Severe Hypothermia

Severe hypothermia is life-threatening. Mild hypothermia (32–35 °C body temperature) is usually easy to treat. However, the risk of death increases as the core body temperature drops below 32 °C. If core body temperature is lower than 28 °C, the condition is life-threatening without immediate medical attention

Symptoms of hypothermia include shivering, cold skin, slurred speech and confusion. Babies with hypothermia may feel cold and limp.
Hypothermia needs to be treated quickly. If you think someone has it, call 999 and try to gradually warm them up while you wait for help to arrive.
Causes of hypothermia include not wearing warm clothes in cold weather, falling into cold water and living in a cold house.
Keeping your house warm, having warm drinks and wearing extra layers when you’re outside in the cold can help reduce your risk of hypothermia.
Early signs of hypothermia include:
shivering
cold and pale skin
slurred speech
fast breathing
tiredness
confusion
These are symptoms of mild hypothermia, where someone’s body temperature is between 32C and 35C.
If their temperature drops to 32C or lower, they’ll usually stop shivering completely and may pass out.
This is a sign that their condition is getting worse and emergency medical help is needed.
Hypothermia in babies:
Babies with hypothermia may look healthy, but their skin will feel cold.
They may also be limp, unusually quiet and refuse to feed.
SELF-CARE
You should call 999 and then give first aid if you think someone has hypothermia.
First aid for hypothermia:
To warm the person up:
1. Move them indoors.
2. Remove any wet clothing and dry them.
3. Wrap them in blankets.
4. Give them a warm non-alcoholic drink, but only if they can swallow normally.
5. Give energy food that contains sugar, such as a chocolate bar, but only if they can swallow normally.
If the person cannot be moved indoors, find something for them to rest on to protect them from the cold ground, like a towel or a blanket.
If they do not appear to be breathing – and you know how to do it – give them CPR, but you must continue this until professional help arrives in the form of the ambulance service or a medical team.
Things to avoid:
Some things can make hypothermia worse:
do not put the person into a hot bath
do not massage their limbs
do not use heating lamps
do not give them alcohol to drink
These actions can cause the heart to suddenly stop …
Be Prepared To Resuscitate

Stroke

A stroke is a very serious condition where the blood supply to part of your brain is cut off. It needs to be treated in hospital as soon as possible.

Common symptoms of a stroke include your face dropping on 1 side, not being able to lift your arms and slurred speech.
A stroke needs to be treated in hospital as soon as possible. Treatments include medicines to treat blood clots and sometimes brain surgery.
A stroke can be caused by either a blood clot in the brain or bleeding in the brain.

The main symptoms of stroke can be remembered with the word FAST:
Face – the face may have dropped on 1 side, the person may not be able to smile, or their mouth or eye may have dropped.
Arms – the person with suspected stroke may not be able to lift both arms and keep them there because of weakness or numbness in 1 arm.
Speech – their speech may be slurred or garbled, or the person may not be able to talk at all despite appearing to be awake; they may also have problems understanding what you’re saying to them.
Time – it’s time to dial 999 immediately if you see any of these signs or symptoms.

MEDICAL TREATMENTS
Treatment depends on the type of stroke you have, including which part of the brain was affected and what caused it.
Strokes are usually treated with medication. This includes medicines to prevent and dissolve blood clots, reduce blood pressure and reduce cholesterol levels.
In some cases, procedures may be required to remove blood clots. Surgery may also be required to treat brain swelling and reduce the risk of further bleeding if this was the cause of your stroke.

Cardiac Arrest Survival

Most cardiac arrests occur when a diseased heart’s electrical system malfunctions. This malfunction causes an abnormal heart rhythm such as ventricular tachycardia or ventricular fibrillation. Some cardiac arrests are also caused by extreme slowing of the heart’s rhythm (bradycardia).

Coronary artery disease is the most common cause of sudden cardiac death, accounting for up to 80% of all cases. Cardiomyopathies and genetic channelopathies account for the remaining causes. The most common causes of non-ischemic sudden cardiac death are cardiomyopathy related to obesity, alcoholism, and fibrosis

Can sudden cardiac arrest be prevented? Death is best treated by prevention. Most sudden death is associated with heart disease, so the at-risk population remains males older than 40 years of age who smoke, have high blood pressure, and diabetes (the risk factors for heart attack).

