Overheating in general — dressing too warmly or sleeping under an electric blanket — can lead to heat rash.

• Prolonged bed rest. Heat rash can also occur in people who are confined to bed for long periods, especially if they have a fever.

Risk factors:

Factors that make you more prone to heat rash include:

• Age. Newborns are most susceptible.

• Tropical climates. People living in the tropics are far more likely to have heat rash than are people in temperate climates.

• Physical activity. Anything that makes you sweat heavily, especially if you’re not wearing clothing that allows the sweat to evaporate, can trigger heat rash.

Newborns, infants, the elderly, and obese individuals with large areas with skin-on-skin contact areas (for example, a large overlapping area of abdominal fat) are at risk for developing heat rash. They all are especially at risk if they are immobile for long periods of time and parts of the skin aren’t exposed to circulating air, which results in the inability of the sweat ducts to “breathe” (evaporative cooling).

Heat rashes are more common in places with hot, humid, climates because people sweat more.

Sun rash:

Some people have skin that can develop rashes with exposure to direct sunlight including people on certain antibiotics, or people exposed to some chemicals, fragrances, dyes, or disinfectants. This is called photodermatitis.

In some people exposure to the sun in the spring or early summer can trigger an itchy, red rash on the front of the neck and chest and the arms and thighs called polymorphous light eruption (PMLE). It usually clears without treatment in a few days, although it can come back.

Skin allergies:

Spring and summer are times when there are many substances that can cause allergic skin reactions in the environment – molds, pollens, plant and animal substances. Hives (urticaria) can be triggered by heat or sweat. Eczema (atopic dermatitis) can worsen in the summer, especially with excess sweating. Certain plants and grasses can cause skin rashes.

Rashes from bites and stings:

Bites and stings usually cause pain and slight swelling, but they can cause a severe skin reaction in some people, particularly if they are allergic to stings. Sometimes the reaction is localised to swelling at the site of the bite or sting. This may be many centimeters wide but gradually goes away over a few days.

In some people the reaction to the bite or sting affects their whole body and can cause itchy skin anywhere on the body, swelling of the face, lips, tongue, throat, and upper airway, a fast heart rate and low blood pressure. A severe allergic reaction affecting the whole body is called anaphylaxis and is a medical emergency.

How is heat rash diagnosed?

Heat rash can usually be identified by its appearance and does not usually require medical attention. But if it doesn’t go away after 3 or 4 days, or if it appears to be getting worse, or if your child develops a fever, contact your doctor right away.

When you or your child has a rash, be sure to watch for signs of infection, including:

• Increased pain, swelling, redness, or warmth around the affected area.

• Red streaks extending from the affected area.

• Drainage of pus from the area.

• Swollen lymph nodes in the neck, armpit, or groin.

• Fever of 100°F (37.8°C) or higher, or chills with no other known cause.

If any of these symptoms develop, contact your doctor immediately.

Treatment for heat rash?

Most prickly heat rashes heal on their own. The following steps can help relieve symptoms.

• Start by removing or loosening your baby’s clothing and move him or her to a cool, shady spot.

• Let the skin air-dry instead of using towels.

• If your baby’s skin is irritable when touched, calamine lotion or hydrocortisone cream may be used with your doctor’s approval.

• Avoid ointments or other lotions because they can irritate the skin.

The following tips can help prevent future episodes of the rash:

• Dress your child in as few clothes as possible during hot weather.

• Keep the skin cool and dry.

• Keep the sleeping area cool.

Heat rash home remedies:

Most heat rash resolves without treatment, often within a day after changing to a cooler environment.

The best way to prevent heat rash is to avoid sweating by staying in cooler areas, using fans and limiting physical activity.

The following self-care steps and remedies may help with heat rash.

First step: The first step in treating heat rash is to wash the affected area with a gentle soap (for example, Dove non-soap cleanser or something similar). 

