HEAD AND SPINE INJURIES A hematoma may not appear for a day or as

long as several weeks.

- The brain is a soft and delicate organ. A
hard blow to the head can injure the
brain or spinal cord even when there
CAUSES OF HEAD INJURY
are no visible signs of trauma to the
scalp or face. That’s why all head • Falls (most common cause);
injuries are considered serious and
should be assessed by your doctor or • Exercising and sports-related accidents;
the nearest hospital emergency • Physical assaults;
department.
• Traffic accidents.
HEAD INJURY

- Head injury is a common injury

suffered by people of all age groups,
especially children. Fortunately, most
head injuries are mild, temporary, and
curable without persisting health
problems. Some head injuries may,
however, affect the brain or the tissue
surrounding it, resulting in long-term
complications.
- A head injury is any sort of injury to the
brain, skull, or scalp. This can range
from a mild bump or bruise to a
traumatic brain injury.
TYPES OF HEAD INJURIES
• Concussion: This is a jarring injury to your
brain. Most of the time, people remain
conscious. They may feel dazed and lose
balance for a brief time.
• Brain contusion: This is a bruise of your brain.
Minor bleeding in your brain
causes swelling.
• Skull fracture: This is a crack in the skull.
Sometimes, the broken skull bones can
cut into the brain.
• Hematoma: This is bleeding in your brain that
collects and clots, forming a bump.
WHO HAS THE HIGHEST RISK
• Children;
• The elderly;
• Drug and alcohol users.
First aid when the injured person is conscious
- Encourage the injured person to
minimise any movement of their head
or neck. Scalp injuries can bleed
profusely, so control any significant
blood loss from head wounds with
direct pressure and a dressing. While
examining the wound, avoid disturbing
blood clots forming in the hair.
Reassure the person and try to keep
them calm.
First aid when the injured person is
unconscious
- The person should not be moved unless
they are in immediate danger. Any
unnecessary movement may cause
greater complications to the head injury
itself, the spine or other associated
injuries. A good rule is that if the head is
injured, the neck may be injured too.
Your role is to protect the injured person from
any potential dangers at the scene. You should
also monitor their airway and breathing until
the arrival of an ambulance. If the person’s
breathing becomes impaired due to a problem
with their airway, you may need to very
carefully tilt their head back (and support it)
until normal breathing returns. If the person
stops breathing or has no pulse,
cardiopulmonary resuscitation (CPR) may be
required.
CONCUSSION
- A concussion is a type of traumatic
brain injury—or TBI—caused by a
bump, blow, or jolt to the head or by a
hit to the body that causes the head
and brain to move rapidly back and
forth. Balance problems or dizziness, or
double or blurry vision. Bothered by
light or noise. Feeling sluggish, hazy,
foggy, or groggy. Confusion, or
concentration or memory problems.
Treatment of concussion
- Concussion is a mild traumatic brain
injury that follows some trauma to the
head. It is a diagnosis made by a doctor
when it is certain a more serious head
injury has not occurred. Symptoms of
concussion can persist for up to three
weeks after trauma. Your doctor or
hospital will provide advice for yourself
and your family regarding your ongoing
care when being discharged for home.
Most importantly, be alert for any
danger signs over the next one or two
days, such as persistent vomiting, loss
of coordination, or bad or worsening
headaches despite analgesia (pain-
relieving medication). Seek medical
attention immediately.
SPINAL INJURY
- A spinal cord injury damages the spinal
cord itself or nearby tissues and bones.
Depending on the severity of the injury,
you may lose function or mobility in
different parts of your body.
Treatments include surgery, medication
and physical therapy. A newer approach
looks to tap working nerves.
Is a spinal cord injury the same as a back
injury?
A spinal cord injury isn’t the same as a back
injury. Back injuries may damage bones or soft
tissues in the spine, but they don’t affect the
spinal cord.
TYPES OF SPINAL CORD INJURY
Spinal cord injuries can be complete or
incomplete (partial):
• Complete: A complete injury causes total
paralysis (loss of function) below the level of
the injury. It affects both sides of the body. A
complete injury may cause paralysis of all four
limbs (quadriplegia) or the lower half of the
body (paraplegia).
• Incomplete: After an incomplete injury, some
function remains on one or both sides of the
body. The body and brain can still communicate
along certain pathways.
SPINAL INJURY
- A person who has sustained a head injury may
have also injured their spine. In elderly people,
the force required to cause neck injuries is
much less than in younger people. It can even
occur from a standing height fall in the elderly.
-It is important to keep the injured person’s
head in line with their neck. Avoid twisting their
head or allowing their head to roll to the side. If
you can, roll a t- shirt, towel or similar soft item
and place it around their neck to keep their
head straight. Don’t try to move them unless
there is an urgent need to.
HOW DO SPINAL INJURIES HAPPEN?
Some possible causes of spinal cord injuries
(from most to least common) include:
• Motor vehicle accidents.
• Falls.
• Gunshot wounds.
• Sports injuries.
• Surgical complications.
BONES, JOINTS AND MUSCLE INJURY
A fracture is a broken bone.
A potential complication is compartment
syndrome.
Fractures are usually caused by traumas like
falls, car accidents or sports injuries. But some
medical conditions and repetitive forces (like
running) can increase your risk for experiencing
certain types of fractures.
If you break a bone, you might need surgery
to repair it. Some people only need a splint,
cast, brace or sling for their bone to heal. How
long it takes to recover fully depends on which
of your bones are fractured, where the fracture
is and what caused it.
BONE FRACTURE BASICS
• Open Fracture: A fracture in which the bone
breaks through the skin and can be seen
outside the leg. Or there is a deep wound that
exposes the bone through the skin. This is also
called a compound fracture.
• Closed Fracture: A fracture that does not
break the skin. This is also called a simple
fracture.
• Partial Fracture: An incomplete break of the
bone
• Complete Fracture: A complete break of the
bone causing it to be separated into two or
more pieces
• Stable Fracture: The broken ends of the bone
line up and have not moved out of place.
• Displaced Fracture: There is a gap between
the broken ends of the bone. Repairing a
displaced fracture may require surgery.
TYPES OF BONE FRACTURE
1. Transverse Fracture- Transverse fractures are
breaks that are in a straight line across the
bone. This type of fracture may be caused by
traumatic events like falls or automobile
accidents.
2. Spiral Fracture-, this is a kind of fracture that
spirals around the bone. Spiral fractures occur
in long bones in the body, usually in the femur,
tibia, or fibula in the legs. However, they can
occur in the long bones of the arms. Spiral
fractures are caused by twisting injuries
sustained during sports, during a physical
attack, or in an accident.
3. Greenstick Fracture- This is a partial fracture
that occurs mostly in children. The bone bends
and breaks but does not separate into two
separate pieces. Children are most likely to
experience this type of fracture because their
bones are softer and more flexible.
4. Stress Fracture- Stress fractures are also
called hairline fractures. This type of fracture
looks like a crack and can be difficult to
diagnose with a regular X-rays. Stress fractures
are often caused by repetitive motions such as
running.
A dislocation is a disruption of a joint in which
5. Compression Fracture- When bones are the bone ends are no longer in contact.
crushed it is called a compression fracture. The
Trauma that forces a joint out of place causes
broken bone will be wider and flatter in
a dislocation. Car accidents, falls, and contact
appearance than it was before the injury.
sports such as football are common causes of
Compression fractures occur most often in the
this injury.
spine and can cause your vertebrae to collapse.
A type of bone loss called osteoporosis is the Dislocations also occur during regular
most common cause of compression fractures. activities when the muscles and tendons
surrounding the joint are weak. These injuries
6. Oblique Fracture- An oblique fracture is
happen more often in older people who have
when the break is diagonal across the bone.
weaker muscles and balance issues.
This kind of fracture occurs most often in long
bones. Oblique fractures may be the result of a A sprain is an injury to ligaments, articular
sharp blow that comes from an angle due to a capsule, synovial membrane, and tendons
fall or other trauma. crossing the joint.
7. Impacted Fracture- An impacted fracture A strain is a stretching or tearing of the muscle,
occurs when the broken ends of the bone are causing:
driven together. The pieces are jammed
together by the force of the injury that caused Pain
the fracture. Swelling
8. Segmental Fracture- The same bone is Bruising
fractured in two places, leaving a “floating”
segment of bone between the two breaks. AMPUTATIONS
These fractures usually occur in long bones such Can occur as a result of trauma or a surgical
as those in the legs. This type of bone fracture intervention
may take longer to heal or cause complications.
You must control bleeding and treat for shock.
9. Comminuted Fracture- A comminuted
fracture is one in which the bone is broken into Be aware of the victim’s emotional stress.
3 or more pieces. There are also bone
Emergency Medical Care
fragments present at the fracture site. These
types of bone fractures occur when there is a Perform a primary assessment.
high-impact trauma, such as an automobile
Stabilize the patient’s ABCs.
accident.
Perform a rapid scan or focus on a specific
10. Avulsion Fracture- An avulsion fracture
injury.
occurs when a fragment is pulled off the bone
by a tendon or ligament. These types of bone Follow standard precautions.
fractures are more common in children than
adults. Sometimes a child’s ligaments can pull Suspect internal bleeding.
hard enough to cause a growth plate to
fracture.
SPLINTING PELVIC BINDER