Ventricular fibrillation disrupts the heart’s pumping action, stopping blood flow to the rest of the body. A person in sudden cardiac arrest will collapse suddenly and lose consciousness, with no pulse or breathing

Common heart attack signs and symptoms include: Pressure, tightness, pain, or a squeezing or aching sensation in your chest or arms that may spread to your neck, jaw or back. Nausea, indigestion, heartburn or abdominal pain. Shortness of breath.

Paediatric seizures

Pediatric absence seizures (also called petit mal seizures) are characterized by a brief altered state of consciousness and staring episodes.

Typically the child’s posture is maintained during the seizure. The mouth or face may move or the eyes may blink. The seizure usually lasts no longer than 30 seconds.

Anything that interrupts the normal connections between nerve cells in the brain can cause a seizure.

This includes a high fever, high or low blood sugar, alcohol or drug withdrawal, or a brain concussion. But when a child has 2 or more seizures with no known cause, this is diagnosed as epilepsy.

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CPR during covid 19

COVID-19 in relation to CPR and resuscitation in first aid and community settings

Whenever CPR is carried out, particularly on an unknown victim, there is some risk of cross infection, associated particularly with giving rescue breaths. Normally, this risk is very small and is set against the inevitability that a person in cardiac arrest will die if no assistance is given. The first things to do are shout for help and dial 999.

Recognise cardiac arrest by looking for the absence of signs of life and the absence of normal breathing.

Do not listen or feel for breathing by placing your ear and cheek close to the patient’s mouth. If you are in any doubt about confirming cardiac arrest, the default position is to start chest compressions until help arrives.

Make sure an ambulance is on its way. If COVID 19 is suspected, tell them when you call 999.

If there is a perceived risk of infection, rescuers should place a cloth/towel over the victims mouth and nose and attempt compression only CPR and early defibrillation until the ambulance (or advanced care team) arrives. Put hands together in the middle of the chest and push hard and fast.

Early use of a defibrillator significantly increases the person’s chances of survival and does not increase risk of infection.

If the rescuer has access to any form of personal protective equipment (PPE) this should be worn.

After performing compression-only CPR, all rescuers should wash their hands thoroughly with soap and water; alcohol-based hand gel is a convenient alternative.

We are aware that paediatric cardiac arrest is unlikely to be caused by a cardiac problem and is more likely to be a respiratory one, making ventilations crucial to the child’s chances of survival. However, for those not trained in paediatric resuscitation, the most important thing is to act quickly to ensure the child gets the treatment they need in the critical situation.

For out-of-hospital cardiac arrest, the importance of calling an ambulance and taking immediate action cannot be stressed highly enough. If a child is not breathing normally and no actions are taken, their heart will stop and full cardiac arrest will occur.

Therefore, if there is any doubt about what to do, this statement should be used.

It is likely that the child/infant having an out-of-hospital cardiac arrest will be known to you.

We are aware that doing rescue breaths will increase the risk of transmitting the COVID-19 virus, either to the rescuer or the child/infant. However, this risk is small compared to the risk of taking no action as this will result in certain cardiac arrest and the death of the child.

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Sepsis / Blood Poisoning

Sepsis is a potentially life-threatening condition triggered by an infection or injury. It is also known as blood poisoning or septicaemia.

Symptoms of sepsis

In sepsis, the body’s immune system goes into overdrive as it tries to fight an infection.

This can reduce the blood supply to vital organs such as the brain, heart and kidneys. Without quick treatment, sepsis can lead to multiple organ failure and death.

Early symptoms of sepsis are difficult to distinguish from most infections, and may include:

  • a high temperature (fever); though this may not be present: and due to changes in the circulation (blood flow in the body) there may be a low body temperature instead
  • chills and shivering

You should be aware about potential sepsis symptoms if you/your child/someone you are with:

  • becomes very unwell
  • are acting differently than they have previously when experiencing an infection
  • have a fast heartbeat
  • have fast breathing /difficulty breathing

In some cases, symptoms of more severe sepsis or septic shock develop soon after when your blood pressure drops to a dangerously low level.

