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First Aid Management for Hypovolemic Shock

Hypovolemic shock is a medical emergency that occurs from significant blood and/ or fluid losses in the body leaving the heart unable to pump sufficient blood.

First Aid Management for Hypovolemic Shock
First Aid Management for Hypovolemic Shock

Hypovolemic shock is a medical emergency that requires immediate medical attention. It occurs from significant blood and/ or fluid losses in the body leaving the heart unable to pump efficiently, causing insufficient blood supply to the body. It may eventually progress for many of the body organs to stop working. It is the leading cause of death in people with traumatic injuries. Hypovolemic shock is also called haemorrhagic shock.

When a person suffers from excessive bleeding, blood flow is not sufficient to the body. It is the blood that carries the oxygen and other essential nutrients needed by the body to function properly. When these substances are lost more quickly than it is replaced, the body organs begin to fail. Thus when the heart begins to fail pumping enough blood, symptoms of shock begin to show. In some cases, it may begin to show the trauma triad of death, a vicious cycle that can quickly lead to death if not acted upon immediately.

Causes of Hypovolemic Shock

The normal blood volume in a healthy adult is typically between 4.7 and 5 litres. When a person loses about a fifth (20%) or more of this normal blood volume, it can cause hypovolemic shock. Some of the possible causes of blood and fluid loss in the body are the following:

Signs and Symptoms of Hypovolemic Shock

Signs and symptoms of hypovolemic shock will vary depending on how much blood and fluid loss is. However, it must be noted that all symptoms of shock are fatal and must be treated as medical emergencies. Symptoms of external bleeding will be evident, whereas there might be troubles identifying internal bleeding until symptoms show. Some of the signs and symptoms of hypovolemic shock include:

  • Low blood pressure
  • Weak pulse
  • Increased heart rate
  • Unconsciousness
  • Chest pain
  • Cyanosis of lips and fingernails
  • Cool, pale, clammy skin
  • Little or no urine output
  • Excessive sweating
  • Dizziness
  • Confusion
  • Anxiety
  • Short, shallow breaths
  • External bleeding: profuse bleeding at injury site
  • Internal bleeding: bleeding from outlets of the body, including, vomiting blood, blood in the urine or stool, vaginal bleeding; abdominal pain and swelling; chest pain

Complications of Hypovolemic Shock

If hypovolemic shock is left untreated, it will result to death. The other complications may include:

  • Damage to the organs, including the brain, kidneys, etc.
  • Gangrene (tissues death) of the extremities
  • Heart attack

First Aid Management for Hypovolemic Shock

A person should call for the emergency medical services immediately for symptoms of hypovolemic shock. While waiting for the paramedics, first aid may be given to help avoid complications from developing. The following steps are generally recommended:

  • Keep the person comfortable cover with a blanket or coat to avoid hypothermia.
  • Assist the person to lying down flatly with the feet elevated about 12 inches to increase circulation. However, if there is a suspected head, neck, back, or leg injury, do not move the individual’s position unless there is danger in the immediate environment.
  • Do not attempt to give anything by mouth to avoid choking.
  • If the individual is suffering from an allergic reaction, treat appropriately.

Disclaimer: This article does not provide medical advice and should not be substituted for formal training. The information given should not be used for self-diagnosis. Seek medical attention when necessary. It is important to recognise medical emergencies at all times to avoid complications from developing. To learn more about to how to manage hypovolemic shock, enrol in basic first aid and CPR training like standard or emergency first aid.

Sources:

Hypovolemic shock. (2012). National Institutes of Health. Retrieved October 16, 2013, from http://www.nlm.nih.gov/medlineplus/ency/article/000167.htm

Nall, Rache (2012). Hypovolemic Shock. Healthline. Retrieved October 16, 2013, from http://www.healthline.com/health/hypovolemic-shock?toptoctest=expand

 

Breath Holding Spell: Symptoms, Causes and Treatment

A breath holding spell refers to a child holding his breath due to anger, fear, frustration or fear. Children between the ages of 6 months to 2 years of age are frequently known to hold their breath. Often breath holding spells do not result in loss of consciousness – they are normal reactions to anger and frustrations.

