Unit 3 Lesson 4: Spinal, Head, and Neck Injuries (PDF)

Unit 3 Trauma-Related Medical Issues Lesson 4 Spinal, Head, and Neck Injuries Lesson Goal At the end of this lesson, you will be able to provide emergency first aid for a patient with a spinal, head, or neck injury. Spinal Injuries Injury to the head, neck, shoulders, back, and abdomen may...

Unit 3 Trauma-Related Medical Issues Lesson 4 Spinal, Head, and Neck Injuries Lesson Goal At the end of this lesson, you will be able to provide emergency first aid for a patient with a spinal, head, or neck injury. Spinal Injuries Injury to the head, neck, shoulders, back, and abdomen may cause injury to the spinal cord. A spinal injury may be difficult to identify and can temporarily or permanently interrupt the relay of messages from the brain to the body, eliminating a person’s ability to move, feel, or even breathe. Spinal injuries may present some of these symptoms: constant or intermittent pain or tenderness in the neck or back weakness in the arms or legs with or without movement respiratory distress tingling, numbness, loss of sensation in upper or lower extremities obvious deformity of the spine (rarely seen) loss of bladder or bowel control persistent erection ✅ HL234.1. Describe how to provide treatment for a neck or spinal injury Spinal Motion Restriction If scene size-up and the primary assessment suggest spinal injury, minimize movement of the patient’s spine. 1. Position yourself at the patient’s head. 2. Make sure the patient’s head is in a neutral position lying down, so that the patient’s nose is at the same level as or in line with their navel (belly button). Chapter 2 First Aid for Criminal Justice Officers / 105  3. Place your thumb and fingers below the ears and on the shoulders. This way the motion of the neck with respect to the torso is restricted. Make sure that the head is not extended forward or backward or rotated. 4. Continue to restrict spinal motion until EMS arrive. Patients should not be transported in the seating position. Jaw Thrust Maneuver Perform a jaw thrust maneuver when you suspect an unresponsive patient has a neck or spinal injury and you need to establish an open airway. 1. Position yourself at the patient’s head. Place one hand on each side of the patient’s head with your thumbs resting on the cheekbones. 2. Grasp the angles of the patient’s lower jaw on both sides and press down with your thumbs as you lift the jaw. If the lips close, push the lower lip open with your index finger. 3. Use a lifting motion to move the jaw forward with both hands. This pulls the tongue away from the back of the throat. 4. Maintain spinal motion restriction until EMS arrive. If the situation becomes unsafe, move the patient. The object is to keep the breathing patient’s head in the same position you found it and to prevent movement until advanced medical person- nel arrives. If you must leave the patient unattended to call EMS or if the scene becomes unsafe, do not leave the patient on their back, place them in a recovery position. When you return, do not move the patient again if they are breathing and stable in the recovery position. Head, Face, and Scalp Wounds Head and neck injuries are among the most serious emergencies. They can impair the upper airway and cause breathing difficulties. Impacts to the head and neck can also cause hidden fractures. If a head or neck injury is obvious or suspected, or if a trauma patient is unresponsive, immediately stabilize the head and neck. If the patient is wearing a helmet, do not remove the helmet unless it is obstructing their airway. Scalp wounds may bleed profusely but are usually easy to control with direct pressure. After deter- mining that the wound is not deep and there are no obvious skull depressions, treat a scalp wound the same as you would a soft-tissue injury. 106 / Florida Basic Recruit Training Program (HL): Volume 2 ✅ HL234.2. Describe how to provide treatment for a head, face, or scalp injury To treat a patient for a laceration or cuts to the head, face, or scalp: 1. Use a dressing to apply direct pressure to the site. Be careful not to obstruct the airway and to allow for normal breathing.  The location and severity of the wound determines whether you apply direct pres- sure or loosely dress the wound.  Never apply direct pressure to a head wound if the patient has an obvious or depressed skull fracture. You might drive fragments of bone into brain tissue, caus- ing further damage.  If fluid drains from the ears or the head, loosely cover the ears with a dressing. 2. Trauma to the mouth can cause a lot of bleeding. Your main concern is to establish and maintain an open airway. 