Contents
First aid for a head injury should be provided to the patient at the scene of the accident as accurately and quickly as possible. Only in this way will it be possible to protect the victim from complications in the future and even save his life.
If we are talking about injuries received in everyday life, then often these are classic bruises of the scalp. Unlike open wound surfaces, which are accompanied by bleeding, bruises are characterized by damage to the soft tissues of the cranium without gaping wounds. Despite the fact that in this scenario, the risks of infection due to the ingress of pathogens of various diseases into the body are leveled, closed head injuries are more often even more dangerous than open ones.
The problem is that in the absence of a pronounced deformation, most people prefer to do it on their own, without seeking qualified help.
But if the head part is damaged, such frivolity can result in serious complications such as a brain concussion or a hematoma. The latter, because of the hair, can hardly be seen in the mirror on its own.
The severity of injury
In order for the provision of assistance to the victim to really have the desired effect, experts recommend that at least a cursory initial examination be carried out before the start of pre-medical manipulations. This will determine the approximate severity of the head injury.
The easiest way to deal with a mild degree of flow, which is more typical of accidental household injuries like hitting your head on the edge of the locker. The deviation is not accompanied by any heavy bleeding, it does not bring any special discomfort at the time of recovery. Usually, such light bruises are limited to the formation of a small swelling, which is popularly called a “bump”.
It comes off on its own, but sometimes, to speed up the process, it is allowed to apply cold immediately after the impact. This will reduce some pain, as well as limit the spread of swelling.
The situation is a little more complicated with damage to the integrity of the skin. The category includes not only extensive wounds that occur when a large area of skin is scratched along with hair. Even ordinary abrasions provoke an outflow of blood. But only in the first case, the patient has to deal with a large amount of blood, and in the second – to stop only capillary bleeding.
With urgent measures, it will be possible to block capillary breaks to stop the blood within 5-10 minutes.
Three other categories are considered separately:
- jaw damage;
- craniocerebral trauma;
- combined options.
Complex pathologies are more suitable for describing polytrauma, when, in addition to head deformity, destabilization of the spine or any other part of the body is also fixed. This format is most often found in road accidents, fights and industrial injuries, when there is a lesion of the chest and limbs.
A particularly serious development is called a passing deviation in the issue of the integrity of the neck systems. We are talking about the rupture of nerve endings and large vessels designed to nourish the brain.
Almost always, a blow to the head is accompanied by minor, but still skin lesions. In addition to the directly upper layer, the natural integrity of fatty tissue is violated. Because of this, there is an obstruction of the flow of blood through the affected vessels. The clinical picture ends with the collection of blood at the site of localization, which externally transforms into a hematoma of various sizes.
Depending on the severity and statute of limitations of the impact, the color of the hematoma changes. If initially it turns purple due to fresh blood streaks under the skin, then later the tone changes. The transformation is due to the start of the process of hemoglobin breakdown and increased activity of leukocytes. Outwardly, such manifestations are expressed in a change in color to a blue-green color with yellowness.
The swampy shade is provided by biliverdin, and bilirubin is responsible for giving yellowness.
If there is a strong external pressure during a mechanical injury, then it is often accompanied by destabilization of the tendon helmet. Doctors recognize such a deviation due to the hematoma, which seems to spread over the face.
When the casualty falls victim to the face, he or she has to deal with soft tissue damage. It has one pitfall that the townsfolk do not know about. Some people unknowingly confuse the outer rim of a hemorrhage with a depressed cranial fracture.
Specific symptoms
All symptoms associated with any type of head injury are expressed differently depending on the specific location of the lesion. If we are talking about the front part, when the usual integrity of the skin is broken and the deep tissues are affected, then pain becomes the first dangerous sign. The syndrome is reinforced by hemorrhage. After a while, a bruise appears on the face.
If a serious damage to the skull is recorded, then the victim is faced with the same phenomena that can be traced with a brain bruise:
- nose bleed;
- dizziness;
- headache;
- vomiting.
With such a development of the scenario, medical assistance should be provided immediately, until irreversible processes are launched.
With occipital lesions, patients often complain of the inability to focus their eyes and other vision problems. This is explained by the anatomical features of the human body, because it is in the back of the head that the center responsible for visual functions is located.
Often in this situation, a concussion, a general weakness, which often becomes the foundation for frequent fainting.
Eye injury is marked by circular hemorrhage. But not everyone knows how to distinguish it from the so-called glasses effect. The latter is suitable for describing the state of a cranial fracture.
Emergency medical attention will be needed for those who have been hurt in the jaw. Here, the first step is to check the chewing function. If during the light test it turns out that a person is not able to perform a normal chewing movement, then this suggests a fracture.
Especially carefully should be checked the condition of children who have become victims of head injuries. In babies, all types of deviations presented may not at first declare themselves, and in adolescence or even adulthood, serious deviations in terms of brain activity come around.
Clinical features of head injuries
All head injuries can be divided into several broad categories according to the standard principle, as is typical for sorting injuries to the abdomen or chest.
Schematically, the classification is divided into three divisions:
- closed;
- open;
- penetrating.
The first point implies the absence of destabilization of the aponeurosis. Instead, there are bruises of various locations and sizes, as well as other versions of soft tissue rupture.
With open analogues, the emphasis is on the defeat of the aponeurosis. But the worst situation is with penetrating wounds, when, in addition to destroying the integrity of the surface and subcutaneous tissue with vessels and nerve roots, damage to the dura mater is noted. It is these variations that harm the patient the most.
In addition to the typical classification according to the mechanism of damage in the medical classification, there is another structured sorting. It relies on clinical manifestations, including:
- brain concussion;
- bruises;
- compression by intracranial hematomas.