A child having a breath holding spell may show changes in skin color, initially starting off with red, after which the lips may turn blue. This will result in the loss of consciousness. However, the child will begin breathing breath holding spellsnormally within one minute and will wake up and be alert instantly.

Treatment options for breathing holding spells may include medication to prevent them and a special pacemaker for the spells.

Disclaimer: the material posted on this page on breath holding spells is for learning purposes only. To learn to recognize and manage childcare and babysitting emergency’s sign up for workplace approved first aid and CPR programs.

Causes

A breath holding spell may be an emotional reaction to anger, frustration, fear or injury. Breath holding spells rarely result in the child’s loss n consciousness, however, the child will recover within a minute. Breath holding spells are normal in children aging from 6 months to 2 years.

Signs and symptoms

Signs and symptoms of breath holding spell in children include:

  • The child may cry once or twice before the breath holding spell
  • The child holds his or her breath for as long as possible or until the lips turn blue or the child passes out
  • The child loses consciousness
  • The child’s limbs become too rigid or stiff
  • The child begins to breathe normally within a minute after which he or she will awaken and be fully alert again

Treatment

For most children, treatment is not needed for breath holding spell. Many children simply outgrow breath-holding spell within 6 years of age. The best way to treat breath holding spells is to avoid them. Children often hold their breaths in response to fear or anger, therefore, parents should try to prevent such traumatic events from taking place. In order to minimize the impact of breath holding spell in children, parents and caretakers must ensure that they remain calm before and after the spell. It is important that all objects nearby are removed and the child is in a safe place in order to prevent injuries, in case the child collapses due to loss of consciousness.

Placing a cold cloth on your child’s forehead may shorten the period of the breath holding spell. Since mild or brief seizures are normal during a breath holding spell, it is important that you do not give your child any anti-seizure medication as your child is not suffering from epilepsy.

It is very rare in children to have breath-holding spells, due to an inherited disease. In such cases, immediate medical attention should be sought as soon as possible.

Home care treatment

Follow these home care treatment steps to reduce breathing-holding spells:

  • Measure the time taken for the breath holding spell
  • Apply a moist, cold washcloth on the child’s forehead
  • Lay the child on his back, flat on the ground to encourage blood flow to the brain
  • Remain calm before and after the breath holding spell
  • After the breathing holding spell, give your child a hug

When to seek medical attention

See you doctor if your child is having these problems along with breath holding spell:

  • Worsening breathing difficulty
  • Worsening wheezing
  • You child is holding his or her breath for more than 1 minute
  • Your child is having a seizure
  • Increased severity or frequency of breath holding spells

 Learn More

To learn more about managing children with breath holding spells enroll in workplace approved childcare and / or babysitting first aid and CPR courses with a credible provider.

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Excessive sweating

Excessive sweating also known as hyperhidrosis refers to a condition in which a person is sweating profusely. Normally sweating occurs as a natural reaction of the body to heat and warm environments to cool the body down through the evaporation of sweat from the surface of the skin. Excessive sweating or hyperhidrosis, however, occurs without any environmental triggers such as heat. In young adults excessive sweating occurs as a result of excessive sweatingfear, apprehension or emotional stress. However, excessive sweating also occurs as one of the symptoms of many diseases such as lung disease, heart disease, stroke and diabetes.

A person with hyperhidrosis will experience sweating on the armpits, face, palms, soles of the feet and trunk. Treatment for excessive sweating may include anti-anxiety medication, antidepressants, botulism toxin injections and for severe conditions, surgery may also be required.