Next, rinse the area with water and gently pat dry with a towel. It is recommended to wash several times a day, especially after exercise, prolonged walking, or heat exposure.

• Remain in a cool environment and allow for adequate ventilation of the skin.
  

  

• Take cool showers or baths

• Rest in an air-conditioned room at 70 F to 72 F (21 C to 22 C) is therapeutic. If no air conditioning is available at home, safe retreats include indoor shopping malls, grocery stores, movie theaters, hotel lobbies, ice skating rinks, bowling alleys, etc.

• Avoid skin-to-skin contact by placing a clean cotton washcloth or material between skin folds like under the breasts or abdomen.

• Apply cool packs over the affected areas (do not leave packs on longer than 20 minutes per hour).

Medical treatment for heat rash:

Heat rash or prickly heat resolves on its own once the skin cools, but on occasion the sweat glands can become infected. The signs of infection include pain, increased swelling, and redness that does not resolve. Pustules may form at the site of the rash. This infection occurs because bacteria have invaded the blocked sweat gland. Antibiotic treatment may be required. Chronic and recurrent heat rash may need to be treated by a health care practitioner or dermatologist (skin specialist).

Heat Rash Prevention:

Prevention is the most important treatment for heat rash; by allowing the skin to be exposed to circulating air, the potential for sweat ducts to become blocked and the glands to become inflamed decreases.

• Wear cool breathable fabrics such as cotton.

• Avoid polyester and nylon clothing.

• Maintain a comfortable room temperature with fans and air conditioning.

• Babies and infants should be kept comfortably cool and dry. Because of babies’ and infants increased fat folds and diaper irritation, they frequently get rashes on their diaper area and abdomen folds (diaper rash).

• Infant drooling may cause further occlusion of sweat ducts and hair follicles leading to heat rash on the face cheeks.

• Bedridden and wheelchair bound patients should be rotated and moved to avoid constant sweating and occlusion in the same area.

How effective are electric fans in preventing heat rash?

Keeping the skin cool on hot days is an important preventive measure. Air circulation (with fans or by other methods) usually will help with skin cooling. It is important not to bundle newborns and infants too tightly so that air can get to the skin, but it also is important to keep them warm enough.

It is important to move individuals who are immobile (for example, some elderly, those with paralysis, or are weak) so all parts of the body can be exposed to fresh air and help prevent tissue breakdown.

How can people protect their health when temperatures are extremely high?

The body can adapt very well in hot weather, but it takes time to acclimate. The actual temperature is just one factor when a person decides to work, play, or exercise in the heat. The heat index adds humidity to the equation since sweat cannot evaporate if the water content in the air (humidity) is high. If the air holds as much water as it can there is no place for sweat to go, and evaporation cannot cool the body.

To avoid heat-related illnesses, avoid working or exercising in extreme heat. If it is required, to avoid dehydration and other complications, take frequent breaks to get out of the heat and drink plenty of fluids to replenish fluid lost via sweat.

Early signs of heat-related illnesses include light-headedness, weakness, and nausea. It is important to get out of the heat, cool off, and re-hydrate immediately to avoid heat-related problems such as heat exhaustion and heat.

How much water should I drink in hot weather?

It is hard to gauge how much water is lost through sweat, and the thirst mechanism may not be sensitive enough to remind a person to drink enough. In general, the kidneys are a good guide to whether there is enough water in the body. If the body is dehydrated, the kidneys will try to hold on to as much water as possible. Symptoms and signs of the kidneys preserving water are decreased urine production, urine concentrated in colour, and a strong urine odour. Urine is clear when there is enough fluid in the body.

In a hot environment, a person should drink enough water to make the urine clear, and make sure the body is producing sweat.

Should I take salt tablets during hot weather?

Taking salt tablets is rarely a good idea. While the body loses many electrolytes when it sweats, there are mechanisms in place to compensate for the loss. Usually, keeping the body hydrated with plain water is adequate but does not resupply electrolytes. Sports drinks (for example, Powerade, Gatorade) may be reasonable alternatives.