These can include:

How sepsis is treated

If sepsis is detected early and hasn’t affected vital organs yet, it may be possible to treat the infection at home with antibiotics. Most people who have sepsis detected at this stage make a full recovery.

Almost all people with severe sepsis and septic shock require admission to hospital. Some people may require admission to an intensive care unit (ICU).

Because of problems with vital organs, people with severe sepsis are likely to be very ill and the condition can be fatal.

However, sepsis is treatable if it is identified and treated quickly. In most cases, this leads to a full recovery with no lasting problems.

Recovering from sepsis

The amount of time it takes to fully recover from sepsis varies, depending on factors such as:

  • the severity of the sepsis
  • the person’s overall health
  • how much time was spent in hospital
  • whether treatment was needed in an ICU

Some people make a full recovery quicker than others and not everyone experiences long-term problems.

However, possible problems may include physical symptoms, such as:

  • feeling lethargic or excessively tired
  • muscle weakness
  • swollen limbs or joint pain
  • chest pain or breathlessness
  • post-sepsis syndrome

People at risk

Anyone can develop sepsis after an injury or minor infection, although some people are more vulnerable.

People most at risk of sepsis include those:

  • with a medical condition or receiving medical treatment that weakens their immune system
  • who are already in hospital with a serious illness
  • who are very young or very old
  • who have just had surgery or who have wounds or injuries as a result of an accident

Sepsis, septicaemia and blood poisoning

Sepsis is often known as either blood poisoning or septicaemia. However, these terms refer to the invasion of bacteria into the bloodstream.

Sepsis can affect multiple organs or the entire body, even without blood poisoning or septicaemia.

Sepsis can also be caused by viral or fungal infections. Although bacterial infections are by far the most common cause.

Airway Obstruction in Children

What is airway obstruction?

If your child is struggling to breathe, turning blue, or has a battery stuck in their ear, nose or throat, seek emergency medical care right away.

Airway obstruction, also known as foreign body airway obstruction, happens when a small item gets stuck in a child’s throat or upper airway and makes it hard for the child to breathe. Because of its small size, a child’s airway can get blocked when a piece of food or a small, round object like a coin or marble gets lodged in their throat. Other common household items like drapery cords or plastic bags can strangle or suffocate a child.

On average, 5,000 children, ages 14 and under, are treated in hospital emergency rooms each year for airway obstruction. The majority of these children are ages 4 and under.

More than 650 children die in a given year from choking, strangulation, suffocation or getting trapped in a household appliance or toy chest.

How to reduce the risk of airway obstruction

Cut food into small pieces

The American Academy of Pediatrics (AAP) recommends that children younger than 4 should not be fed any round, firm food unless the food is cut into small, non-round pieces. Young children may not chew food properly, swallow food whole and start choking. Foods to avoid or cut into small pieces for children under age 4 include:

  • hot dogs whole or sliced into circles
  • meat chunks
  • whole grapes
  • popcorn
  • peanuts and other whole nuts
  • pumpkin seeds and other seeds
  • raisins
  • raw carrots

Children younger than 4 should not be given hard candy or chewing gum.

Young children can eat hot dogs and grapes, as long as the skins are taken off and the food is cut into small, non-round pieces.

Supervise your child’s eating

Always keep your eye on young children while they are eating. Sometimes, choking can occur when an older child feeds a younger sibling unsafe food. Ensure that your young children sit upright while eating, and never allow them to walk, play or run with food in their mouths.

Keep choking hazards out of reach

Nonfood items that are small, round, or conforming can be a choking hazard to your young child. You may want to purchase a small parts tester to help determine which items are choking hazards. Make sure your child plays with age-appropriate toys, keeping small items that are a choking hazard out of reach. Check under your furniture and between seat cushions for choking hazards such as:

  • coins
  • small balls
  • balloons (inflated and deflated)
  • marbles
  • small game parts
  • small toy parts
  • safety pins
  • jewelry
  • buttons
  • pen caps
  • round coin-like batteries (like for a watch)

Remove strangulation and suffocation hazards

Children can strangle themselves with consumer products that wrap around the neck, such as window blind and drapery cords, ribbons, necklaces, pacifier strings and drawstrings on clothing. A few tips to keep in mind to keep your child safe:

  • Tie up or cut all window blind and drapery cords, and remove any hood and neck drawstrings from your children’s outerwear.
  • Do not allow your child to wear necklaces, purses, scarves, or clothing with drawstrings on playground equipment.
  • Do not allow your child to play on beanbag chairs that contain small foam pellets — if the bean bag chair rips, your child can inhale and choke on the pellets.
  • Do not allow your young child to play with shooting toys. An arrow, dart or pellet can be a choking hazard if shot into a child’s mouth.
  • Make sure the spacing between bed guardrails, frames, and all spaces in the head- and foot-boards do not exceed 3.5 inches. Small passages through which a child’s body, but not the head, fit can strangle a child. This includes spaces in bunk beds, cribs, playground equipment, baby strollers, carriages and high chairs.

Remove suffocation hazards

Infants can suffocate in soft bedding, or when a person rolls over onto them in an adult bed. Here are a few other tips to help prevent suffocation:

  • Discard plastic bags and plastic wrapping that could cover the nose and mouth and suffocate a small child.
  • Remove the doors of unused household appliances and lids from toy chests so that children can not become trapped and suffocate inside.
  • Do not let children under age 6 sleep on the top bunk of a bunk bed as they could strangle or suffocate themselves if they fall.

Place sleeping infants on their backs

The medical community recommends placing infants on their backs in their cribs to reduce the risk of sudden infant death syndrome (SIDS). Placing infants on their backs may also reduce the chance of choking. Infants may have a difficult time lifting their heads if they are face down. The crib should adhere to national safety standards, with a firm, flat mattress. Avoid putting soft bedding, toys, and other soft products, pillows and comforters in the crib with your infant.

Hip Fracture

A hip fracture is a serious injury, with complications that can be life-threatening. The risk of hip fracture rises with age.

Risk increases because bones tend to weaken with age (osteoporosis). Multiple medications, poor vision and balance problems also make older people more likely to fall — one of the most common causes of hip fracture.

A hip fracture almost always requires surgical repair or replacement, followed by physical therapy. Taking steps to maintain bone density and avoid falls can help prevent a hip fracture.

Symptoms

Signs and symptoms of a hip fracture include:

  • Inability to get up from a fall or to walk
  • Severe pain in your hip or groin
  • Inability to put weight on your leg on the side of your injured hip
  • Bruising and swelling in and around your hip area
  • Shorter leg on the side of your injured hip
  • Outward turning of your leg on the side of your injured hip

Causes

A severe impact — in a car crash, for example — can cause hip fractures in people of all ages. In older adults, a hip fracture is most often a result of a fall from a standing height. In people with very weak bones, a hip fracture can occur simply by standing on the leg and twisting.

Risk factors

The rate of hip fractures increases substantially with:

  • Age. Bone density and muscle mass tend to decrease with age. Older people can also have problems with vision and balance, which can increase the risk of falling.
  • Your sex. Hip fractures occur in women about three times more often than they do in men. Women lose bone density faster than men do, in part because the drop in estrogen levels that occurs with menopause accelerates bone loss. However, men also can develop dangerously low levels of bone density.
  • Osteoporosis. If you have this condition, which causes bones to weaken, you’re at increased risk of fractures.
  • Other chronic medical conditions. Endocrine disorders, such as an overactive thyroid, can lead to fragile bones. Intestinal disorders, which can reduce your absorption of vitamin D and calcium, also can lead to weakened bones.

    Medical conditions that affect the brain and nervous system, including cognitive impairment, dementia, Parkinson’s disease, stroke and peripheral neuropathy, also increase the risk of falling.

    Having low blood sugar and low blood pressure also can contribute to the risk of falls.

  • Certain medications. Cortisone medications, such as prednisone, can weaken bone if you take them long-term. Certain drugs or certain combinations of medications can make you dizzy and more prone to falling. Drugs that act on your central nervous system — such as sleep medications, antipsychotics and sedatives — are most commonly associated with falls.
  • Nutritional problems. Lack of calcium and vitamin D in your diet when you’re young lowers your peak bone mass and increases your risk of fracture later in life. It’s also important to get enough calcium and vitamin D in older age to try to maintain the bone you have. As you age, try to maintain a healthy weight. Being underweight increases the risk of bone loss.
  • Physical inactivity. Lack of regular weight-bearing exercise, such as walking, can result in weakened bones and muscles, making falls and fractures more likely.
  • Tobacco and alcohol use. Both can interfere with the normal processes of bone building and maintenance, resulting in bone loss.