Disclaimer: this post on hyperhidrosis and excessive sweating is for learning purposes only. To learn about how to manage and recognize minor and major medical emergencies associated with heavy perspiration enrol in workplace approved first aid and CPR courses.

Causes of excessive sweating

Excessive sweating is commonly caused due to stress; however, it may also occur due to the following conditions:

  • Alcoholism
  • Asthma
  • Angina
  • Cancer
  • Congestive heart failure
  • Cardiac arrhythmias
  • COPD
  • Fever
  • Diabetes
  • Gout
  • Leukemia
  • Low blood sugar
  • Menopause
  • Myocardial infarction
  • Tuberculosis – night sweats
  • Pneumonia

Rare causes of excessive sweating may include:

  • Anaphylaxis
  • Aortic insufficiency
  • High altitude sickness
  • Mitral insufficiency
  • Mitral stenosis
  • Pheochromocytoma
  • Pulmonary embolism
  • Pulmonary hypertension
  • Thyrotoxicosis

Signs and symptoms signs and symptoms of excessive sweating include:

  • Excessive sweating from the armpits
  • Excessive sweating from the palms of the hands
  • Excessive sweating from the soles of the fee
  • Excessive sweating from the trunk
  • Excessive sweating from the face

Treatment

Treatment for excessive sweating usually involves anti-anxiety medication and antiperspirants.

Treatment for excessive sweating includes:

  • Antiperspirants – 20% aluminum chloride
  • Botulinum toxin injections
  • Anti-anxiety medication
  • Surgical removal of the sweat glands
  • Endoscopic thoracic sympathectomy – surgical removal of the nerves that cause sweating from the sweat glands

If you are experiencing excessive sweating or hyperhidrosis, see a dermatologist for diagnosis and treatment.

Home care and prevention

In order to reduce the risk of excessive sweating or hyperhidrosis or excessive sweating or resolve excessive sweating, follow these steps:

  • Avoid common triggers such as hot environments
  • Stay away from humid environments as much as possible
  • Quit smoking and avoid passive smoking
  • Avoid caffeine and caffeinated beverages such as coffee, tea or fizzy beverages
  • Avoid consuming alcohol
  • Avoid eating spicy food
  • Drink plenty of water and cool fluids
  • Reduce stress
  • Avoid overwork and plan your day properly
  • Avoid working at night
  • Avoid decongestant cold medication
  • Use antidepressants containing aluminum chloride
  • Take medication as prescribed ad directed by your health care provider. Avoid skipping doses at this may just make the medication ineffective. Familiarize yourself with the common side effects of the drugs prescribed by your health care provider

Warning signs

See your doctor immediately if any of the following problems occur along with excessive sweating:

  • Chest pain/angina
  • Heart palpitations
  • Breathing difficulty
  • Fainting
  • Seizures
  • Severe fatigue or weakness

Learn More

To learn more about the serious medical emergencies that can be associated with excessive sweating register for first aid and CPR programs with credible workplace approved providers / training partners.

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Dealing with Falls among Seniors

With age comes wisdom but at the same time – physical changes. The ageing process can take toll on the different body systems and organs. While some of these changes are obvious, others are simply more subtle. Ageing can cause the bone to lose its density through the process of bone absorption. This gradual change in the bone composition can increase the risk of long term injuries, especially after falls.

Ageing and falls

Falls are all too frequent among seniors and are the most common causes of serious injuries and hospital admissions due to trauma. Studies show that one in three persons over 65 years suffer from a fall every year. Of these, Elderly man injured by fallingaround 30 percent suffer moderate to severe injuries that can make their lives difficult and even shorten their life expectancy. Every year, the healthcare industry spends millions for treating non-fatal fall injuries among seniors.

Fractures: The leading consequence of fall

For older people, fractures are the most common serious consequences of falls. As mentioned above, the bones constantly change through a process of “ remodelling”, which results in loss of bone tissue and mass. The loss of minerals in the bones makes it more fragile.