What is the best clothing for hot weather or a heat wave?

Evaporation works to cool the skin only if the sweat that the body produces is allowed to evaporate. Lightweight, loose clothing allows air circulation to the body’s surface and helps promote cooling. While cotton is the classic fabric that can be used, some synthetic fabrics have been developed to wick sweat from the skin and allow more efficient skin or body cooling.

What is the prognosis for heat rash?

Heat rash or prickly heat tends to be self-limiting and gets better once the skin cools and is allowed to breathe. Prevention by not allowing heat to accumulate in body areas, followed by cooling the skin are the most common ways to obtain the best prognosis for heat rash.

Heat Rash Do’s

• Do get out of the heat.

• Do wear cool, breathable fabrics such as cotton.

• Do maintain comfortable temperatures with fans and air conditioning.

• Do wash off the skin with mild soap and pat dry after sweating or exercise.

• Do take a cool shower or bath.

Heat Rash Don’ts

• Don’t wear polyester and nylon fabrics in the summer.

• Don’t cover with ointments, Vaseline, or heavy creams.

• Don’t scrub or rub the skin to remove heat rash bumps.

• Don’t stay in the heat or humidity.

• Don’t go in a hot tub, sauna, or Jacuzzi.

Different Heat rash images

Home Treatment:

If you have influenza, you can expect the illness to go away on its own in about 7 to 10 days. In the meantime, you can take steps to feel better:

• Get extra rest. Bed rest can help you feel better. It will also help you avoid spreading the virus to others.

• Drink plenty of fluids to replace those lost from fever. Fluids also ease a scratchy throat and keep nasal mucus thin. Water, soup, fruit juice, and hot tea with lemon are all good choices.

• If fever is uncomfortable, sponge your body with lukewarm water to reduce fever. Do not use cold water or ice. Lowering the fever will not make your symptoms go away faster, but it may make you more comfortable.

• To relieve body aches and headache, take acetaminophen or ibuprofen.

• To help clear a stuffy nose, breathe moist air from a hot shower or from a sink filled with hot water.

• Avoid antihistamines. They do not treat flu symptoms and may make nasal drainage thicker.

• If the skin around your nose and lips becomes sore from repeated rubbing with tissues, apply a bit of petroleum jelly to the area. Using disposable tissues that contain lotion also may help.

• Use cough drops or plain, hard candy to help ease coughing.

• Elevate your head at night with an extra pillow if coughing keeps you awake.

• Avoid smoking and breathing secondhand smoke. This is good advice anytime, but it is especially important when you have a respiratory infection like a cold or the flu.

Prevention:

Increase your chance of staying healthy by:

• Washing your hands often, especially during winter months when the flu is most common.

• Keeping your hands away from your nose, eyes, and mouth. Viruses are most likely to enter your body through these areas.

• Eating a healthy and balanced diet.

• Getting regular exercise.

• Not smoking. Smoking irritates the lining of your nose, sinuses, and lungs, which may make you susceptible to complications of the flu.

• Taking probiotics. One study has shown that taking probiotics helps prevent influenza symptoms and reduce antibiotic use in children

Treatment Overview

In most healthy people, influenza (flu) will go away in 5 to 7 days. The worst symptoms usually last 3 to 4 days. Home treatment to ease symptoms and prevent complications is usually all that is needed.

Antiviral medicines may help:

• Reduce the severity and duration of symptoms caused by infection with influenza A or B virus.

• Shorten the length of the illness.

• Control outbreaks of the flu in nursing homes.

• Reduce the spread of the virus to people at high risk for severe complications of the flu (high-risk groups).

• Reduce complications from the flu.

People at high risk of complications are encouraged to contact a doctor within 48 hours of their first symptoms to find out whether they need medicine to shorten the illness. They also should call a doctor to receive medicine if they have been exposed to the flu.