A splint is a flexible or rigid device that is used Used to splint the bony pelvis to reduce
to protect and maintain the position of an hemorrhage from bone ends, venous
injured extremity. disruption, and pain

Rigid Splints Meant to provide temporary stabilization

Made from firm material Should be light, made of soft material, easily
applied by one person, and should allow access
Applied to the sides, front, and/or back of an
to the abdomen, perineum, anus, and groin
injured extremity
HOW TO APPLY A SPLINT
Prevent motion at the injury site
1. Follow DRABC
Takes two EMTs to apply
2. Check for other injuries such as open, closed
Follow the steps in Skill Drill 29-3.
and complicated fractures

3. If there is an open wound; apply gauze,

Formable Splints pressure and cover to control bleeding

Most commonly used formable splint is the 4. Ask the casualty to refrain from moving
precontoured, inflatable, clear plastic air splint
5. Handle casualty with care
Comfortable
6. Immobilise fracture with broad bandages to
Provides uniform contact prevent movement at the joints above and
below the fracture by: 1. Supporting the limb –
Applies firm pressure to a bleeding wound gently wrap bandages around the natural
Used to stabilize injuries below the elbow or hollows of the limb.2. Position a padded splint
knee along the injured limb 3. Place padding between
the splint and the natural formation of the limb
Traction Splints and secure firmly with bandages 4. If a leg
Used primarily to secure fractures of the shaft fracture, also immobilise foot and ankle
of the femur Check that bandages are not too tight or too
Several different types: loose every 15 minutes (too tight – the skin is
bulging outside the bandage, too loose – you
Hare splint Sager splint can get multiple fingers underneath the
bandage)
Reel splint Kendrick splint
7. Watch for signs of loss of circulation to foot
(if leg injury) or hand (if arm injury)

8. Observe the casualty closely

9. Seek medical assistance