Some parts of the body that are most vulnerable to fractures after a fall include the hip area, arms and hand, and leg and ankle bones. Among these common bone fractures, hip fractures are attributed to more serious health problems as well as greater number of fatalities.

Seniors who have broken their hips often require hospital admission that may last for about 2 weeks. Moreover, around half of seniors hospitalized due to hip fracture will have some difficulties returning home and living independently.

Individuals that care for seniors, at the bare minimum, should enrol in first aid training through credible providers to ensure they can provide assistance to seniors during emergencies.

Contributory factors

There are a number of factors that can increase the risk of falls among older people. These factors include:

  • visual changes or impairment (e.g. cataracts, myopia or presbyopia);
  • problems with the nervous system (e.g. sciatica);
  • muscle and joint problems (e.g. arthritic conditions);
  • problems with balance and gait (e.g. Parkinson’s disease or post-stroke); and
  • taking medications that can cause sleep or disorders with balance.

Environmental hazards can also contribute in the incidence of fall. Some of the common environmental hazards include:

  • uneven or slipper floor surfaces;
  • tripping obstacles that include loose steps, rugs and mats, and pets;
  • poor lighting;
  • objects scattered on the steps or floor; and
  • unstable furniture.

Majority of fatal falls among seniors occur in the home. However, it can also occur in public spaces such as in cinemas, malls, shopping center as well as in health care institutions.

Preventing falls

While falls are very common among seniors, there are things you can do to prevent fatal injuries. Here are some tips on how falls can be prevented:

  • Regular physical exercise to improve mobility, flexibility and strength;
  • Avoiding use of medication that can affect consciousness;
  • Taking medications for underlying medical conditions; and
  • Modifying the environment such as removing potential tripping obstacles, installing anti-skid tape on floor and grab bars and ensuring adequate.

Learn More

To learn more about recognizing emergencies and providing first aid to individuals that are victims of falls enrol in workplace approved first aid courses (enrol here).

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Influenza: Risk factors and Complications

Influenza refers to a viral infection that targets the upper respiratory system which includes the nose, throat and lungs.

Risk factors

The following factors increase the risk of developing flu and its major symptoms:sneezing

  • Age. Often young children and people over the age of 65 are more likely to suffer from seasonal flu than the age groups in between. However, the H1N1 pandemic in 2009 mostly struck young adults and teenagers.
  • Living conditions. People living in areas accommodated by many other people such as military camps, barracks, and nursing homes are more likely to be infected due to close contact with people. Similarly, young children are also susceptible to the infection as they go to school and day care centers.
  • Occupation. Nurses, child care and health care workers come in contact with infected people suffering from influenza. Influenza can spread by breathing in contaminated air or touching contaminated objects.
  • Pregnancy. Pregnant women develop flu and influenza complications usually in the second and third trimesters.
  • Chronic illnesses. These include diabetes, asthma and heart problems. People suffering from chronic illnesses are more likely to develop influenza complications.
  • Suppressed immune system. Chemotherapy, corticosteroids, anti-rejection drugs and HIV/AIDS can greatly suppress your immune system and make you more susceptible to suffer from infections. A weakened immune system also makes you more prone to catch the influenza virus and suffer from its complications.

Complications

For healthy and young people, influenza virus does not produce major complications regardless of the fact that the sufferer may consider the condition to be a nuisance, the symptoms disappear on their own. However, high risk groups such as young children, older adults and people with weak immune systems are likely to suffer from major complications that may leave long lasting effects. Some of the most common complications include:

  • Pneumonia
  • Sinus infections
  • Bronchitis
  • Ear infections

Of all complications, pneumonia seems to be the most recurrent complication in the world’s population. Moreover, it is also the most serious complication out of them all. For older people and people suffering from chronic illness, pneumonia might actually turn into a deadly complication. It is recommended that you get vaccinated for influenza and pneumococcal pneumonia to provide yourself with protection from both conditions.