Home Treatment

Most of the time headaches get better or go away with home treatment and do not require a visit to a doctor. Home treatment for headaches can often help reduce the severity of pain and the length of time the pain is present. Home treatment may also relieve other symptoms, such as fever, nausea or vomiting, anxiety, or muscle aches. Start home treatment as soon as you can. Be sure to review the home treatment information for any other symptoms you may have.

If your doctor has prescribed a specific treatment for your headaches, begin treatment as soon as a headache starts. Be sure to follow his or her instructions when taking any prescription medicine for your headache.

For mild pain without other symptoms, try the following:

• Rest in a quiet, dark room.

• Place a cool compress on your forehead.

• Do not smoke, drink alcohol, or use illegal drugs.

Reduce headaches

You may be able to reduce the frequency and severity of your headaches by trying:

• Relaxation exercises. These exercises can help take away tension and stress that cause headaches or make them worse.

• Heat, such as hot water bottles, heating pads, or hot baths, to relax tense muscles. Be careful not to burn yourself.

• Ice, such as an ice pack applied to the back or the neck or the temples.

• Massage therapy, biofeedback, and other complementary medicine treatments can reduce muscle tension, especially in your neck and shoulder muscles. Muscle tension can cause headaches or make them worse.

Headaches in children

When your child has headaches:

• Talk to your child. Let him or her know you care. Extra attention and quiet time may be all that is needed to relieve the pain.

• If your child’s doctor has prescribed a specific treatment for his or her headaches, begin treatment as soon as your child complains of the pain.

• Let your child rest quietly in a darkened room with a cool compress on his or her forehead.

• If your child’s headache pain is mild, encourage him or her to go on with normal activities.

• Let your child do his or her usual activities if he or she feels like it unless the headache pain is moderate to severe.

Prevent headaches:

• Eat regularly. Do not skip meals. Choose nutritious foods. Do not fill up on salty foods or carbonated beverages.

• Keep a regular sleep schedule. Set a bedtime and time to get up, and stick to them, even on weekends. This will help your body get used to a regular sleep time. Avoid oversleeping.

• Physical therapy may help you strengthen your neck muscles, improve your posture, and increase your mobility.

Practice good posture and body mechanics at home and at work:

• Sit straight in your chair with your lower back supported. If you sit most of the day, take breaks once an hour to stretch your neck muscles. There are some specific neck exercises you can do during your breaks.

• If you work at a computer, adjust your monitor so that the top of the screen is at eye level. Use a document holder to keep the copy at the same level as the screen.

• If you frequently use the telephone, consider a headset or speakerphone. Do not cradle the handset between your shoulder and your ear.

Headaches can often be prevented by avoiding things that may cause, or “trigger,” the pain. Although these triggers may be different for different people, generally avoid:

• Alcohol and caffeine (coffee, tea, or soda pop).

• Sudden caffeine withdrawal.

• Foods, such as very salty foods or foods that contain the preservative MSG.

• Poor eating habits, including missing meals, extreme diets, and fasting.

• Dehydration.

• Changes in usual sleep patterns, not getting enough sleep, or oversleeping.

• Stress, anxiety, or depression.

• Medicines, such as heart medicines, blood pressure medicines, and hormones.

• Poor posture and body mechanics.

• Smoking cigarettes or cigars, or breathing secondhand smoke.

• Glare from sunlight or artificial light.

• Exposure to strong odors.

• Strain in the muscles of the jaw from grinding or clenching teeth or chewing gum.

To prevent a child’s headache:

• Make sure your child gets enough rest.

• Offer frequent nutritious snacks and beverages during the day. Do not allow your child to fill up on salty foods or carbonated beverages.

• Do not allow your child to skip meals.

Introduction:

The brain is a soft and delicate organ. A hard blow to the head can injure the brain or spinal cord even when there are no visible signs of trauma to the scalp or face. That’s why all head injuries are considered serious and should be assessed by your doctor or the nearest hospital emergency department.

