Head Injury

Emergency personnel should immediately attend to all potentially serious head injuries

Call the doctor to ask about any of the following situations. Your doctor will recommend home care, set up an appointment to see you, or direct you to go to a hospital's Emergency Department.

• A person is pushed to the ground or struck a hard object with the head but did not lose consciousness
• Vomiting more than once
• Confusion
• Drowsiness
• Weakness or inability to walk
• Severe headache

Go to the Emergency Department by ambulance in the following situations. People with less severe injuries may be taken by car to the Emergency Department

Severe head trauma or a fall from more than the height of the person or a hard fall onto a hard surface or object

Loss of consciousness for more than 1 minute, vomiting more than once, confusion, drowsiness, weakness or inability to walk, or severe headache

Prevent movement of the neck in severe head injury or if the injured person has any neck pain . If the person needs to vomit, carefully roll them onto their side without turning the head

Should an injured person be allowed to fall asleep? Many people mistakenly believe that it is important to keep a person awake after they have been struck on the head. Children often are more emotionally disturbed than they are physically injured after a minor fall. They will cry and be upset, but as the parent rushes them to the hospital, the child may begin to calm down. They have expended a lot of physical and emotional energy crying and then will often want to fall asleep.

You do not need to keep a child or other head injury victim awake. In many cases it is even helpful to the emergency doctor to be able to awaken a child who is now calm and rested and able to behave normally. This gives the doctor a much better assessment of the severity of the head injury..

If a person who was initially normal after a head injury cannot be awakened or is extremely difficult to awaken, he or she may have a more serious head injury and should be evaluated by a doctor.

Self-Care at Home

Emergency medical personnel should immediately treat any serious or potentially serious head injury.

Minor head injuries may be cared for at home.

Bleeding under the scalp, but outside the skull, creates "goose eggs" or large bruises at the site of a head injury. They are common and will go away on their own with time. Using ice immediately after the trauma may help decrease their size.

• Do not apply ice directly to the skin. Ice should be applied for 20-30 minutes at a time and can be repeated about every 2-4 hours as needed. There is little benefit after 24 hours.
• Use a light washcloth as a barrier and wrap the ice in it. You can also use a bag of frozen vegetables wrapped in cloth. This conforms nicely to the shape of the head.
• Make your own ice pack by adding 1/3 cup of 70% isopropyl alcohol (the green-colored kind is best to help identify it later) to 2/3 cup of water in a zip-lock-style bag (double bag it to prevent leaking). The mixture turns into "slush." Freeze this homemade ice pack for use when needed. Caution: If you have small children in your home, watch them carefully when using the ice pack. Drinking the mixture can be poisonous.
• Commercially available ice packs use chemicals to create cold. They are designed to be kept in a first-aid kit and need not be kept frozen. These can be applied directly to the skin, although a barrier can also be used if bleeding is present. They must be disposed of after a single use but can be handy in case of emergencies.

When a minor head injury results from a fall onto carpet or other soft surface and the height of the fall is less than the height of the person who fell and there is no loss of consciousness (in other words, the person was not "knocked out"), a doctor's visit is not usually needed. Apply ice to lessen swelling.

Prevention

Sensible prevention includes wearing helmets when bike riding, inline skating, driving motorcycles, and other similar activities.

Safety belts, car seats, and airbags when used properly can prevent head injuries in motor vehicle accidents.

Drinking while driving is one of the most common causes of motor vehicle crashes. Many serious head injuries would be prevented by avoiding this dangerous behavior.

Fall-proofing includes checking your home for areas where someone may fall: stairs, bathtubs, throw rugs, and furniture

Outlook

Prognosis varies and depends on the severity of the injury. It is now commonly recognized that even minor head injuries can have long-term consequences (usually psychological or learning disabilities). Serious head injuries can result in anything from full recovery to death or a permanent coma.