Learn More

To learn about more serious medical emergencies and complications such as shock, breathing emergencies, anaphylaxis and asthma enrol in workplace approved first aid and CPR training with a provider near you.

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First Aid for Sore Throats

Sore throat is medically termed as pharyngitis which refers to a condition resulting from an inflamed pharynx, which is positioned behind the throat. Inflammation can also affect the tonsils, the back of the tongue and the soft palate—often caused by a viral infection.

Sore throats are also symptoms of bacterial infection affecting the respiratory tract such as strep throat or tonsillitis. Sore throats are contagious and are thus contracted with the contact of contaminated objects. People and children working or studying with close contact are more prone to contracting the condition. The infectious agents are often transmitted by coughing, sneezing, not washing your hands thoroughly—you will incur the condition of you come into close contact, touch or breathe the air near an affected person.

The infection is at its peak during the fall and winter seasons because people spend most of their time indoors.

Symptoms

Of course, the most obvious symptom of pharyngitis is a sore throat. However, it is crucial to realize that sore throat also occurs as a result of many other illnesses and conditions such as cold sores, flu, strep throat and sore throatmononucleosis. Other symptoms that may occur along with sore throat are:

  • Runny and stuffy nose—congestion
  • Persistent and dry coughing
  • Redness of the throat
  • Red eyes
  • Hoarse voice
  • Diarrhea—only in children
  • Occasionally, painful sores and reddishness around the mouth region

Sore throat that occurs due to a fungal infection (Thrush) will exhibit the following symptoms:

  • Sore throat
  • Breathing difficulties
  • White patches in the mouth

This infection is often contracted by young children and people with weak or suppressed immune systems.

When to seek medical attention

If any of the following symptoms arise due to sore throat, visit your doctor immediately:

  • A fever above 101 F
  • Breathing difficulties through the mouth
  • Difficulties while swallowing—preventing you from taking adequate nutrition and fluids
  • Loud breathing
  • Throat pain that lasts for more than 2 weeks
  • Excessive drooling

Treatment

Bear in mind that viral infections will not respond to antibiotics, therefore, making it highly ineffective. Antibiotics will only work in the case of strep throat which is caused by a bacterial infection. Therefore, treatment depends mainly on alleviating the symptoms and making the victim feel more comfortable:

  • Drink lots of fluids. This will prevent dehydration and make you feel better. Therefore, drink plenty of warm fluids such as tea, soup and also have cool fluids such as soft ice cream and water—to relieve your throat pain.
  • Get plenty of rest. The more you rest, the more your body will be able to respond to the infection and act against it.
  • Gargle with warm salt water. This will reduce the pain.
  • Over the counter pain killers such as ibuprofen and acetaminophen will alleviate throat pain. Do NOT give aspirin to children under 2 years of age.
  • Antihistamines also alleviate some symptoms of sore throat.
  • You can sue a humid vaporizer to reduce congestion while resting.
  • Taking vitamin C supplements can reduce the duration of the condition.

Additional Information

Rarely do sore throats result in the need of immediate first aid or CPR, however, with serious breathing emergencies such as asthma, anaphylaxis or chooking the skills learned in credible first aid and CPR training are applicable.

Related Video to Sore Throats

http://www.youtube.com/watch?v=YUnTYAaYuXY

External Bleeding: How You Can Help

First Aid Kits at Saskatoon First Aid
Having a first aid kit can definitely help with any major or minor bleeding emergencies.

Many people are afraid to help someone who is bleeding heavily. Some are simply afraid of blood while many have no knowledge about the first aid for external bleeding. While it is reassuring to know that many adults actually donate blood and lose a pint of blood with no serious effects, prolonged bleeding and severe loss of blood can lead to shock, which is a dangerous medical condition. You can help prevent shock and its complications by providing immediate first aid. To learn the skills to manage victims of external bleeding enrol into emergency first aid.

