1. Head and Spinal Injuries
Chapter 12
Head and Spinal Injuries

2. Head Injuries
Scalp wounds
Skull fracture
Brain injuries

3. Scalp Wounds Associated with heavy bleeding
The scalp has a rich blood supply.
The vessels do not constrict.
The brain obtains its blood supply from arteries in the neck.

4. Care for Scalp Wounds
Control bleeding by using direct pressure over wound.
If skull fracture is suspected, apply pressure around the edges of the wound.
Keep head and shoulders slightly elevated if spinal injury is not suspected.
Seek medical care.

5. Skull Fracture A skull fracture is a break or crack in the cranium.
May be open or closed

6. Recognizing a Skull Fracture
Pain at point of injury
Deformity of the skull
Bleeding from ears and nose
Cerebrospinal fluid leaking from ear or nose
Discoloration around eyes
Discoloration behind ear
Heavy scalp bleeding if the skin is broken
Penetrating wound

7. Care for a Skull Fracture
Monitor breathing and provide appropriate care.
Stabilize the victim’s neck to prevent movement.
Elevate the victim’s head and shoulders to help control bleeding.
Cover the wounds with a sterile dressing.
Apply pressure around the edges of the wound.

8. Brain Injuries
When the head is struck with force, the brain bounces against the inside of the skull.
Swelling of brain tissue compresses the brain, which interferes with brain functioning.
Three types of commonly occurring brain injuries:
Concussion
Contusion
Hematoma

9. Recognizing Brain Injury (1 of 2)
Confused facial expression
Slow to answer questions or follow instructions
Easily distracted and unable to follow through with normal activities
Unaware of time, date, and place
Making disjointed statements
Stumbling, unable to walk a straight line

10. Recognizing Brain Injury (2 of 2)
Distraught
Asking a question that has already been answered or inability to memorize a series of three words
Coma, unresponsiveness

11. Care for Brain Injury (1 of 2)
Seek immediate medical care.
Suspect a spinal injury in an unresponsive victim until proven otherwise.
Stabilize the victim’s head and neck.
Monitor the victim’s breathing.
Control scalp bleeding with sterile dressings.
Roll the victim onto his or her side to help drain vomit.

12. Care for Brain Injury (2 of 2)
If spinal injury is not suspected, keep the victim in a slightly head-elevated position.
If victim is unresponsive, roll him or her onto the left side.
The victim’s level of responsiveness is one of the best indicators of neurologic function.
Using the mnemonic AVPU is especially helpful with small children.

13. Eye Injuries Penetrating eye injuries Blows to the eye
Cut of the eye or lid
Chemical in the eyes
Eye avulsion
Loose objects in the eye
Light burns to the eye

14. Penetrating Eye Injuries
Penetrating eye injuries are severe injuries that result a sharp object penetrates the eye.
Suspect penetration any time you see a lid laceration or cut.

15. Care for Penetrating Eye Injuries
Seek immediate medical care.
Stabilize the object.

16. Blows to the Eye
Blows to the eye range in severity from minor or sight threatening.
A shiner or black eye occurs when some of the blood vessels around the eye rupture.
A blunt object can break the bone around the eyeball.

17. Care for Blows to the Eye
Apply ice for about 15 minutes.
Do not apply pressure on the eye.
Seek medical care if there is pain or reduced vision.

18. Cuts of the Eye or Lid
The signs of a cut eyeball or lid include the following:
Cut appearance of the cornea or sclera.
Inner liquid filling of the eye may come out through the wound.
Lid is cut.

19. Care for Cuts of the Eye or Lid
If eyeball is cut, do not apply pressure.
If eyelid is cut, apply gentle pressure.
Bandage both eyes lightly.
Seek medical care.

20. Chemical in the Eyes Chemicals in the eyes can threaten sight.
Alkalis cause greater damage than acids because they penetrate deeper and continue to burn longer.
Damage can occur in 1 to 5 minutes.

21. Care for Chemical in the Eye
Hold the eye open.
Flush the eye with water for at least 20 minutes.
Loosely bandage both eyes with cold, wet dressings.
Seek medical care.

22. Eye Avulsion
A blow to the eye can avulse it (knock it out) from its socket.
This is a serious injury.

23. Care for Eye Avulsion Cover the eye loosely.
Protect injured eye with a paper cup or doughnut-shaped pad.
Cover the undamaged eye with a patch.
Seek immediate medical care.

24. Loose Objects in the Eye
Loose objects in the eye are the most frequent eye injury and can be very painful.
Tearing is common because it is the body’s way of trying to remove the object.

25. Care for Loose Objects in the Eye
Lift the upper lid over the lower lid.
Try flushing the object out with water.
Examine the lower lid by pulling it down gently.
If you see the object, remove it with moistened sterile gauze.

26. Light Burns to the Eye
Burns can result if a person looks at a source of ultraviolet light such as sunlight, bright snow, or tanning lamps.
Severe pain occurs 1 to 6 hours after exposure.

