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First AidFirst Aid
Chapter 8
Head and Spine Injuries
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Head Injuries: Scalp WoundsHead Injuries: Scalp Wounds
Bleeding scalp does NOT mean blood supply to brain is affected
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Head Injuries: Scalp WoundsHead Injuries: Scalp Wounds
What to Do: Control bleeding If you suspect a skull fx,
apply pressure around wound Keep head and shoulders elevated
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Head Injuries: Scalp WoundsHead Injuries: Scalp Wounds
DO NOT: Remove embedded object Clean the wound
if suspect skull fx.
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Head Injuries: Skull FXHead Injuries: Skull FX
Hard to determine unless fx is obvious
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Head Injuries: Skull FXHead Injuries: Skull FX
Signs: Pain at the point of
injury Deformity of
skull
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Head Injuries: Skull FXHead Injuries: Skull FX
Signs: Bleeding
from ears or nose
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Head Injuries: Skull FXHead Injuries: Skull FX
Signs: Leakage of
clear pink tinged fluid (CSF) from ear or nose
CSF: Cerebral Spinal
Fluid
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Head Injuries: Skull FXHead Injuries: Skull FX
CSF:Drip onto cloth, if a pink ring forms around a blood tinged center, this is a positive “halo sign”
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Head Injuries: Skull FXHead Injuries: Skull FX
Signs: Discoloration
around eyes several hours after injury
Raccoon Eyes:
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Head Injuries: Skull FXHead Injuries: Skull FX
Signs: Discoloration behind an ear appearing several hour after injury
Battle’s Sign:
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Head Injuries: Skull FXHead Injuries: Skull FX
Signs: Unequal pupils Profuse scalp bleeding with broken skin
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Head Injuries: Skull FXHead Injuries: Skull FX
Signs: Penetrating
wound, impaled object
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Head Injuries: Skull FXHead Injuries: Skull FX
DO NOTStop the flow of blood or CSF from an ear or nose.
Increases pressure within the
skull
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Head Injuries: Skull FXHead Injuries: Skull FX
DO NOTRemove an impaled object
Stabilize object with
bulky dressings
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Head Injuries: Skull FXHead Injuries: Skull FX
DO NOTClean an open skull fx wound
Can cause
infection of the brain
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Head Injuries: Skull FXHead Injuries: Skull FX
What to Do:Monitor ABCs
Cover wound with sterile dressing
Stabilize neck against movement
Elevate head and shoulders
Apply pressure around wound edges.
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Brain InjuriesBrain Injuries
Brain can bounce around inside skull if head is struck with sufficient force.
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Brain InjuriesBrain InjuriesBrain will swell when injuredConfined inside skull
Little room to accommodate swelling
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Brain InjuriesBrain Injuries
Pressure inside skull increases, interferes with brain functioning.
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Brain InjuriesBrain InjuriesWhat to Look For:Level of Responsiveness – Awake, Alert, Oriented?Unresponsive, Confused or Disoriented?
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Brain InjuriesBrain InjuriesWhat to Look For:Memory LossN/VHAVisual changesUnequal PupilsSeizures
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Brain InjuriesBrain Injuries
What to Look For:
Paralysis, weakness or loss
balance
Blood or CSF from ears or nose
Combativeness
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Brain InjuriesBrain Injuries
What to Do:
SMA
Stabilize head and neck
Monitor ABCs
Treat scalp wound or skull FX
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Brain InjuriesBrain Injuries
What to Do:
Turn to side for vomiting
Slightly elevate head if possible
Monitor level of responsiveness
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Brain InjuriesBrain InjuriesDO NOT
Stop flow of CSFElevate legsClean open skull Fx wound
Elevating legs
increases intra-cranial
pressure
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Brain InjuriesBrain Injuries
NOT SURE?
