Head Injuries

Head Injuries

Mo Salah with a concussed fanOn Saturday afternoon, an 11-year-old boy, called Louis, was waiting outside Melwood, the training ground of his footballing heroes Liverpool Football Club, hoping that he might get a glimpse of one or two of his heroes as they exit the ground from their training session. This boy was in luck! He was lucky enough to catch a glimpse of his hero, Mo Salah. This was the start of a series of events for Louis, one that he would want to avoid and the other that he is happy happened.

On seeing his hero drive out of the training complex he decided to chase the car down the road, colliding with a lamppost in doing so. This knocked him unconscious. The 11-year-old was aided home, not living that far away, and was awaiting the arrival of an ambulance as he had been unconscious with a suspected head injury. However no one expected what arrived before the ambulance….

Mo Salah arrived at the lad’s house to check that he was ok and was then happy to pose for a photograph with him, as well as reminding Louis that he needs to look where he is going when he is running, to avoid causing himself any harm.

The photo has been shared on social media by Louis’ stepdad, Joe Cooper, and we thank him for the photograph used above, and is the basis of this month’s article which focuses on head injuries. Before we get to head injuries themselves, we would just like to reassure you that Louis is perfectly fine, other than having to have his nose reset, during a visit to Liverpool’s Alder Hey Children’s Hospital. When asked if the pain was worth it, his very simple one-word reply came – ‘definitely!’

Head Injuries

Head injuries occur more often than a lot of people realise.

A head injury can be potentially serious, with life-threatening injuries. They can lead to damage to the brain due to the lack of oxygen that gets to the brain; this damage can be permanent and severe. There may be other injuries that occur following the event that causes a head injury which can include injuries to the neck and spine, and scalp wounds. For further information on the spine, please ensure that you check out January’s article. Before we explore the 3 different head injuries, we should look at the make-up of the head.

The head itself is made up of 4 major parts, all of which have a major function in the human body:

1: Skin:

The skin is a major organ of the body which, at the thickest part of itself, is only a few millimetres thick, however it has 7 main functions:

Protection

The skin protects the body from harmful things in the outside world including the cold, germs and the sun’s rays. This is a pretty remarkable job when you consider how thin, delicate and flexible it really is.

Sensation

The skin picks up sensations through the network of nerve endings that feed the skin and sends the signals back, The skin is able to pick up how much pain there is at one point, if there is any pressure on it, as well as whether the body is hot or cold, and then send a message back to the brain to get the temperature regulated!

Allows movement

The skin is an amazing organ, as well as being the largest organ that we have. It has evolved over the years to ensure that whilst it is protecting the body it also allows the body to produce a range of movements that are needed to survive, for example, move and eat.

Endocrine

The skin aids the endocrine system by producing the vitamin D that the body needs, in order to rejuvenate and grow cells as well as for the metabolism of the body.

Excretion

The skin plays a part in the excretion system, through its production of sweat. Sweating is good for the body as it eliminates excess water and salts as well as reducing the amount of urea.

Immunity

The skin is a natural physical barrier to infections, germs and diseases entering the body. It also carries adaptive immune systems to enable it to actively fight off infections.

Regulate temperature

Effectively your skin is your thermostat, it regulates your body heat by instigating shivering so the blood vessels contract when you’re out in the cold or through the secretion of sweat when you are hot.

2. Skull

The skull is the bony structure that traps your brain inside, it forms the head of vertebrates and its most important job is to provide a protective cavity for your brain, as well as structuring the face. The skull is made up of 2 parts: The cranium and the mandible.

3. Cerebrospinal Fluid

Cerebrospinal fluid (CSF) is a colourless clear body fluid that is found in the brain and the spinal cord. It is produced in the specialised ependymal cells of the choroid plexuses of the ventricles of the brain and is absorbed in the arachnoid granulations. CSF has 3 main functions:

  • Protect the brain and spinal cord from trauma,
  • Supply nutrients to the nervous system, and
  • Remove waste products from the cerebral metabolism.

4. The Brain

The brain is one of the most complex and largest of all organs in the human body. It is made up of more than 100 billion nerves that communicate in trillions of connections called synapses. The brain is made of many specialised areas that work together.

It is argued that the brain is the most important organ in the whole of the body. It is the organ that:

  • Co-ordinates actions and reactions,
  • Allows us to think and to feel,
  • Enables us to have memories and feelings.

The above are arguably all the things that make us human, therefore the brain makes us human! Of course, the brain works only by receiving the oxygen and blood that it needs to survive and therefore it is vitally important that these things are preserved to get to it.

From our quick rundown of the 4 important parts of the head, it is clear to see that the head is really important and should be looked after as much as is possible, and of course it can be seen why any head injury can cause such big problems.

Let’s look into head injuries.

There are 3 main head injuries that we will explore in this month’s article, they are:

1. Concussion,
2. Compression,
3. Fractured Skull

1. Concussion

Concussion is often referred to as ‘shaking of the brain’ as this is effectively what concussion is. Because the brain is cushioned by the cerebrospinal fluid, when the head receives a blow the brain can bounce from one side of the head to the other.