Classical concussion occurs in approximately 80% of all recorded cases of damage to the head of the body. It is characterized by the absence of macrostructural pathology, which is explained by the presence of damage only at the cellular level. In physiological terms, concussion can be designated as a functionally reversible pathology.
Specific manifestations of this condition are called:
- being unconscious for up to several minutes;
- nausea;
- vomiting;
- amnesia;
- dizziness;
- spilling headache;
- increased sweating;
- double vision.
At the same time, vital functions remain normal. But neurological abnormalities, albeit in a minor manifestation, are still diagnosed. They cover:
- asymmetry of tendon reflexes;
- small-scale nystagmus.
All of the above takes place over the next week with sufficiently effective therapy. But in order to make sure that there are no more significant consequences, the victim will be sent to undergo an additional examination without fail. This includes the need to provide images obtained during computed tomography or magnetic resonance therapy.
No less often, intracranial hematomas are found in patients, which, as they grow, begin to compress still healthy tissues. Bruises form under the dura mater, or above it. The cause of the disease is depressed fractures of the cranial bones.
Despite the fact that their clinical manifestations are similar to what occurs with a brain contusion, they still have their own distinctive features. The main such feature is the so-called “light gap”.
Doctors call this the time interval between awakening after a faint and a sharp immersion in a coma. At this time, the person feels relieved, but in fact, cerebral edema begins to progress sharply.
Brain contusions
Separately, such lesions as bruises of the brain itself are considered. They are divided into three degrees of severity, which are distinguished by gross macrostructural damage to the medulla.
This is manifested by hemorrhage and destruction.
A bruise does not do without subarachnoid hemorrhage. Fractures of the skull bones are frequent companions of the presented injuries. They are accompanied by significant edema with swelling of the substance of the brain.
If the patient, after direct external impact on the skull, remained unconscious for no more than twenty minutes, then this indicates an easy scenario. After waking up, the victims begin to complain of endless dizziness, which is complemented by nausea and vomiting.
These patients have retrograde or anterograde amnesia. Against the background of stable functioning of vital functions, the violation of the usual activity of the cardiovascular system looks more depressing. We are talking about bradycardia or hypertension.
In the neurological part, experts note pyramidal insufficiency, clonic nystagmus and mild anisocoria.
With moderate severity, disconnection from reality can last about two hours. Almost immediately after waking up, a person begins to be disturbed by repeated vomiting. In addition, pronounced amnesia manifests itself, and even some deviations in mental health.
Vital disorders are expressed in prolonged bradycardia, which is supported by hypertension along with tachypnea. But the airways remain normal, which reduces the risk of more serious diseases.
The neurological status may include all those signs that are characteristic of a mild course of the disease, as well as be diluted with asymmetry of tendon reflexes with muscle tone.
In some cases, meningeal symptoms and pathological traces make themselves felt. Among other things, focal types of destabilization are occasionally possible, such as pupillary, oculomotor, speech disorders, as well as paresis of the limbs.
The severe degree is characterized by a long duration. A person can be in a coma for several weeks, while his vital functions are seriously impaired, representing an increased threat to life.
The most pronounced alarming symptoms are stem symptoms, which include floating movements of the eyeballs, destabilization of the rhythm and frequency of breathing. Paresis of the extremities, convulsive seizures, pathological foot signs are diagnosed.
The longer the coma lasts, the less favorable the prognosis for later life becomes. The reason for this is the large affected areas. Including a violation of the bone structures of the head, as well as massive subarachnoid hemorrhages.
If, after the injury, you do not see a doctor in time, then the consequences for a person can be quite unpleasant: memory loss or loss, impaired attention, difficulties in doing household chores, emotional distress, etc.
First aid
With an open wound surface, the first step is to disinfect the site of injury. For this, antiseptic agents are used. But to fill the wound with iodine or brilliant green is not worth it. Instead, it will be more effective to use an ointment or gel that is aimed at neutralizing the pain syndrome.
Immediately after stopping the bleeding or simultaneously with emergency measures, you need to call an ambulance team. While the experts will get to the scene, you will need to continue to provide assistance. First, the patient is given complete rest, arranging him in a comfortable position as motionless as possible.
This is followed by the application of a sterile dressing. Only on top of it is it allowed to apply cold. It is allowed to do this only for a few minutes with breaks of half an hour between sets.
As a cold, a chilled object is used, or ice folded into a rubber heating pad, a bag. Due to its spectrum of action, it is possible to reduce the pain load, which will have a beneficial effect on limiting the spread of hematoma. When the injury is minor, it is advised to apply cold at short intervals throughout the day.
Experts call the first post-traumatic hours indicative. When observing the victim during this period, it will be possible to build further forecasts. As a preventive measure for aggravating the clinical condition, the victim is forbidden to give food and water for the next couple of hours.
Even if the victim complains of acute pain in the lesion, it is strictly forbidden to give him any painkillers before the doctors arrive. This can blur the overall picture, which will add problems to the doctor in the subsequent diagnosis of severity.
In addition to the mandatory rules for first aid, experts have developed a whole summary of tips on what not to do with a head injury. The first point of the strategy is the adoption by the patient of a strictly horizontal position, since in a sitting position, the processes of damage can proceed more quickly.
Here it is not necessary to rely on the words of the victim himself, who claims that he is comfortable even sitting. Often such people are disoriented without realizing it.
It will also be necessary to ensure that the victim does not change his position at first without special need.
When it comes to an open wound surface, before applying a sterile dressing, one should not try to pull out bone fragments, foreign bodies stuck in the skin from the wound. Even a slight fluctuation can open massive bleeding, as the debris here serves as vascular blockers.
Following such simple rules will save the health and life of the victim of a head injury of any severity.