1. Serious Injuries

2. Head Injuries Intro read e-mail Prevention

3. Bicycle Safety Helmets Bike wreck Ride on right side of road Rear view mirror

4. Motorcycle Helmet Law New law in 1999 Over 18, no helmet required Results in more long term hospital stays?? Three and four wheeler accidents

5. Brain Injuries Hard to assess due to: Unresponsiveness, confusion Brain tissue swells Causes intracranial pressure Brain stem may be squashed by the pressure Can affect heart/lung functioning Check for two points of injury Seek medical attention for all brain injuries! (monitor for 24 hours)

6. Three Types of Brain Injuries Concussion Contusion Hematoma

7. Concussion (3 Grades) Temporary loss of brain function Usually no permanent damage (Can be severe) “Bell rung” (recognizing concussions p. 177) No bleeding in the brain The longer memory is lost or the longer one remains unconscious, the more serious Should you let the victim go to sleep? Management: Monitor – seek medical help if necessary

8. Contusion Bruising (bleeding in the brain tissue)of the brain X-ray or MRI Is typically more serious Management: Monitor and seek medical help if necessary

9. Hematoma Localized collection of blood Blood clot Most serious type of brain injury Management: Monitor and seek medical help

10. Concussion Management in Sports Wearing a helmet? Leave on unless: Signs of severe head injury Obstructed airway Helmet so loose that neck stabilization is not possible

11. Signs of Intercranial Pressure Memory loss / confusion Ask questions “What day is it?” Severe headache Vomiting and nausea (esp. > 2 hours) Cerebral spinal fluid Combativeness Weakness, dizziness, lack of mobility Double vision / unequal pupils Seizures / unusual drowsiness Seek medical attention

12. Spine Injuries Suspect spinal injury in all head injury victims or severe accidents Stabilize in position found unless to save life If need to roll victim over, log roll, stabilize In water? Do not move? Check for CSM

13. Spine Injuries #2 Check for: Painful limb movement Numbness, tingling, weakness, burning sensation Loss of bowel or bladder control Paralysis Deformity Unequal pupils CSF fluid

14. Spine Injuries #3 Ask victim: Move toes, fingers, squeeze hand, press foot against hand Babinski test Stabilize victim

15. Chest Injuries Types Injuries to chest wall Injuries to lungs Check ABC’s Stabilize: Support with a pillow Conscious: sit up or place with injured side towards the ground (to ease breathing)

16. Rib Fractures Painful to move, cough, breathe Point tenderness Do not wrap (restricts breathing) Stabilize Encourage deep breathing Seek medical attention?

17. Flail Chest Major injury Several ribs in the same area are broken in more than one place Chest wall may move in opposite direction from the rest of the chest Stabilize with pillow or hand Place with injured side towards the ground Treat for shock Monitor ABC’s and seek medical attention

18. Injuries To Lungs Hemothorax Blood fills chest, lungs can’t expand Pneumothorax – air fills chest cavity Open pneumothorax (sucking chest wound) Air moves in and out of chest cavity Lungs can’t expand Tension pneumothorax – air is pulled in, can’t exit

19. Sucking Chest Wound Call 911 Place a thin sterile dressing over the wound. Cover dressing with a plastic bag or wrap to make an air-tight seal. As victim exhales, tape it in place on three sides (May use gloved hand) Victim having trouble or getting worse? Remove, allow air to escape, then reapply

20. Severe Blow To Abdomen Place on side Expect vomiting No foods or liquids Seek medical attention

21. Protruding Organs Do not re-insert Cover loosely with moist, sterile dressing or clean cloth If moist is not available, use non adherant dry dressing Best to wait for EMS (saline solution) Cover area plastic wrap, taped loosly Then cover with towel or blanket Treat for shock Seek medical attention

22. Pelvic Injuries Accompanied by: Pain Shock Internal bleeding Inability to use lower extremities Damage to bladder and other organs

23. Determining Pelvic Injuries Gently press downward and inward at iliac crest Do not press if pain is already present Pain may indicate broken pelvis (suspect spinal cord injury)

24. Pelvic Injuries: What To Do Treat for shock Pad between thighs Tie knees and ankles together Keep on firm surface Seek medical attention