Always call triple zero (000) for an ambulance in an emergency. This article offers first aid suggestions, but is not a substitute for professional medical care.

Traumatic head injuries are a major cause of death, and disability but it might be best to refer to the damage done as traumatic brain injury.

The purpose of the head, including the skull and face, is to protect the brain against injury. In addition to the bony protection, the brain is covered in tough fibrous layers called meninges and bathed in fluid that may provide a little shock absorption.

When an injury occurs, loss of brain function can occur even without visible damage to the head. Force applied to the head may cause the brain to be directly injured or shaken, bouncing against the inner wall of the skull. The trauma can potentially cause bleeding in the spaces surrounding the brain, bruise the brain tissue, or damage the nerve connections within the brain.

Caring for the victim with a head injury begins with making certain that the ABCs of resuscitation are addressed (airway, breathing, circulation). Many individuals with head injuries are multiple trauma victims and the care of their brain may take place at the same time other injuries are stabilized and treated.

Skull Fracture

The skull is made up of many bones that form a solid container for the brain. The face is the front part of the head and also helps protect the brain from injury. Depending upon the location of the fracture, there may or may not be a relationship between a fractured skull and underlying brain injury. Of note, a fracture, break, and crack all mean the same thing, that the integrity of the bone has been compromised. One term does not presume a more severe injury than the others. Fractures of the skull are described based on their location, the appearance of the fracture, and whether the bone has been pushed in.

Location is important because some skull bones are thinner and more fragile than others. For example, the temporal bone above the ear is relatively thin and can be more easily broken than the occipital bone at the back of the skull. The middle meningeal artery is located in a groove within the temporal bone. It is susceptible to damage and bleeding if the fracture crosses that groove.

More Head Injury Overview

Intracranial Bleeding

• Intracranial (intra=within + cranium=skull) describes any bleeding within the skull. Intracerebral bleeding describes bleeding within the brain itself. More specific descriptions are used based upon where the blood is located.

• Bleeding in the skull may or may not be associated with a skull fracture. An intact skull is no guarantee that there is not underlying bleeding, or hemorrhage, in the brain or its surrounding spaces. For that reason, plain X-rays of the skull are not routinely performed.

• Epidural, sub dural, and subarachnoid bleeding are terms that describe bleeding in the spaces between the meninges, the fibrous layered coverings of the brain. Sometimes, the terms hemorrhage (bleeding) and hematoma (blood clot) are interchanged. Because the skull is a solid box, any blood that accumulates within the skull can increase the pressure within it and compress the brain. Moreover, blood is irritating and can cause edema or swelling as excess fluid leaks from the surrounding blood vessels. This is no different than the swelling that can occur surrounding a bruise on an arm or leg. The only difference is that there is no room within the skull to accommodate that swelling.

Two types of head injury

Head injuries can be classified as:

• Open – with bleeding wounds to the face or head.

• Closed – no visible signs of injury to the face or head.

Closed head injuries

The soft, jelly-like brain is protected by the skull. The brain doesn’t fill the skull entirely – it floats in a clear, nourishing liquid called cerebrospinal fluid. This fluid acts as a shock absorbed, but its protective value is limited.

The kinetic energy of a small knock to the head or face can be absorbed by the cerebrospinal fluid, but a hard impact can smash the brain against the inside of the skull. This can bruise the brain or tear blood vessels.If blood and blood serum start to escape,the swelling is contained within the skull. Intracranial pressure (pressure inside the skull) can cause permanent damage by literally crushing the brain.

Open head injuries

An open, or penetrating, head injury means you were hit with an object that broke the skull and entered the brain. This is more likely to happen when you move at high speed, such as going through the windshield during a car accident. It can also happen from a gunshot to the head.

Head injuries include:

• Concussion, in which the brain is shaken, is the most common type of traumatic brain injury.

• Scalp wounds.

• Skull fractures.

