Chapter 7 Injuries to the Head and Spine

1. 1 Chapter 7Injuries to the Head and Spine  Nabeel Al-Mawajdeh RN.MCS

2. 2 Head Injury Any blow to the head can result in a head injury. Head injuries can cause damage to the: - Scalp: such as a minor bump on the head or scalp wound that bleeds - Skull: such as a skull fracture (a break or crack in the bone that surrounds the brain) - Spinal fluid in the brain - Brain itself such as: a concussion, a contusion (the brain tissue is bruised), or a haematoma (blood collects in an area of the brain from a broken blood vessel) Nabeel Al-Mawajdeh RN.MCS

3. 3 Head Injury (Cont’d) Bleeding in the brain often starts within the first 24 hours after a head injury and can last for three days or longer. It is very important that you watch for signs and symptoms of a serious head injury during the first 24 hours. Note: Also, suspect a neck injury when there is a blow to the head. Nabeel Al-Mawajdeh RN.MCS

4. 4 Head Injury (Cont’d) Signs & symptoms: Inability to move any part of the body or weakness in an arm or leg. Loss of vision, blurred or double vision, pupils of unequal size. Blood or fluid that comes from the mouth, nose or ear. Dent, bruise, cut or blood on the scalp. Vomiting. Drowsiness, headache, Stiff neck, confusion, loss of consciousness. Convulsions. Nabeel Al-Mawajdeh RN.Mcs

5. 5 Prevention of Head Injury 1. Wear a helmet when biking, roller-blading, horseback riding, riding in an all-terrain vehicle or boxing. Insist that your child does, too. 2. Use child safety seats and/or seatbelts in any car, van or truck. 3. Teach your child: a. To stop and look both ways before crossing a street b. About the dangers of running into the street without first looking c. Not to run under the garage door as it closes d. Not to bang his or her head against something hard during a temper tantrum. Nabeel Al-Mawajdeh RN.Mcs

6. 6 Prevention of Head Injury (Cont’d) 4. Don't leave a child alone in a shopping cart. When available, use carts with seatbelts or child safety seats. 5. Don't leave a child alone on a high place like a sofa, changing table or bed. (Take caution yourself when climbing ladders or walking on the roof, etc.) 6. Install window locks or guards on windows on upper floors. Place a sturdy gate at the top of the stairs. Lock the door to the basement. Keep stairs free of clutter. Nabeel Al-Mawajdeh RN.Mcs

7. 7 Emergency Care of Head Injury 1. Take appropriate BSI precautions. 2. Assume spine injury. Provide manual stabilization of the head, and use the jaw- thrust maneuver to open the airway. For the unconscious patient, insert an oro-pharyngeal airway without hyper extending the neck. Have suctioning equipment ready, since the patient is prone to vomiting. 3. Provide artificial ventilation if breathing is inadequate or absent. 4. Apply a rigid cervical collar, immobilize the neck and spine. Administer high- concentration oxygen. Control bleeding. Nabeel Al-Mawajdeh RN.Mcs

8. 8 Emergency Care of Head Injury (Cont’d) 7. Keep the victim at rest. 8. Provide emotional support to the conscious patient. 9. Manage the shock if present. 10. Transport the victim promptly. 11. Monitor vital signs/15 min. Nabeel Al-Mawajdeh RN.Mcs

9. 9 Spine Injury Anything that puts too much pressure or force on the neck or back can result in a neck and/or spinal injury. Causes: Accidents - with cars, motorcycles, snowmobiles, toboggans, rollerblades, etc. Falls - especially from high places . Diving mishaps - from diving into water that is too shallow A hard blow to the neck or back while playing a contact sport such as football Violent acts such as a gunshot wound that penetrates the head, neck or trunk. Suspect a neck injury, too, if a head injury has occurred. Nabeel Al-Mawajdeh RN.Mcs

10. 10 Spine Injury (cont’d) Signs & symptoms: Paralysis of extremities or impaired sensations/motion. Pain without movement. Pain with movement. Tenderness anywhere along the spine. Impaired breathing. Deformity. Loss of bowel or bladder control. Neurogenic shock. Nabeel Al-Mawajdeh RN.Mcs

11. 11 Prevention of Spine Injury Use padded headrests in your car to prevent whiplash. Drive carefully and defensively. Wear seatbelts, both lap belts and shoulder harnesses. Buckle children into approved car seats appropriate for their age. Wear a helmet whenever you ride a bicycle or motorcycle or when you roller skate or roller blade. Wear the recommended safety equipment for contact sports. Nabeel Al-Mawajdeh RN.Mcs

12. 12 Prevention of Spine Injury (Cont’d) Take care when jumping up and down on a trampoline, climbing a ladder or checking a roof. Check the depth of the water before diving into it. Do not dive into water that is less that 9 feet deep. Never dive into an above-ground pool. Nabeel Al-Mawajdeh RN.Mcs

13. 13 Emergency Care of Spine Injury Manual stabilization for the head until the victim is properly secured to a backboard, then apply cervical collar. Assess airway, breathing, and circulation. Quickly assess sensory and motor function if the victim is responsive. Apply the appropriate spinal immobilization device at the appropriate speed. If the victim has paralysis or weakness of the extremities, administer high concentration oxygen. Transport and continue assessing the victim. Nabeel Al-Mawajdeh RN.Mcs

14. 14 The End Nabeel Al-Mawajdeh RN.Mcs