3. If the patient’s teeth were knocked out from their mouth and you locate the teeth, wrap them in moist dressing and transport them with the patient. Traumatic Brain Injury A traumatic brain injury (TBI) is a brain injury that occurs when sudden trauma causes damage to the brain. TBI can occur when the head suddenly and violently hits an object, when the brain hits the inside of the skull, or when an object penetrates the skull and enters brain tissue. ✅ HL234.3. Describe the signs and symptoms of traumatic brain injury (TBI) Symptoms of a TBI can be mild (often referred to as a concussion), moderate, or severe and can include: changes in LOC/altered mental status unequal size of pupils discoloration around the eyes and behind the ears trouble breathing vomiting seizures coma paralysis in infants or children, the inability to nurse, take a bottle, or eat Chapter 2 First Aid for Criminal Justice Officers / 107 Infant TBI ✅ HL234.4. Describe how traumatic brain injury (TBI) occurs in infants and children In an infant or child younger than 6 years of age, a TBI is usually caused by violent shaking or blunt impact. This type of head trauma, also known as shaken baby syndrome (SBS), is a sign of child abuse. The National Center for Shaken Baby Syndrome estimates that over a thousand children receive injuries or die from head trauma related to child abuse each year. SBS is the primary cause of death and disability from child abuse in infants and young children. Infants have weak neck muscles and delicate blood vessels in their brains. The brain floats in a fluid inside the skull. Shaking or blunt trauma to the head causes the infant’s brain to hit the inside of their skull. This action causes nerve fibers to tear and will make the infant stop crying and lose consciousness. Torn blood vessels cause swelling, which limits circulation of blood, decreases the supply of oxygen to the brain, and leads to brain damage. Visible swelling, bruising, and lacerations can help you identify but are not required for you to suspect whether abusive head trauma occurred. Signs and symptoms of head trauma can appear more quickly in infants than adults. Treatment for TBI A patient with symptoms of moderate or severe TBI should receive emergency first aid as soon as possible. The goal of treatment is to prevent further injury, and ensure proper oxygen and adequate blood supply to the brain. ✅ HL234.5. Describe how to provide treatment for an adult, child, or infant experiencing a traumatic brain injury (TBI) To treat a patient for a TBI: 1. Treat an obvious head laceration, swelling, or bruising as you would a head, scalp, or face injury. 2. Reassess every five minutes. Consider all patients with TBI as unstable. 3. If the victim is a law enforcement officer, disarm the officer at the first sign of change in mental status. Eye Trauma Types of eye injuries can involve sand or dirt in the eye, eyelid injuries, chemical burns, objects impaled in the eye, or an extruded eyeball. Treating eye injuries varies according to the nature of the injury. 108 / Florida Basic Recruit Training Program (HL): Volume 2 ✅ HL234.6. Describe how to provide treatment for an eye injury To treat a person with an eye injury: 1. Discourage the patient from rubbing their eye. This can cause more damage to the eyeball. 2. Carefully and separately, examine each eye. 3. Identify the injury’s cause, when it occurred, whether it affects both eyes, and when the patient first noticed symptoms. 4. Cover the injured eye to limit eye movement for all eye injuries. 5. Cover both eyes to limit eye movement for all severe eye injuries (such as impaled objects or extruded eyeballs). 6. Use a rigid eye shield or cover that does not press down on the eyeball to avoid further damage. To treat a patient with an eyelid injury: 1. Gently apply a patch, preferably rigid, to the affected eye. This limits eye movement, which can cause further injury. 2. Stop bleeding with light pressure if the injury does not affect the eyeball itself. To treat a patient with an impaled object in the eye: 1. Do not remove an impaled object or apply pressure to the eyeball or the object. 2. As with other impaled objects, stabilize the object. Cover the other eye to limit movement. To treat a patient for trauma to their eye socket: 1. Do not try to restore the eyeball to the socket if the eyeball extrudes from its socket. 2. Cover both eyes with a moist dressing, and apply a bandage. 3. Try to stay with the patient until EMS arrives. Neck Injuries The neck contains major blood vessels and the windpipe (trachea). Neck wounds can bleed profusely. Air entering a blood vessel in the neck can cause stroke, heart attack, or an air bubble that clogs an artery in the lungs. When assessing for a neck wound, look for obvious deformity of the neck, open wounds with possible bubbling of air, swelling, and spinal injury. Treating a neck injury varies according to the nature of the injury; however, you will apply a dress- ing followed with a bandage after the bleeding has stopped. Do not wrap the bandage around the neck but around the armpit opposite the injury. Chapter 2 First Aid for Criminal Justice Officers / 109 ✅ HL234.7. Describe how to provide treatment for an open neck wound To treat a patient with an open neck wound: 1. If the injury is spurting blood, apply direct pressure using wound packing to the artery. You will remain in this position until EMS arrives based on scene safety. 2. If the injury is a deep laceration, cover the wound with an occlusive dressing (air and water tight dressing), followed with a bandage. 3. If the injury is oozing blood, apply enough pressure to stop bleeding while maintaining an open airway and spinal motion restriction. 110 / Florida Basic Recruit Training Program (HL): Volume 2