1. Chapter 23: The Head and Face

2. Copyright ©2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 2 Eye Injuries  Specks in the eyes  Contusions  Cuts, punctures, and abrasions  Blow-out fracture  Hyphema  Conjunctivitis

3. Copyright ©2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 3 Ear Injuries  Cauliflower ear  Swimmer’s ear  Foreign bodies  Tympanic rupture

4. Copyright ©2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 4 Nose Injuries  Epistaxis  Nasal fractures  Septal deviations

5. Copyright ©2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 5 Mouth and Jaw Injuries  Fractures  Temporomandibular joint injury  Injuries to teeth

6. Copyright ©2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 6 Grading Concussions  Inappropriate care of concussions can have serious consequences.

7. Copyright ©2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 7 Glasgow Coma Scale  Observations are rated numerically. Higher scores indicate more responsiveness.

8. Copyright ©2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 8 Motor Response  Follows simple commands6  Localizes pain5  Withdraws from pain4  Abnormal flexion3  Abnormal extension2  No response1

9. Copyright ©2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 9 Eye-Opening  Opens eyes on own4  Opens eyes when asked loudly3  Opens eyes in response to pain2  No response1

10. Copyright ©2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 10 Verbal Response (Talking)  Correct place, self, month, year5  Confused or disoriented4  Uses words but makes no sense3  Makes unknown sounds2  No response1

11. Copyright ©2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 11 AVPU Scale  A method to determine the level of consciousness  Alert  Verbal – responds to verbal command  Pain – responds to painful stimulus  Unresponsive

12. Copyright ©2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 12 Cantu, Colorado, American Academy of Neurologists (AAN)  Three concussion grading systems, all commonly used

13. Copyright ©2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 13 Grade 1  Cantu –No loss of consciousness (LOC) –Posttraumatic amnesia (PTA) or postconcussion signs clear < 30 sec.  Colorado –Transient mental confusion –No PTA and no (LOC)  AAN –No LOC, transient confusion –Symptoms clear in < 15 minutes

14. Copyright ©2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 14  Cantu –LOC lasting < 1 min. and PTA or –Postconcussion signs > 30 min. and < 24 hrs.  Colorado –No LOC –Confusion with PTA  AAN –No LOC –Symptoms lasting > 15 minutes Grade 2

15. Copyright ©2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 15 Grade 3  Cantu –LOC more than 1 min. or PTA > 24 hrs or –Postconcussion signs lasting > 7 days  Colorado –Any LOC  AAN –Any LOC

16. Copyright ©2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 16 Brain Injuries  Brain effects constitute the most serious threats to athletes with head injuries.

17. Copyright ©2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 17 Subdural Hematoma  A subdural hematoma is usually the result of the tearing of small veins under the dura mater.

18. Copyright ©2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 18 Epidural Hematoma  Epidural hematomas are often associated with a skull fracture and arterial injury.