First Aid Treatment for External Bleeding

First aid treatment for external bleeding can be summarized as Look, Apply and Elevate.

  • LOOK

Check the affected site to assess the severity of the injury/wound. Check if there is any foreign body or debris that has lodged in the wound.

  • APPLY

Apply direct pressure over the wound or injured site. Place a piece of clean cloth or sterile dressing over the wound (or whatever clean sheet is available), and then apply direct pressure. If the victim is conscious and is able, encourage him to press on the wound. If the victim is unconscious or not capable, you can provide direct pressure.

Direct pressure over the wound encourages the blood to clot and prevent further bleeding and loss of blood. Ideally, the sterile dressing or clean cloth should be held firmly in place using bandage (triangular bandage or non-adhesive bandage). You can make use of improvised bandage from whatever you have handy, such as a tie, cloth, scarf and so on.

  • ELEVATE

Elevate the injured site. If the wound is located in the arms or legs, raise the affected area above the level of the heart. Gravity pulls the blood reducing blood flow to the wound and loss of blood.

If the victim has lost a significant amount of blood, he is most likely to experience shock. Be ready to provide appropriate first aid for shock. Never leave the victim alone and keep him warm. Provide reassurance continuously.

Personal Safety and Protection

In all first aid treatments, protecting yourself from any potential danger is of primary importance. As much as possible, avoid direct contact with body fluids, including blood. This does not only ensure your personal safety but also that of the victim. Here are some ways on how you can protect yourself while providing first aid for external bleeding:

  • Use gloves (if available). First aid kits would always have gloves in its stock. Gloves come in many different materials and sizes.
  • Ask the victim to apply direct pressure to injury if he is able.
  • Use dressings, bandages, or any improvised materials (shirt, cloth, or handkerchief) to protect your hand from the wound.
  • If you have wounds or injuries in your hands, keep it covered with dressing, plasters or bandage.
  • If your skin has been exposed to blood, wash it off well with hot water and soap. Use bleach and water solution to remove spills of vomit or blood.

If you are concerned about possible infection, you can consult your healthcare provider. It is important to note that the chances of cross-infection while providing first aid on a bleeding victim is very low.

Related Video on External Bleeding

First Aid for a Black eye

A physical trauma that affects the region around the eye, causing internal bleeding beneath the skin in that region allowing it to appear dark is a black eye. A black eye can be an indication of a severe injury such as skull fracture or a serious head trauma but most of the time the injury is mild and recovers within a few days.

Sometimes, a head trauma may not only cause a black eye but an eye injury such as a corneal abrasion which refers to bleeding inside the eye. Serious eye damage can lead to impaired vision and even loss of eyesight. An extremely high pressure inside the eye called glaucoma may also result due to an eye injury; therefore it is advisable that you seek medical help immediately.

Signs and symptoms

  • Darkening of the region around the eye
  • Swelling in the affected region
    cold compress
    A cold compress is a very effective way of reducing the bruising of a black eye.
  • Pain
  • Blurred vision
  • Headaches

If any of the following severe symptoms occur, call a medical expert immediately:

  • Dual vision
  • Prolonged headache
  • Bleeding on the surface of the eyes
  • Inability to move the affected eye(s)
  • Oozing of fluid from the eyes, nose or ears
  • Loss of vision
  • Unconsciousness

Treatment

In case of a mild injury, follow these steps:

  • Apply cold packs on the affected region around the eye. Do not apply pressure directly on the eyeball. You may also use a towel wrapped in ice for this purpose. Applying pressure with ice packs can alleviate pain and reduce swelling. Use this procedure for 1-2 days.
  • To reduce pain, you may take acetaminophen; however, it is advisable that you do not take blood thinning agents such as aspirin.
  • Inspect your eyeball and look for signs of severe injury. If you can see blood on the white parts of the eye or eyes, visit an ophthalmologist (eye specialist) immediately.
  • If you experience vision problems such as impaired vision, blurred vision or double vision seek medical help immediately.
  • If you notice bleeding in the eyeball or nose, call medical help promptly.
  • For a severe head trauma or brain injury, you will have to visit a neurologist and for face disfigurement, you should visit a plastic surgeon.