Head injuries may cause bleeding:

• In the brain tissue.

• In the layers that surround the brain

Spinal injuries

A person who has sustained a head injury may have also injured their spine. In elderly people, the force required to cause neck injuries is much less than in younger people. It can even occur from a standing height fall in the elderly.

It is important to keep the injured person’s head in line with their neck. Avoid twisting their head or allowing their head to roll to the side. If you can, roll a t-shirt, towel or similar soft item and place it around their neck to keep their head straight. Don’t try to move them unless there is an urgent need to.

Signs and symptoms of spinal injuries may include:

• Body lying in an awkward, unnatural position.

• Skin feeling clammy and cool.

• Reporting unusual tingling sensations in the limbs or an absence of any sensation, including pain.

• Inability to move limbs.

Toddlers and head injuries

Toddlers fall over all the time. Parents should note that:

• A fall from the child’s own height usually isn’t enough to cause a serious head injury.

• The size of a bump on the head has no connection with the severity of injury.

• Minor head injuries, like a bump on the head, can be treated with cuddles and an age-appropriate dose of children’s pain-relieving syrup.

Medical attention should be sought immediately if the child shows any signs of serious head injury, particularly if they are unusually drowsy or vomiting, if you think the fall was heavy enough to have caused harm or if the child appeared to be unconscious or did not immediately cry after the fall.

Examples of a heavy fall are falling down some stairs, rolling from a normal height change table to a hard floor, falling from a bed to a hard surface or a head strike on bedside furniture. If in doubt, see your doctor

Head injury is a common reason for an emergency room visit. A large number of people who suffer head injuries are children. TBI (traumatic brain injury) accounts for over 1 in 6 injury-related hospital admissions each year.

Alternative Names :

Brain injury; Head trauma

Head Injury Causes:

Adults suffer head injuries most frequently due to falls, motor vehicle crashes, colliding or being struck by an object, and assaults. Falls and being struck are the most common causes of head injury in children.

Causes

Common causes of head injury include:

• Accidents at home, work, outdoors, or while playing sports
• Falls
• Physical assault
• Traffic accidents

Most of these injuries are minor because the skull protects the brain. Some injuries are severe enough to require a stay in the hospital.

Symptoms and signs:

• altered conscious state, often deteriorating over time.

• blurred or double vision.

• a thumping or pounding headache

• nausea or vomiting

• loss of balance and coordination.

• altered sensation in the fingers or down one side of the body.

• loss of short-term memory – e.g. recent events.

• noisy breathing.

• leaking fluid from the nose or one ear.

• history of a blow to the head.

A severe head injury is when:

• Consciousness is lost for more than 30 seconds.
• You or your child are drowsy and do not respond to commands as normal.
• Has unequal pupils or arm and leg weakness.
• Has something stuck in their head (a phrase or sound).
• Has a second fit or convulsion, other than the single brief experience when injury occurred.

A moderate head injury:

• Has lost conciousness for less than 30 seconds.
• Is alert and responds to normal commands.
• Has vomited two or more times.
• Has a headache.
• One brief fit may have occurred straight after initial injury.
• May have large bruise, lump or cut on head.

A minor head injury:

• You or your child did not lose consciousness.
• Alert and interactive as usual.
• May have vomited but only once.
• May have bruising or cuts to the head.
• Otherwise normal.

Bruises from a Head Injury

Small bangs on the head can cause large bruises and large soft swellings. This is because the scalp has a very good blood supply and the bone of the skull is just under the skin, meaning there is ‘no’ padding to absorb the knock.

Sometimes, the severity of the bruise can be controlled with the application of ice to the site of swelling (if there is no ice, try a packet of frozen veggies such as frozen peas). Make sure you wrap the ice in a damp cloth, do not put something very cold directly on the skin.

The swelling of the area of injury should go down quite quickly, leaving the colored bruise and a small spot of pain. If the swelling sight stays, you or your child should seek medical advice.

