Emergency First Aid for Children

10. Head Injuries

Head Injuries

All injuries to the head are potentially dangerous, and always require medical

attention

• Cuts• Concussion• Contusion• Haemorrhage• Compression

5 main types of head injury

Pages 42-45

Each year, around 1 million people in the UK need treatment for head injuries, almost of half of which are caused by road accidents*. For children, one of the highest risks is cycling accidents, though damage can be reduced by 85% if they wear a helmet. All head injuries are potentially very serious and should be monitored closely.

*Source - Headway, the brain injury association.

Head Injuries• Signs & Symptoms of serious head injury

Deep cuts or tears to the scalp

Goose egg swelling over scalp

Nausea and/or vomiting

Severe headache

Drowsiness or difficulty being roused

Unequal sized pupils, or pupils that do not respond to light

Visual disturbance

Fluid flowing from eyes and/or mouth

Paralysis, numbness

Loss of function over one half of body

Behaving as though drunk

Fits, confusion or unconsciousnessPages 42-45

Unconsciousness

An abnormal state resulting from an An abnormal state resulting from an interruption of the brain’s normal interruption of the brain’s normal

activity.activity.

Pages 42-45

Unconscious Casualty

1. Ensure the airway is open and clear

2. Check and recheck the levels of response

3. Examine the casualty thoroughly

3 Rules of Treatment

Pages 42-45

Levels of Response

AlertVoicePain Unresponsive

Responds normally – can hold a normal conversation

Responds to voice –obeys commands

Responds to pain only

Does not respond to anythingPages 42-45

First Aid for Head Injury

Breathing in vomit while unconscious is the most common cause of death after a head injury.

1st priority is to protect victim airway by tilting back the jaw.Always assume they have spinal injury and protect their neck.

If casualty is not breathing – start resuscitation.

Carefully apply direct pressure to any scalp wounds that are bleeding.

Watch for vomiting.

Pages 42-45

First Aid for head injury cont’d

If they are Unconscious, lay then on the floor with head and shoulders slightly raised.

If unconscious, place them in the recovery position whilst protecting their neck.

Call the emergency services.

See how alert they are using AVPU. Reassure them if they are alert.

Continue to watch their breathing, circulation and level of consciousness until help arrives.

Even if they regain consciousness, insist they go to hospital to be checked out.

Scalp Wounds

AIMS

• Control blood loss

• Arrange transport to hospital

The scalp has a rich supply of bloodWhen damaged the skin splits.Bleeding may be profuse

Treatment:• Cover the injury with a clean pad or sterile dressing. Apply pressure, place another pad on top if necessary

Scalp Wounds

• Bandage the dressing firmly in place.

• Help the casualty to lie down with head and shoulders slightly raised. Watch for any changes in their condition.

Concussion

The brain may “shaken” by a blow causing concussion

.

You will need to distinguish between:

• A bump on the head with no concussion

• A brief period of concussion (20 seconds), and an

• Extended period of unconsciousness

Pages 43

Concussion

Recognising concussion:

• Brief loss of consciousness, dizziness or nausea on recovery

• Loss of memory immediately preceding events

• A mild headache

Pages 43

ConcussionConscious casualty

• Sit casualty down, treat any minor bruise or wound with a cold compress

• WATCH for signs of abnormal behaviour. If casualty doesn’t recover within a few minutes – call a doctor

Casualty regains Consciousness

quickly

• Call a doctor

• Ensure casualty rests. If they do not recover completely within 30 minutes – call an ambulance.

UnconsciousCasualty

• Call an ambulance.

• Open the airway, check breathing. Be prepared to resuscitate.

Pages 43

Skull and Facial Injuries

NOTE: All skull fractures are potentially very dangerous and require URGENT medical attention.

Skull FracturesSigns of a skull fracture• A “boggy” soft swelling or egg-shaped bruise on

the head

• Bruising around eye and/or ear area

• Noticeably lopsided appearance to the head

• Deteriorating level of consciousness

• Blood visible in whites of eyes

• Clear or blood stained fluid from nose or earsPage 44

Skull Fractures

Aim

• To keep airway open

• Arrange for urgent removal to hospital

Treatment

• Open the airway

• Place casualty in recovery position

Page 44

Skull Fracture– DELAYED REACTION –

Recognising Cerebral Compression:• Disorientation and confusion• Sever headache• Impaired consciousness• Noisy breathing, becoming slow• Slow but strong pulse• Unequal pupils• Weakness or paralysis• Raised temperature

•There may be a serious reaction to head injury hours or even days later.

CALL AN AMBULANCE

Cheekbone and Nose Fractures

Aims

• Minimise pain and swelling

• Arrange removal to hospital

Treatment

• Apply a cold compress

• Treat associated nosebleed if necessary

APPLY COLD COMPRESS

Fractures to the Lower Jaw

Signs & Symptoms

• There is pain, nausea and/or swelling of the jaw area

• Casualty cannot bite and is dribbling• Distortion of the teeth• Difficulty swallowing, breathing or

speaking• A wound or bruising inside the mouth

Fractures to the Lower Jaw

Aims

• Protect the airway

• Arrange removal to hospital

Treatment

• Ensure that any blood, mucus or saliva in the mouth is allowed to dribble out

• If necessary remove debris from the mouth

Emergency First Aid for Children

End of Section