11. open head injury

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Head InjuryHead In

jury --

A head injury may consist of a cut or bruiseof the scalp, a concussion, a fracture of the skullwith injury to the brain, extruding brain matter,

or a combination of these injuries. If the skin has been broken, it is called an open head injury. Ifthe skin has not been broken, it is a closed headinjury. Both open and closed head injury can besevere and life-threatening.


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S/S of Open and Closed Head Injuries:S/S of Open and Closed Head Injuries:Bleeding from the scalp

Visible skull fracture

Visible brain tissue


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The following s/s are also indications of a headThe following s/s are also indications of a head

injury, even if no open wound is present:injury, even if no open wound is present:

eformity of the head

!lear or bloody fluid leaking from the nose orear.

"Black eyes# and bleeding in the whites of theeyes.

Bruise behind one or both ears.

$eadache, nausea, or vomiting.


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%oss of consciousness &either current or recentunconscious'.

Vision problems.(taggering or di))inessrowsiness.

*ental confusion.(lurred speech.!onvulsions, twitching.

ifficulty in breathing.+aralysis.(i)e of pupils uneual.


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evel of Consciousnessevel of Consciousness::

hen a head injury is present, always check thecasualtys level of consciousness by asking him to

tell you his name, where he is, the month and year,or other information which cannot be answered bya simple yes or no. Incorrect responses, inability toanswer, or changes in responses may indicate a

serious head injury. /eport the casualtys responsesor lack of response to medical personnel.


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!osition a casualty with a head Injury:!osition a casua

lty with a head Injury:

If the casualty is conscious, does not have asevere head or spinal injury, and other injuries

do not prohibit his sitting up, have the casualtysit up, 0he casualty should lean against a tree,wall, or other object, if possible.


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If the casualty is conscious, does not have a

severe head or spinal injury, is notaccumulating drainage in his throat, and is notable to sit up, elevate his head slightly.

If the casualty is choking, nauseous, vomiting,or bleeding from his mouth, position thecasualty on his side in order to promote

drainage and to maintain an open airway.+lace the casualty on the side opposite that of

the wound.


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Casualty Positioned on his Side


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If the casualty is having convulsions, ease him

to the ground and gently support his head andneck. o not try to forcefully hold his arms andlegs. 0rying to "pin down# jerking limbs will probably cause additional injury. o not putyour finger or other objects in the casualtysmouth. 1 casualty with convulsions presents atwo-fold problem in that you must treat his

injuries and you must also keep him fromaccidentally hurting himself.


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"#pose the wound"#pose the wound::

/emoved headgear. 2 If the casualty is wearing a mask and hood and

the "all clear# signal has not been given, do notremove the casualtys mask and hood or attempt todress the wound. If the mask or hood has been breached, repair it with tape or wet cloth stuffing if possible. o not attempt to clean the wound or

attempt to push any brain matter back into thehead. If an object is protruding from the wound,make bulky dressing from the cleanest materialavailable, build up the area around the object, and

secure the dressing with improvised bandages.


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$ressing to a wound on the forehead or %ac& of$ressing to a wound on the forehead or %ac& of

the head:the head:

/emove the filed dressing from its wrappers.

3rasp a tail in each hand, hold the dressingdirectly over the wound, pull the dressing open,

and place the white side of the dressing directlyover the wound.


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+lace one hand on the dressing to keep itfrom slipping.

rap one tail hori)ontally around thecasualtys head and bring it back across thedressing. 1ngle the bandage so that it will

cover the top or bottom edge of the dressing.


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Wound on

Forehead

Wrapping Tail Around Head

CAUTION : Apply the dressing and

bandage so as to not interfere with the

casualty's ision or hearing unless theeye or ear is in!ured"

#rap the second tail around the

casualty's head in the opposite

direction"


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Bring the tail back across the dressing angled so it

will cover the other edge &top or bottom' of thedressing.

> Continue to wrap the bandage around the headagain until it meets the first tail.

> Tie the tails in a non-slip knot on the side ofthe head.

!aution4 T he bandages should be tight enough so the

dressing will not slip but not tight enough to place undue pressure on the wound.