The effects of concussion can take up to 24 – 48 hours for them to show themselves, but usually the recovery time is only really a few days with very often little long-term damage.

Should the casualty have concussion you should be on the lookout for:

  • Unconscious for a short period of time, where the response levels should improve afterwards,
  • The casualty should recover back to themselves completely with no complications,
  • Memory loss (of the incident) or confusion is common, as is repetition,
  • Unusual behaviour,
  • Pale, clammy skin,
  • Mild general headache,
  • Dizziness and
  • Nausea.

Concussion can be harder to spot in children and therefore you should be on the lookout for any changes in their normal pattern of behaviour, for example are they crying a lot more than normal, have their feeding or sleeping patterns changed, have they even lost an interest in objects or people.

2. Compression

Compression is a serious, and can be a life-threatening, injury. It is caused when the casualty has received a heavy blow to their head causing a bleed or swelling inside the skull which is pressing on the brain.

If you are suspecting cerebral compression, your casualty may show these signs and symptoms:

  • A recent head injury, which has apparently recovered, but now the casualty is deteriorating,
  • Levels of response becoming worse as the conditions develops,
  • Confusion and irritability,
  • Flushed, dry skin,
  • Intense headache (Imagine the worst one you can think of!), and
  • Nausea.

3. Fractured Skull

A fractured skull is serious as the damaged part of the bone may cause direct injury to the brain itself, or it can cause bleeding which can cause pressure to build up on the brain.

You should suspect a skull fracture for a casualty who has received a head injury and their levels of response are dropping and lowering.

Other signs and symptoms may include:

  • Concussion and/or compressions signs and symptoms may be present,
  • Cerebrospinal fluid and blood coming from the ears, nose, mouth or tear ducts,
  • Swelling or bruising of the head,
  • Swelling or bruising behind one or both ears,
  • Swelling or bruising around one or both of the eyes.

Treatment

It is very important that you remember any blow which is large enough to cause a head injury can also cause a spinal injury, therefore you must treat your casualty with care. For more on spinal injuries see January 2019’s article.

Should your casualty have been unconscious, or their response levels are dropping, or you are suspecting a spinal injury call 999/112 for emergency help straight away.

Remember to maintain their airway and breathing. If you are unsure how to do this, then why not book onto one of our courses?

Is your casualty unconscious but breathing? If the answer to this question is yes, then keep them still and continually monitor their breathing. If they are struggling to maintain their own airway then they will need to be carefully rolled into the recovery position, remember to keep their head, neck and spine in line.

Is your casualty unconscious and not breathing? Then you will now have to proceed with Cardio-Pulmonary Resuscitation (CPR) in order to help them until the paramedics arrive.

What if your casualty is conscious? In this situation, help the casualty to lie down, keeping their head, neck and spine in line in case there is a spinal injury that you and they are not aware of.

You will need to carefully consider if there are any other injuries that you will need to treat. If they are bleeding then you should try to control it by applying some gentle pressure to the affected area, however, should the blood be coming from the ear, then allow the blood to drain away, do not try to plug the ear.

There are some useful tips that are worth remembering when you are dealing with a suspected head injury as follows:

If you are suspecting that the casualty is suffering from concussion, arrange for them to see a healthcare practitioner as soon as possible. Do not allow them to continue playing sports and remain with them until they have been properly assessed by the trained medical professional.

Always be alert to the casualty’s levels of consciousness, breathing and pulse, and record all of your observations to hand over to the medical staff.

Seek medical advice before allowing the casualty to eat or drink.

Are you ready for the most commonly asked question that we receive about head injuries?

The question is this: Following a head injury is the casualty (usually child instead of casualty) allowed to sleep?

The correct answer to this question is that they are allowed to sleep following a head injury, however you should be able to wake them and get a response. Generally, you should look to get a response every 10 minutes from them.

We would add that even if they have appeared to have recovered sufficiently from their head injury, you should be looking out for subsequent reduction in the levels of their response.

The reason that the advice now allows a casualty to sleep is because it is the body’s natural way of healing. If the casualty wants to go sleep after a head injury at their normal sleep time, then this may be a normal thing as opposed to being a worry, but remember they have just received a head injury and should have their response levels checked. If they would not normally go to sleep at this time, then maybe this is a worry sign, so be extra vigilant and if they are not able to be woken, or they do not respond to your response check then you should call the emergency services for an ambulance.

What should I look out for in the days following a head injury?

Should you see any of these signs and symptoms in your casualty in the days following a head injury, they should go to the hospital immediately:

  • Worsening headache,
  • Nausea or vomiting,
  • Increased drowsiness,
  • Weakness in an arm or leg,
  • Speech problems,
  • Dizziness,
  • Bleeding or fluid coming from an ear or the nose,
  • Visual problems,
  • Seizures, and/or
  • Confusion.

If you wish to find out more, why not book onto a First Aid course with us that covers head injuries. All our course information pages detail what is covered on that specific course.

We look forward to welcoming you onto a course in the future.

In the meantime,
enjoy the summer and please do stay safe!

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