1. First Aid Chapter 8 Head and Spine Injuries

2. Head Injuries: Scalp Wounds Bleeding scalp does NOT mean blood supply to brain is affected

3. Head Injuries: Scalp Wounds What to Do: Control bleeding If you suspect a skull fx, apply pressure around wound Keep head and shoulders elevated

4. Head Injuries: Scalp Wounds DO NOT: Remove embedded object Clean the wound if suspect skull fx.

5. Head Injuries: Skull FX Hard to determine unless fx is obvious

6. Head Injuries: Skull FX Signs: Pain at the point of injury Deformity of skull

7. Head Injuries: Skull FX Signs: Bleeding from ears or nose

8. Head Injuries: Skull FX Signs: Leakage of clear pink tinged fluid (CSF) from ear or nose CSF: Cerebral Spinal Fluid

9. Head Injuries: Skull FX CSF: Drip onto cloth, if a pink ring forms around a blood tinged center, this is a positive “ halo sign ”

10. Head Injuries: Skull FX Signs: Discoloration around eyes several hours after injury Raccoon Eyes:

11. Head Injuries: Skull FX Signs: Discoloration behind an ear appearing several hour after injury Battle ’ s Sign:

12. Head Injuries: Skull FX Signs: Unequal pupils Profuse scalp bleeding with broken skin

13. Head Injuries: Skull FX Signs: Penetrating wound, impaled object

14. Head Injuries: Skull FX DO NOT Stop the flow of blood or CSF from an ear or nose. Increases pressure within the skull

15. Head Injuries: Skull FX DO NOT Remove an impaled object Stabilize object with bulky dressings

16. Head Injuries: Skull FX DO NOT Clean an open skull fx wound Can cause infection of the brain

17. Head 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.

18. Brain Injuries Brain can bounce around inside skull if head is struck with sufficient force.

19. Brain Injuries Brain will swell when injured Confined inside skull Little room to accommodate swelling

20. Brain Injuries Pressure inside skull increases, interferes with brain functioning.

21. Brain Injuries What to Look For: Level of Responsiveness – Awake, Alert, Oriented? Unresponsive, Confused or Disoriented?

22. Brain Injuries What to Look For: Memory Loss N/V HA Visual changes Unequal Pupils Seizures

23. Brain Injuries What to Look For: Paralysis, weakness or loss balance Blood or CSF from ears or nose Combativeness

24. Brain Injuries What to Do: SMA Stabilize head and neck Monitor ABCs Treat scalp wound or skull FX

25. Brain Injuries What to Do: Turn to side for vomiting Slightly elevate head if possible Monitor level of responsiveness

26. Brain Injuries DO NOT Stop flow of CSF Elevate legs Clean open skull Fx wound Elevating legs increases intra-cranial pressure

27. Brain Injuries NOT SURE? Seek Medical Attention if the following signs appear within 48 hours after head injury:

28. Brain Injuries SMA if: Increase severity of headache N/V lasting more than 2 hours Drowsiness, confusion Vision problems Cannot use arms or legs Slurred speech Seizures

29. EYE Injuries What to Do For Penetrating injuries: SMA Protect injured eye Cover both eyes

30. EYE Injuries What to Do For Blows to the eye: Ice pack SMA as needed

31. EYE Injuries What to Do For Cuts of the eye and eye lid: Bandage both eyes SMA

32. EYE Injuries What to Do For Chemical burns of the eye: Immediately flush with water for at least 20 minutes Loosely bandage with cold, wet dressing SMA

33. EYE Injuries What to Do For Eye knocked out: Avulsed Cover loosely with sterile dressing moistened with clean water Project injured eye Cover undamaged eye SMA

34. EYE Injuries What to Do For Foreign Objects: Try to flush out by rinsing gently with warm water Examine and remove if seen

35. NOSE Injuries Nose 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

36. NOSE Injuries Nose Bleeds DO NOT Tilt head backwards Probe nose with applicator Move head and neck if suspect spine injury

37. NOSE Injuries Nose Bleeds Keep victim sitting Keep head tilted slightly forward Pinch soft parts of nose together for 5 minutes Apply Ice pack prn

38. NOSE Injuries Nose 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)

39. Dental Injuries Knocked-Out Tooth Rinse mouth and use gauze to control bleeding Find tooth, handle by crown, not root Place back into socket if possible See Dentist crown root

40. Dental Injuries Knocked-Out Tooth DO NOT Place tooth in water, alcohol, Betadine, mouth wash, skim milk, or milk by-products Scrub tooth Remove partially extracted tooth

41. Dental Injuries Toothache Rinse mouth with warm water Use dental floss to remove trapped food Soak cotton ball in oil of cloves and place on tooth Analgesic See Dentist

42. Dental Injuries Toothache DO NOT Place analgesic tablet directly on tooth Wait to see dentist if there is pus or facial swelling

43. Spine Injuries What to Look For: Head injuries Painful, limited or no movement in arms or legs Loss of bowel or bladder Deformity of head or neck

44. Spine Injuries Pedal Pushes Hand Squeezes Have victim push foot against your hand Have victim squeeze your hand

45. Spine Injuries Ask: Pain? Can you move your hands and fingers? Can you move your feet and toes?

46. Spine Injuries If unresponsive: Test response by pinching arm, hand and leg, foot

47. Spine Injuries What To Do: Monitor ABCs Stabilize against movement – Hold head between hands and arms or use objects to stabilize

48. Spine Injuries DO NOT: Move the victim unless ABSOLUTELY necessary

49. Learning Activities 8 1. For a suspected skull fx, press around the wound not directly on it. Yes Head Injuries

50. Learning Activities 8 2. DO NOT removed impaled objects. Yes Head Injuries

51. Learning Activities 8 3. Head injury victims should be checked for possible spine injury. Yes Head Injuries

52. Learning Activities 8 Scenerio: Carpenter fell from ladder. Responsive now but was motionless for a few minutes. C/o severe HA and dizziness. 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

53. Learning Activities 8 1. After blow to eye, apply ice pack for about 15 minutes. Yes Eye Injuries

54. Learning Activities 8 2. Tears are sufficient to flush chemicals from the eye. No Eye Injuries

55. Learning Activities 8 3. Use a clean damp cloth to remove object from surface of eye. Yes Eye Injuries

56. Learning 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?

57. Learning Activities 8 1. 1. Preserve a knocked out tooth in alcohol or mouth wash. No Dental Injuries

58. Learning Activities 8 2. 2. Scrub knocked-out tooth before going to dentist. No Dental Injuries

59. Learning Activities 8 3. 3. Sometimes a knocked-out tooth should be reinserted. Yes Dental Injuries

60. Learning 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?

61. Learning Activities 8 1. 1. DO NOT move and stabilize against movement a victim with a suspected spine injury. Yes Spine Injuries

62. Learning Activities 8 2. 2. Inability to move fingers and or feet may indicate a spine injury. Yes Spine Injuries

63. Learning Activities 8 3. 3. A head injury may be a reason to suspect a spine injury. Yes Spine Injuries

64. Learning 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?

65. First Aid Kits ItemQuantity Paper or Styrofoam cup1