KIN 150 Head and Neck injuries

Whats meninges?

• Continuous membrane that encases and protects both the brain and spinal cord

  • Directs forces

  • Provide a corridor

What are scalp injuries?

External forces are dissipated and absorbed by the scalp

Bleeding is often profuse

Control bleeding with gentle pressure

If a skull fracture is present, apply pressure to edges of wound

Keep head slightly elevated if spinal cord injury is ruled out

Refer

What are signs and symptoms for skull fractures?

Pain 

Deformity

Bleeding from nose or ears

CSF leakage

•  Halo skin

Raccoon eyes (Basilar Skull Fx)

Battle Sign

• Ecchymosis at the mastoid process

• Occurs several hours later

How to care for skull fracture?

• Monitor vitals

• Stabilize head and neck

• Slightly elevate head 

• Control bleeding

• Cover wound

• Refer

Whats meningitis?

Inflammation of the Meninges

• Dura Mater

• Arachnoid Mater

• Pia Mater 

Seen in college-aged students living in dorms or military personnel living in barracks

Whats fungal mengingitis?

not contagious, caused by medication that weakens the immune system

Whats viral meningitis?

serious, but rarely fatal; symptoms last for 7-10 days, patient usually fully recovers

Whats bacterial meningitis?

serious, resulting in death if not promptly treated

Signs and symptoms for meningitis?

• High fever and chills

• Stiff neck

• Intense headache

• Sensitivity to light and sound

  • Photophobia

• Nausea and vomiting

• Convulsions and/or coma

Treatment for meningitis?

• Hospitalization 

• Analyze CSF with spinal tap

• Bed rest 

• Fluids

• Antibiotic medications for bacterial meningitis

Whats cervical dislocation?

Relatively uncommon but occur more than fractures

MOI – violent rotation and flexion of the head

Most common in C_4-6 vertebra

Signs and symptoms for cervical dislocation?

• Pain

• Numbness

• Weakness

• Paralysis

Treatment for cervical dislocation?

Same as fracture, although this condition is much more serious than a simple fracture

Whats cervical and root injuries?

• Laceration by bony fragments 

• Hemorrhage 

• Contusion 

• Cervical cord neuropraxia 

• Shock

Signs and symptoms for cervical and root injuries?

• Paralysis is possible

• Immediate loss of function below the level of injury

At or above C₃ – _Quadriplegia or death

How to manage cervical and root injuries?

• Minimize additional trauma

  • Stabilize

• Be extraordinarily cautious

• Activate EMS

What are concussions?

An injury to the brain and neurological structures referred to as a mild traumatic brain injury (MBTI)

Whats protections for concussions?

• Scalp

• Skull

• Meninges

• Ventricles in the brain – cerebrospinal fluid acts a cushion that absorbs shock

How to prevent concussions?

Helmets are sport-specifically designed to protect from head injury

They provide a second skull, accepting and dissipating forces

Why cant protection not always prevent concussions?

• Technique

• Mats/padding

• Sensors

• ATC Spotters

Whats a coup injury?

• Fast-moving object impacts the skull

• Injury tends to be on same side as impact

• Force transmitted directly into brain

• Likely to be accompanied by skin injury (laceration, contusion)

Whats contrecoup?

• The moving head strikes an object of large mass, no give

• Acceleration is in opposite direction

• Brain impacts the skull on the side opposite from the head impact

• Usually a closed injury

Whats rotational injury?

• Brain twists inside the skull

• Possible impact injury in 2 places

• Shearing of nerve tissue

• Most likely to be permanently disabling

Whats MBTI?

Like a snow globe - neurotransmitters become mixed up as a result of jarring

Physical damage/deformation is rare 

Intracranial swelling and bleeding may become a problem