Cuts from a Head Injury

Cuts on the scalp will bleed a lot because of the good blood supply in the scalp. Put a clean dressing over the cut and apply pressure to the cut for five or 10 minutes. If the bleeding has not stopped within 10 minutes, it is recommended you seek medical advice. If the cut is longer than 1cm long, the cut may have a quicker and stronger recovery if treated by the doctor or medical department.

First aid for head injury

In cases where there is a serious head injury, always call an ambulance.

First aid when the injured person is conscious

Encourage the injured person to minimize any movement of their head or neck. Scalp injuries can bleed profusely, so control any significant blood loss from head wounds with direct pressure and a dressing. While examining the wound, avoid disturbing blood clots forming in the hair. Reassure the person and try to keep them calm.

First aid when the injured person is unconscious

The person should not be moved unless they are in immediate danger. Any unnecessary movement may cause greater complications to the head injury itself, the spine or other associated injuries. A good rule is that if the head is injured, the neck may be injured too.

Your role is to protect the injured person from any potential dangers at the scene. You should also monitor their airway and breathing until the arrival of an ambulance. If the person’s breathing becomes impaired due to a problem with their airway, you may need to very carefully tilt their head back (and support it) until normal breathing returns. If the person stops breathing or has no pulse, cardiopulmonary resuscitation (CPR) may be required.

How you can help:

1.    Assess the patient

• Assess the patient’s conscious state.

• If not fully conscious, place the patient on the side in a supported position.

• Check that the airway is clear and for signs of life every few minutes.

• If conscious, help the patient to rest in the position of greatest comfort.

• Sometimes patients with head injury may become agitated. Enlist friends or family to calm and reassure the patient. Consider calling the police if the safety of the patient or others becomes threatened.

Call for an ambulance.

2.    Give care until arrival of the ambulance

• Cover any wound with a sterile dressing.

• If there is any discharge from the ears or nose, cover the area with a sterile dressing.

DO NOT pack the ears or nose with dressings.

3.    Monitor the patient

• DO NOT leave the patient alone and keep a constant watch on breathing and consciousness level.

• Check for and treat any other injuries that may have been overlooked.

4.    Maintain body heat

• Cover the patient lightly with clothing or a blanket and protect from extremes of temperature.

Always arrange for a doctor to check the patient in the case of a head injury even if it appears that a full recovery has occurred. In some cases the recognition of serious head injuries may be delayed for 24 to 48 hours due to a gradual increase in swelling or bruising around the brain.

• Note: When a head injury is suspected in a player during contact sport, the first aider should recommend that the patient does not return to the game. The patient should be seen by a doctor for clearance to continue playing.

Head Injury Prevention

• Falls are the number one cause of head injuries. Some, like toddlers falling when learning to walk, are unavoidable. Others may be preventable, especially in the elderly. Opportunities exist to minimize the risk of falling at home with the use of proper floor coverings, the use of assist devices such as canes and walkers, and by evaluating homes for high risk areas like bathrooms and stairs. A primary care health care practitioner or a county health nurse may be able to help with home assessment.

• Routine use of helmets may decrease head injury while riding a bicycle or motorcycle. Their use is also encouraged for sporting activities like skateboarding, skiing, and snowboarding.

Head injuries are a major consequence of motor vehicle crashes. Lives can be saved by wearing seat belts, driving cars with air bags, and by avoiding risky driving behavior (drinking and driving, texting while driving).

Do Not

• Do NOT wash a head wound that is deep or bleeding a lot.

• Do NOT remove any object sticking out of a wound.

• Do NOT move the person unless absolutely necessary.

• Do NOT shake the person if he or she seems dazed.

• Do NOT remove a helmet if you suspect a serious head injury.

• Do NOT pick up a fallen child with any sign of head injury.

• Do NOT drink alcohol within 48 hours of a serious head injury.

A serious head injury that involves bleeding or brain damage must be treated in a hospital.