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0uck in any excess tails. 0ucking in excessmaterial will keep the tails from catching on an

object or accidentally hitting the casualty in theeye.

0ying tails on the side of the head.


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$ressing top of the head$ressing top of the head::

/emove the filed dressing from its wrappers.

3rasp a tail in each hand, hold the dressingdirectly over the wound, pull the dressingopen, and place the white side of the dressingdirectly over the wound.


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+lace on hand on top of the dressing to hold it

in place

3rasp the near tail with the other.

Bring the tail down in front of the ear, underthe chin, up in front of the opposite ear, overthe dressing, and to a point just above and in

front of the first ear. &about a one and one-fourth circle'


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$ringing the Tail Under the Chin


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!aution 4 When passing a tail under the chin,make sure that the tail remains wide and close to the

front of the chin. This will keep the bandage fromchocking the casualty.

/emove your hand from the dressing andgrasp the other &free' tail.


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Bring that tail down the opposite side of theface in front of the ear, under the chin, and upuntil it meets the first tail.

!ross the tails so that each makes 56 degreesturn, 0he cross should be made slightly above

and in front of the ear.


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Bring one tail across the casualtys foreheadand move the eyebrows until it is in front ofthe opposite ear.

Bring the other tail back above the ear, low behind the head at the base of the skull, and upto point above and in front of the opposite ear

where it meets the first tail.


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0ie the tails in a non-slip knot in front of and

above the ear.

0uck in the excess material from the tails.

!aution4 Apply the dressing and bandage so as to notinterfere with the casualty’s vision or hearing unlessthe eye or ear is injured.


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7 !rossing the 0ails &ound on 0op of $ead'


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0ying tails &wound on top of head'


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$ressing to the$ressing to the

chee& or Side of the head:chee& or Side of the head:

3rasp the tail in each hand, hold the dressingdirectly over the wound with the white side ofthe dressing toward the wound, pull the

dressing open, and place the white side of thedressing directly over the wound so that thetails are vertical.

+lace one hand on top of the dressing to hold itin place. If the casualty is able, you an have thecasualty hold the dressing in place while yousecure it.


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Bring the top tail over the top of the head,down in front of the ear, under the chin, upthe side of the face, and over the dressing to a point just above the ear.

!aution 4 When passing a tail under the chin, make sure that the tail remains wide and close to the front f the chin. This will keep the bandage from cocking

the casualty.


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!aution4 Apply the dressing and bandage so as to notinterfere with the casualty’s vision or hearing unless theeye or ear is injured.

Bring the other tail down, under the chin, up theside of the face, in front of the ear, and over thetop of the head until it meets the first tail &almosta full circle'.


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7 Bringing second tail around to meet first tail&wound on cheek'.


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!ross the two tails just above the ear on

the injured side of the face.


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Bring the other tail above the ear, low behind

the back of the head at the base of the skull,and above the other ear until it meets the firsttail.

0ie the tails in a non-slip knot just above andin front of the ear on the uninjured side of thehead. 0uck in the ends of the tails.


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7 0ails tied in non-slip knot and ends tucked


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!aution4

If fluid is coming from the casualty’s

ear, put a field dressing or clean cloth over

the ear to protect the ear and absorb thedrainage. ecure the dressing loosely, but

tight enough to keep the dressing from

slipping. !vacuate the casualty AA".


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'onitor a casualty with a head injury'onitor a casualty with a head injury::

+osition the casualty.1 scalp wound may bleed excessively,

reuiring pressure to control the bleeding.

1 casualty with a serious head wound orwho does not regain consciousness should be examined by medical personnel if

readily available. 0he casualty should beevacuated to a medical treatment facility1(1+.


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1ny person with a head injury should be

evaluated by medical personnel even ifevacuation is not needed.

If you remain with the casualty, check hisresponsiveness every 89 minutes. $ave him tellyou his name, where he is, and the month andyear. If the casualty falls asleep, wake thecasualty to check his level of consciousness. :ote any changes from earlier observations.


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o not give the casualty anything to eat or

drink. ;ating or drinking may cause him tovomit.

0reat for shock, if necessary.

;nd . . .

11. open head injury

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