First aid considering head injury Cause of injury, possible complication, management Tamara Skříšovská Head Injury2 Learning objectives ̶ Student will learn the basic algorithm for approaching a patient with a head injury. ̶ Student will learn how to evaluate the patient's state of consciousness. Head Injury3 Cause of injury Falling from a great height Sport activities Traffic accident Violent attack Head Injury4 Cause of injury- severity ̶ Contusions or injuries to the scalp ̶ Brain concussion ̶ Calvaria and cranial basis fractures ̶ Severe traumatic brain injury (high- energy) • monotrauma or as a part of polytrauma • risk of intracranial bleeding ( epidural, subdural) • internal bleeding does not have accompanied by external injuries Head Injury5 When to seek medical help? Loss of consciousness Retrograde amnesia Repeating vomiting Worsening headaches Sensory impairment (visual, hearing) Sudden behavioural change (aggression, apathy…) Bleeding/ liquid from nose, ears Seizures Weakness / numbness in extremities Difficulties walking or talking Unequal pupil width (anisocoria) Head Injury6 Management ̶ According to severity of the injury ̶ CAVE suspect cervical neck injury ̶ Basal algorithm ABCDE ̶ Evaluation of consciousness using AVPU: • Alert- fully conscious • Verbal- reaction on verbal stimuli • Pain –reaction on painful stimuli • Unresponsive-does not react to any kind of stimuli Head Injury7 Management 1. Safety 2. Position (conscious vs. unconscious) 3. Call for help (ZZS) 4. Thermal Comfort 5. Stop bleeding Head Injury8 Consclusion ̶ Patient´s state can change rapidly (lucid interval), do not leave the patient alone and have a plan how to react in case of loss of consciousness or cease of breathing (CPR) ̶ If the person was injured during sport activities, do not let him/ her continue, unless checked by medical professional ̶ The patient should seek medical help if: over 65 years old, taking anticoagulant medication, has undergo neurosurgery, alcohol or drug intoxication involved Head Injury9 Learning outcomes ̶ Student is able to recognize the symptoms of serious head injuries. ̶ Student knows when to seek medical help for a head injury. Head Injury10 Sources ̶ https://www.prpom.cz/urazy-hlavy/ ̶ https://mladyzdravotnik.cz/prvni-pomoc/poraneni-hlavy/ ̶ https://www.moh.gov.sa/en/HealthAwareness/EducationalContent/ Firstaid/Pages/008.aspx ̶ AUSTIN, Margaret, Rudy CRAWFORD a Vivien J. ARMSTRONG. První pomoc: autorizovaná příručka organizací St John Ambulance, St Andrew's First Aid a British Red Cross. Přeložil Petr STŘÍBRNÝ. V Praze: Slovart, 2015. ISBN 9788073913861. Simulation Centre, Faculty of Medicine, Masaryk University 2020