Team AckoSept 15, 2023
Most of us have experienced some form of minor Head Trauma (HT) such as bumping our head into a thing. Usually, this is not serious. However, HT can also be major, resulting in permanent disability and damage if immediate intervention is not initiated. This article will help you know the details and some first aid tips related to Head Trauma.
Head Trauma is an umbrella term that refers to any form of injury to the scalp, the skull, the brain & other organs that are enclosed within. As a rule of thumb, any head injury is better evaluated in a hospital by a doctor to look for underlying signs of brain injury.
While people of all ages are susceptible to injury, head injuries in older ages and children should be regarded with much higher caution as they are at greater risk of damage.
Head injuries are also common in people who are under the influence of alcohol and drugs. When under the effects of these substances, the potential for permanent damage is more and they must be given medical attention at the earliest.
The first step in case of any Head Trauma is to call for an ambulance immediately.
Do not attempt to move the person by yourself or with the help of others. Keep them as still as possible till an ambulance arrives. Take special care to make sure that you do not change the position of the neck.
Check if the person is breathing and has a pulse. Try to see if they are still conscious and are able to respond to your commands. Do not shake them. If they are unresponsive with no pulse or breathing initiate CPR (cardiopulmonary resuscitation) if there is a trained person immediately available.
Try to keep the head and neck as still as possible in position. You can support them from the sides with your arms.
If there is any active bleeding from a cut on the scalp or face, gently apply firm pressure over the bleeding site with a clean piece of cloth. Take care not to move the head while doing this. Scalp wounds especially tend to bleed a lot, so sometimes that one piece of cloth might get soaked through with blood. In that case, do not remove the cloth. Instead, use another fresh one over the previous one and continue applying firm pressure.
If you see an open wound, like a skull fracture exposing underlying inner structures, do not attempt to clean the site or put pressure on it.
If the person begins to vomit, try to gently roll them over onto one side making sure that the head and neck are moved together. This is to prevent choking and aspiration of the vomit. This must be done with great caution and slowly.
Do not remove any object over or from the wound. Do not remove a helmet if they are wearing one.
The most common causes of Head Trauma include the following.
Fall from a height
Physical assault/domestic violence/abuse
Head injuries can be either open or closed.
A closed injury means that the offending trauma has caused injury to the head without breaking the skull. Most HT is of this type.
Open injuries involve penetration throughout the skull causing the underlying layers and the brain to be exposed. These are always more serious.
Bleeding is a common association with a head injury. Sometimes bleeding can occur internally. The brain is covered by 3 layers of tissue which are called the meninges. Bleeding can occur in between these layers (eg subdural haemorrhage)
Initial symptoms of Head Trauma may be minor but can quickly worsen even over a short span of time. Lay persons may be unable to identify signs that indicate potential underlying damage. It is therefore helpful to identify these and call for help/emergency services immediately.
A head injury can involve the following.
Injuries to the scalp (the skin over the skull)
Injury to the skull resulting in fractures
Concussion: this is a type of brain injury that is caused by a direct blow to the head or by violent shaking of the head & upper body. It can present with headache, loss of balance, disorientation, transient loss of memory, and sometimes loss of consciousness. The effects of a concussion are usually temporary.
The general symptoms of a head injury include the following.
Bruising or bumps on the scalp
Ringing of the ears
Confusion & disorientation
Sudden fainting (sudden loss of consciousness)
Neck pain/inability to move the head
Bleeding from the site of impact
The following symptoms & signs are indicative of something more dangerous and should prompt you to call for an ambulance immediately.
Profuse bleeding from wound site or from nose & ears
Loss of consciousness lasting for more than a few seconds
Slowing down or stoppage of breathing
Inability to respond to verbal questions & commands
Loss of function in one or more limbs
Fits or seizures, which can present as uprolling of the eyes, frothing at the mouth, sudden jerky uncontrolled movements of the arms and legs
Loss of control over bodily functions (urinating or passing motion without knowledge)
Neck pain and inability to move the head
Blurring or loss of vision
Pupils (black part in the centre of the eye) are of unequal sizes in both eyes
When dealing with a child who is injured, it is important to also keep an eye out for the following.
Refusing to eat
Profuse, persistent vomiting
Any visible bump or swelling on the head
Confused, agitated, poorly responsive child
All symptoms mentioned above
As such most of these injuries are accidental and hence have no real way of preventing them. Some simple steps include the following.
Use of protective headgear like helmets while riding a cycle or motorcycle.
Wearing a seatbelt in the car and installing safety seats for young children.
If there are children and aged people at home, you assess areas of possible tripping and falling and take steps to prevent such accidents. For example, installing railings or using non-slip mats in the bathroom to avoid slipping on wet floors.
Ensuring good lighting in the home so no one trips over anything that may be on the floor.
Saying no to driving when under the influence of drugs and alcohol and staying away from the phone while driving.
In most cases, small bumps and bruises after trauma are not serious. However, in such a situation, it is recommended that all children be evaluated by a paediatrician to be safe.
It is very difficult to assess the seriousness of Head Trauma as internal injuries may be present even without any bleeding or swelling externally. Watch for signs such as nausea, vomiting, sedation, severe headache, or confusion. In case of any of these, consult a doctor immediately.
Unless you are in an isolated location where no one can reach you soon, it is better to allow trained paramedical professionals to move the injured person as they will be able to stabilise the neck and spine without causing damage during the process of shifting the patient.
Disclaimer: The content on this page is generic and shared only for informational and explanatory purposes. Please consult a doctor before making any health-related decisions.
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