27. Care for Light Burns to the Eye
Cover both eyes with cold, wet packs.
Tell the victim not to rub the eyes.
Have the victim rest in a darkened room.
Give pain medication, if needed.
Seek medical care.

28. Ear Injuries Most ear problems are not life-threatening.
Except for disk batteries and live insects, few foreign bodies must be extracted immediately.
First aiders should seek medical care for the victim because attempts to remove a foreign body can rupture the eardrum or lacerate the ear canal.

29. Nose Injuries
Nosebleeds
Broken nose
Objects in the nose

30. Nosebleeds Anterior nosebleeds From front of nose
Most common, easier to care for
Posterior nosebleeds
From back of nose
More serious, require medical care

31. Care for Nosebleeds Pinch the soft parts of the nose together.
Press firmly toward the face, for 5 to 10 minutes.
Keep the head higher than the heart.
Apply ice over nose.
Seek medical care if needed.

32. Recognizing a Broken Nose
Pain, swelling, and a possible crooked appearance.
Bleeding and difficulty breathing through nostrils
Black eyes appearing 1 to 2 days after injury.

33. Care for a Broken Nose Seek medical care.
If bleeding is present, give care as for a nosebleed.
Apply an ice pack to the nose for 15 minutes.
Do not try to straighten a crooked nose.

34. Objects in the Nose
A foreign object in the nose is a problem mainly among small children.

35. Care for Objects in the Nose
Try to induce sneezing by having the victim sniff pepper.
Have the victim blow gently while you put compression on the opposite nostril.
Use tweezers to pull out an object that is visible.
Seek medical care if the object cannot be removed.

36. Dental Injuries Objects caught between the teeth Bitten lip or tongue
Loosened tooth
Broken tooth
Toothache

37. Objects Caught Between the Teeth
The main method of detecting a problem is if the victim says that something is caught between the teeth.
The object may or may not be seen.

38. Care for Objects Caught Between the Teeth
Try to remove the object with dental floss.
If unsuccessful, seek dental care.

39. Recognizing a Bitten Lip or Tongue
Signs of a bitten lip or tongue include:
Immediate pain when it happens
Blood may be seen

40. Care for a Bitten Lip or Tongue
Apply direct pressure with sterile gauze.
Apply ice or cold pack.
If bleeding does not stop, seek medical care.

41. Loosened Tooth
Trauma can cause teeth to become loosened in their sockets.
Applying pressure on either side of each tooth can determine looseness.
Any tooth movement indicates a possibly loose tooth.

42. Care for a Loosened Tooth
Have the victim bite down on a piece of gauze to keep the tooth in place.
Consult a dentist or an oral surgeon.

43. Knocked-out Tooth
A majority of the teeth knocked out each year in the United States could be saved with proper treatment.
Time is critical for successful reimplantation.
Steps must be taken to prevent the tooth from becoming dehydrated.

44. Care for a Knocked-Out Tooth
Have victim rinse mouth.
Place gauze in socket.
Find the tooth.
Keep tooth moist.
Take the victim and the tooth to a dentist.

45. Broken Tooth
The front teeth are frequently broken by falls or direct blows.
Such damage is not unusual in the victims of violent acts or motor vehicle crashes.
It is also common in children, especially those with an overbite.

46. Care for a Broken Tooth
Gently clean dirt and blood with a sterile gauze pad and water.
Apply an ice pack to the face to the area of the injury.
If you suspect a jaw fracture, stabilize the jaw.
Seek immediate dental care.

47. Toothache The most common reason for toothaches is dental decay.
Victims frequently complain of pain limited to one area.
Pain can also affect the ear, eye, neck, or the opposite side of the jaw.

48. Recognizing a Toothache
The tooth will be sensitive to heat and cold.
Identify the diseased tooth by tapping the area with a spoon handle or similar object.
A diseased tooth will hurt.

49. Care for a Toothache Rinse mouth with warm water.
Use dental floss to remove any food caught in teeth.
If you suspect a cavity, paint the tooth with clove oil to help suppress pain.
Give the victim pain medication if needed.
Seek dental care immediately.

50. Spinal Injuries
The spine is a column of vertebrae stacked on one another from the tailbone to the base of the skull.
The spinal cord consists of long tracts of nerves that join the brain with the other body organs.
If a broken vertebrae pinches spinal nerves, paralysis can result.
All unresponsive victims should be treated as though they have a spinal injury.
Suspect a spinal injury in all head-injury victims.

51. Recognizing Spinal Injuries
Painful movement or paralysis of arms and legs
Numbness, tingling, weakness, burning sensation in arms and legs
Loss of bladder or bowel control
Deformity of neck

52. Care for Spinal Injuries
Monitor breathing.
For an unresponsive victim, open the airway and check for breathing.
Stabilize the victim to prevent movement by using one of the following methods:
Grasp the victim’s head over the ears and hold the head and neck still until EMS arrives.
Kneel with the victim’s head between your knees or place objects on each side of the victim’s head to prevent it from rolling side to side.