Prevention

  • Be safe and stay away from fist fights.
  • Wear a helmet while driving motor vehicles.
  • Make sure your house is safe and potentially harmful objects are kept away from children’s reach.
  • Do not let children ride bicycles or use skateboards until they are old enough and fully protected.
  • Make sure you protect your eyes in case of an accident.

Learn to Provide Care for Head Injuries

To learn more about eye and other head injuries take St Mark James first aid training. Classes are available in Vancouver, Victoria, Surrey, Edmonton, Calgary, Red Deer, Winnipeg, Halifax, Toronto and Ottawa. Visit the locations page for more information or to register.

Additional Information Via Video

 

Traumatic Brain Injuries – Part 2

A Two-Part Series On Traumatic Brain Injuries (Part 2)

Emergency Management of Traumatic Brain Injury

Mild traumatic brain injuries do not often require treatment, with patient fully recovering after the injury. However, the person who has suffered mild TBI should be closely monitored. If the initial symptoms persist or worsen, or new symptoms develop, the person should be brought back to the emergency department for medical attention.

On the other hand, moderate to severe traumatic brain injuries often happen as an emergency and since they can lead to serious consequences, doctors and first responders must assess the situation immediately.

Emergency care for brain trauma focuses on ensuring an adequate airway and blood supply and preventing further injury. People who suffered TBI may also have other injuries that require immediate attention.

If you are at the scene of the accident or arrived immediately after the injury, it is important that you contact your local emergency service immediately. Do not attempt to move the injured person as it can cause more harm than good. It is also important to take note of information which the first aider or emergency personnel may find useful, such as:

  • how the injury occurred,
  • did the victim lose consciousness and for how long,
  • what parts of the body or head was injured,
  • what type of object hit the person,
  • how forceful the impact was.

The information that bystanders and witnesses provide may be helpful in assessing the severity of the injury and determining the type of injury that might have been sustained.

The first aider assesses the consciousness of the victim using the Glasgow Coma Scale. This is a 15-point test used to assess the initial severity of the injury. In this test, the person is made to follow directions and move their limbs and eyes. Speech and response to stimuli provide crucial clues to the neurologic state of the patient. Although higher scores indicate mild injury, it does not guarantee the prognosis of the victim. Check out the video below for more information about using the Glasgow Coma Scale.

The patient is carefully transferred and transported to the nearest emergency facility for further examination. Once in the emergency department, the focus is on preventing secondary damage caused by bleeding, inflammation or lack of oxygen in the brain.

How is TBI Diagnosed?

There are many different tests that are used to diagnose the location and extent of the injury. Imaging tests such as Magnetic Resonance Imaging (MRI) and Computerized Tomography (CT) are some of the initial diagnostic

CT Scan for Traumatic Brain Injuries
A patient that is suspected of having a traumatic brain injury may undergo a CT scan as shown in the picture above.

tests done. These tests provide visualization of the internal structures of the brain allowing detection of blood clots, bleeding, swelling or bruising of the brain tissues.

In case of closed head injuries that cause increased pressure inside the skull, the doctor may recommend intra-cranial pressure monitoring. A probe is inserted into the skull to monitor pressure inside.

How is TBI treated?

The treatment of TBIs often include use of medications, particularly diuretics to reduce inflammation of brain tissue, anti-seizure drugs to avoid additional damage to brain caused by a seizure, and coma-inducing drugs to minimize the brain’s demand for oxygen.

Surgery may also be recommended to remove hematomas, to repair fractured skull, or to open up a small slit in the skull for drainage of accumulated fluids or provide additional space for swollen tissue.

