Head Injuries These injuries are caused by falls, road accidents, sporting accidents, or working in high risk occupations. They can result in skull fractures, scalp wounds, concussion, brain injury/brain damage, and should always receive urgent medical attention.

Skull Fracture

It may be seen or indicated, in some cases by blood or fluid from the ear, or loss of consciousness, or by a wound or sometimes there may be no signs.

Treatment

•  If breathing and heartbeat stop, begin the A-B-C of resuscitation immediately.
•  If any discharge issues from the ear, incline towards the injured side and cover with a sterile dressing - DO NOT PLUG.
•  If the casualty is unconscious, place him in the recovery position with the injured side down.
•  If the casualty is conscious, place him in a half sitting position, with head and shoulders supported. If you suspect spinal injury, keep the casualty's head and trunk aligned at all times.
•  Check breathing and pulse every ten minutes.
•  Treat for shock.
•  Send for medical assistance and remove to hospital.

Concussion

This is a condition of temporary disturbance to the brain after a head injury. It may involve unconsciousness and, occasionally, loss of memory.

Treatment

•  If breathing and heartbeat stop, begin the A-B-C of resuscitation immediately.
•  If casualty is unconscious, place him in the recovery position while awaiting removal to hospital.
•  In serious cases, check breathing rate, and watch carefully for signs of delayed unconsciousness, shock, stroke.
•  Treat for shock.
•  In all cases consult a doctor.
•  If loss of consciousness is suspected, the person should be examined at a hospital.

Compression

Any head injury may burst a blood vessel in the brain. This causes pressure to be exerted on the brain by blood accumulating within the skull. Compression may develop up to twenty-four hours after the casualty has apparently recovered.

With compression, the pupils of the eyes may be of differing sizes, there will be a diminished pulse rate and a deteriorating level of consciousness, an intense headache, noisy breathing, paralysis, raised temperature.

Treatment

•  The casualty should be removed to hospital immediately.
  This condition requires urgent medical treatment.

Head Injuries in Children

Most head injuries in children are minor. Lacerations bleed freely and seem to be worse than they are.
A fall of more than 3 ft. onto a hard surface is a serious matter. It is very common for children who sustain head injuries, to go pale and vomit immediately and subsequently to be sleepy. This should not cause undue alarm. If in doubt, call an Ambulance.

Treatment

•  Swelling of the skull on either sides of the head, just above the ears, should be taken seriously and needs medical attention.
•  The single most important factor after head injury is progressive drowsiness.
  The type to watch out for is that which comes on following a period of lucidity after a head injury and is progressive. This requires immediate, urgent medical attention.