Seek Medical Attention if the following signs appear within 48 hours after head injury:
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Brain InjuriesBrain InjuriesSMA if:
Increase severity of headache
N/V lasting more than 2 hours
Drowsiness, confusion
Vision problems
Cannot use arms or legs
Slurred speech
Seizures
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EYE InjuriesEYE Injuries
What to Do For Penetrating injuries:
SMA
Protect injured eye
Cover both eyes
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EYE InjuriesEYE Injuries
What to Do For Blows to the eye:
Ice pack
SMA as needed
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EYE InjuriesEYE Injuries
What to Do For Cuts of the eye and eye lid:
Bandage both eyes
SMA
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EYE InjuriesEYE InjuriesWhat to Do For Chemical burns of the eye:Immediately flush with water for at least 20 minutesLoosely bandage with
cold, wet dressing
SMA
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EYE InjuriesEYE InjuriesWhat to Do For Eye knocked out:AvulsedCover loosely with sterile dressing moistened with clean waterProject injured eyeCover undamaged eyeSMA
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EYE InjuriesEYE InjuriesWhat to Do For Foreign Objects:
Try to flush out by rinsing gently
with warm water
Examine and remove if seen
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NOSE InjuriesNOSE InjuriesNose Bleeds 2 types:
Anterior
Posterior
Front of nose. Most common. Blood comes out through one nostril
Back of nose. Massive bleeding backwards into mouth. Serious. SMA
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NOSE InjuriesNOSE InjuriesNose Bleeds DO NOTTilt head backwardsProbe nose with applicatorMove head and neck if suspect spine injury
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NOSE InjuriesNOSE InjuriesNose Bleeds Keep victim sitting
Keep head tilted slightly forward
Pinch soft parts of nose together for 5 minutesApply Ice pack prn
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NOSE InjuriesNOSE InjuriesNose Bleeds SMA if:
Bleeding does not stop
Suspect posterior nose bleed
Suspect broken nose
Victim has high B/P or is taking Anticoagulants (blood thinner)
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Dental InjuriesDental InjuriesKnocked-Out Tooth Rinse mouth and use gauze to control bleedingFind tooth, handle by crown, not rootPlace back into socket if possibleSee Dentist
crown
root
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Dental InjuriesDental InjuriesKnocked-Out Tooth
DO NOTPlace tooth in water, alcohol, Betadine, mouth wash, skim milk, or milk by-productsScrub toothRemove partially extracted tooth
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Dental InjuriesDental InjuriesToothache Rinse mouth with warm waterUse dental floss to remove
trapped foodSoak cotton ball in oil of cloves and place on toothAnalgesicSee Dentist
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Dental InjuriesDental InjuriesToothache
DO NOTPlace analgesic tablet directly on tooth
Wait to see dentist if there is pus or
facial swelling
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Spine InjuriesSpine InjuriesWhat to Look For:Head injuriesPainful, limited or no movement in arms or legsLoss of bowel or bladderDeformity of head or neck
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Spine InjuriesSpine InjuriesPedal Pushes
Hand Squeezes
Have victim push foot against your hand
Have victim squeeze your hand
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Spine InjuriesSpine InjuriesAsk:
Pain?
Can you move your hands and fingers?
Can you move your feet and toes?
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Spine InjuriesSpine InjuriesIf unresponsive:Test response by pinching arm, hand and leg, foot
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Spine InjuriesSpine InjuriesWhat To Do:Monitor ABCs
Stabilize against movement –
Hold head between hands and arms or use objects to
stabilize
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Spine InjuriesSpine InjuriesDO NOT:
Move the victim unless ABSOLUTELY necessary
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Learning Activities 8Learning Activities 8
1. 1. For a suspected skull fx, For a suspected skull fx, press around the wound not press around the wound not directly on itdirectly on it. .
Yes
Head Injuries
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Learning Activities 8Learning Activities 8
2. 2. DO NOT removed DO NOT removed impaled objectsimpaled objects. .
Yes
Head Injuries
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Learning Activities 8Learning Activities 8
3. 3. Head injury victims should Head injury victims should be checked for possible be checked for possible spine injury spine injury . .
Yes
Head Injuries
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Learning Activities 8Learning Activities 8ScenerioScenerio: : Carpenter fell from ladder. Responsive Carpenter fell from ladder. Responsive
now but was motionless for a few now but was motionless for a few minutes. C/o severe HA and dizziness. minutes. C/o severe HA and dizziness.
Swelling on back of head. What to do?Swelling on back of head. What to do?
Monitor ABCs
Stabalize head and neck
Assess level of responsiveness
If bleeding, apply pressure around wound
Elveat head if possible
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Learning Activities 8Learning Activities 8
1. 1. After blow to eye, apply After blow to eye, apply ice pack for about 15 ice pack for about 15 minutesminutes. .
Yes
Eye Injuries
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Learning Activities 8Learning Activities 8
2. 2. Tears are sufficient to Tears are sufficient to flush chemicals from flush chemicals from the eyethe eye. .
No
Eye Injuries
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Learning Activities 8Learning Activities 8
3. 3. Use a clean damp Use a clean damp cloth to remove object cloth to remove object from surface of eyefrom surface of eye. .
Yes
Eye Injuries
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Learning Activities 8Learning Activities 8
Flush with water for at least 20 minutes
SMA
Scenario: Car battery explodes. Battery cap flies off. Battery acid splashes into Sam’s eye. What to do?
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Learning Activities 8Learning Activities 8
1.1. Preserve a knocked out tooth in alcohol or mouth wash.
No
Dental Injuries
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Learning Activities 8Learning Activities 8
2.2. Scrub knocked-out tooth before going to dentist.
No
Dental Injuries
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Learning Activities 8Learning Activities 8
3.3. Sometimes a knocked-out tooth should be reinserted.
Yes
Dental Injuries
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Learning Activities 8Learning Activities 8
Rinse mouth
Stop socket bleeding
Handle tooth by crown
Reinsert tooth
Scenario: Mike (age 20) was struck in mouth. Spit out 2 front teeth. What to do?
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Learning Activities 8Learning Activities 8
1.1. DO NOT move and stabilize against movement a victim with a suspected spine injury .
Yes
Spine Injuries
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Learning Activities 8Learning Activities 8
2.2. Inability to move fingers and or feet may indicate a spine injury .
Yes
Spine Injuries
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Learning Activities 8Learning Activities 8
3.3. A head injury may be a reason to suspect a spine injury .
Yes
Spine Injuries
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Learning Activities 8Learning Activities 8
Monitoe ABCs
Stabalize head and neck against movement
Wait for EMS
Scenario: A car hits concrete median. You completed scene survey. Driver C/O numbness and loss of feeling in both legs. What to do?
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First Aid KitsFirst Aid KitsItem Quantity
Paper or
Styrofoam cup 1