The treatment does not end with hospitalization. Most people who have suffered moderate to severe brain injury require long term rehabilitation to improve abilities that may have been affected. The support of loved ones and significant others is crucial throughout the treatment and rehabilitation process.

Video on Glasgow Coma Scale

Traumatic Brain Injuries – Part 1

A Two-Part Series On Traumatic Brain Injuries (Part 1)

What is Traumatic Brain Injury?

Traumatic Brain Injury (TBI) is a collective term that describes the wide range of pathologic conditions and types of trauma involving the brain. The Centers of Disease Control and Prevention or CDC estimates that around 1.7 million people suffer from TBI each year, of the reported cases, around 52,000 die and 275,000 are hospitalized. TBIs are among the leading causes of trauma death in the US, with at least 30.5% of injury-related deaths associated to it. Not only are TBIs lethal, they are also associated with severe disabilities with long-term deficits and effects.

The understanding of the causes, types of injuries and its effects on the brain, as well as the immediate recognition of signs and symptoms, are crucial in the management of people who suffered brain trauma. Having basic knowledge of brain injuries and its mechanisms can help a lot in the proper care of patients.

Causes of Brain Injury

A TBI is caused by a generated force to the head such as blows, bumps or jolts causing trauma to the delicate neural tissues beneath the cranial vault. These contributory factors are frequently associated with road crashes, violence, falls, and risky sports. However, not all traumas to head lead to a TBI. Depending on the force applied to the head, the severity of the effect to brain can range from mild (brief change in consciousness or mental status) to severe (loss of conscious for an extended period or loss of memory/amnesia after the injury).

Types of Traumatic Brain Injuries

There are two broad classifications of TBIs: penetrating injuries and closed head injuries.

Penetrating Injuries involve foreign objects (e.g. sharp objects, a bullet) that enter the skull causing damage in specific parts of the brain. These injuries can lead to localized or generalized damage to the brain. Symptoms and effects of the injuries vary depending on which part of the brain is affected.

Car Accidents and Closed Head Injuries
Car accidents can cause closed head injuries which cause traumatic brain injuries.

Closed Head Injuries occur when the head suffers direct impact or blow, such as, in motor vehicle crashes. The resulting brain damage are further classified as: concussion, contusion, skull fractures, hematoma, and diffuse axonal injury.

  1. Concussion is the most common type of TBIs that is reported each year. It results from blunt trauma to the head due to fall or blow to the head. The direct injury to the brain causes it to momentarily stop functioning. While concussions are generally mild, with patients completely recovering after a few seconds or minutes, it may have underlying serious effects that become apparent only days after the injury.
  2. Contusion occurs when the head directly bumps with a rigid object. The causes of contusions are the same with concussion but are usually more severe. The forceful impact results in the rapid shifting of the brain and ‘bouncing’ from one side of the skull to the other. The damage can either be localized to the site of impact (coup injury) or in two different sides (coup-contrecoup injury).
  3. Skull fractures occur when the bony skull breaks due to forceful impact. These injuries can cause mild-to-severe brain injury depending on the type and location of fracture. People who suffered skull fracture require close medical supervision.
  4. Intracranial hematomas (epidural, subdural and intracerebral hematoma) develop when the head injury causes a blood vessel to rupture inside the cranial vault. Intracranial hematomas, regardless of its type, require emergency medical attention. Hematomas often cause an abrupt deterioration of brain functions.
  5. Diffuse Axonal Injury is characterized by the extensive damage of a wide area of the brain, usually involving the cerebrum and the brain-stem  This TBI is often caused by car crashes or events involving mechanical sheering forces. Majority of patients who sustain this brain trauma end up in coma or suffer long-term neural deficits.

Closed head injuries can also cause secondary brain damage, such as brain swelling, epilepsy, hematoma, intracranial infection, cognitive problems, etc., that evolves long after the trauma.