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Serious Injuries. Head Injuries. Intro read e-mail Prevention. Bicycle Safety. Helmets Bike wreck Ride on right side of road Rear view mirror. Motorcycle Helmet Law. New law in 1999 Over 18, no helmet required Results in more long term hospital stays??
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Head Injuries • Intro read e-mail • Prevention
Bicycle Safety • Helmets • Bike wreck • Ride on right side of road • Rear view mirror
Motorcycle Helmet Law • New law in 1999 • Over 18, no helmet required • Results in more long term hospital stays?? • Three and four wheeler accidents
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)
Three Types of Brain Injuries • Concussion • Contusion • Hematoma
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
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
Hematoma • Localized collection of blood • Blood clot • Most serious type of brain injury • Management: Monitor and seek medical help
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
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
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
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
Spine Injuries #3 • Ask victim: • Move toes, fingers, squeeze hand, press foot against hand • Babinski test • Stabilize victim
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)
Rib Fractures • Painful to move, cough, breathe • Point tenderness • Do not wrap (restricts breathing) • Stabilize • Encourage deep breathing • Seek medical attention?
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
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
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
Severe Blow To Abdomen • Place on side • Expect vomiting • No foods or liquids • Seek medical attention
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
Pelvic Injuries • Accompanied by: • Pain • Shock • Internal bleeding • Inability to use lower extremities • Damage to bladder and other organs
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)
Pelvic Injuries: What To Do • Treat for shock • Pad between thighs • Tie knees and ankles together • Keep on firm surface • Seek medical attention