Complications

A hip fracture can reduce your independence and sometimes shorten your life. About half the people who have a hip fractures aren’t able to regain the ability to live independently.

If a hip fracture keeps you immobile for a long time, the complications can include:

  • Blood clots in your legs or lungs
  • Bedsores
  • Urinary tract infections
  • Pneumonia
  • Further loss of muscle mass, increasing your risk of falls and injuries
  • Death

Prevention

Healthy lifestyle choices in early adulthood build a higher peak bone mass and reduce your risk of osteoporosis in later years. The same measures adopted at any age might lower your risk of falls and improve your overall health.

To avoid falls and to maintain healthy bone:

  • Get enough calcium and vitamin D. As a general rule, men and women age 50 and older should consume 1,200 milligrams of calcium a day, and 600 international units of vitamin D a day.
  • Exercise to strengthen bones and improve balance. Weight-bearing exercises, such as walking, help you maintain peak bone density. Exercise also increases your overall strength, making you less likely to fall. Balance training also is important to reduce your risk of falls, since balance tends to deteriorate with age.
  • Avoid smoking or excessive drinking. Tobacco and alcohol use can reduce bone density. Drinking too much alcohol can also impair your balance and make you more likely to fall.
  • Assess your home for hazards. Remove throw rugs, keep electrical cords against the wall, and clear excess furniture and anything else that could trip you. Make sure every room and passageway is well lit.
  • Check your eyes. Have an eye exam every other year, or more often if you have diabetes or an eye disease.
  • Watch your medications. Feeling weak and dizzy, which are possible side effects of many medications, can increase your risk of falling. Talk to your doctor about side effects caused by your medications.
  • Stand up slowly. Getting up too quickly can cause your blood pressure to drop and make you feel wobbly.
  • Use a cane, walking stick or walker. If you don’t feel steady when you walk, ask your doctor or occupational therapist whether these aids might help.

What is a head injury

Head Injury

What is a head injury?

Head injuries are one of the most common causes of disability and death in adults. The injury can be as mild as a bump, bruise (contusion), or cut on the head, or can be moderate to severe in nature due to a concussion, deep cut or open wound, fractured skull bone(s), or from internal bleeding and damage to the brain.

A head injury is a broad term that describes a vast array of injuries that occur to the scalp, skull, brain, and underlying tissue and blood vessels in the head. Head injuries are also commonly referred to as brain injury, or traumatic brain injury (TBI), depending on the extent of the head trauma.

Head injuries are rising dramatically–about 1.7 million people have a TBI each year. Millions of Americans are alive today who have had a head injury and now need help with the activities of daily living, costing the country more than $56 billion per year.

What are the different types of head injury?

The following are some of the different types of head injuries:

  • Concussion. A concussion is an injury to the head area that may cause instant loss of awareness or alertness for a few minutes up to a few hours after the traumatic event.
  • Skull fracture. A skull fracture is a break in the skull bone. There are four major types of skull fractures, including the following:
    • Linear skull fractures. This is the most common type of skull fracture. In a linear fracture, there is a break in the bone, but it does not move the bone. These patients may be observed in the hospital for a brief amount of time, and can usually resume normal activities in a few days. Usually, no interventions are necessary.
    • Depressed skull fractures. This type of fracture may be seen with or without a cut in the scalp. In this fracture, part of the skull is actually sunken in from the trauma. This type of skull fracture may require surgical intervention, depending on the severity, to help correct the deformity.
    • Diastatic skull fractures. These are fractures that occur along the suture lines in the skull. The sutures are the areas between the bones in the head that fuse when we are children. In this type of fracture, the normal suture lines are widened. These fractures are more often seen in newborns and older infants.
    • Basilar skull fracture. This is the most serious type of skull fracture, and involves a break in the bone at the base of the skull. Patients with this type of fracture frequently have bruises around their eyes and a bruise behind their ear. They may also have clear fluid draining from their nose or ears due to a tear in part of the covering of the brain. These patients usually require close observation in the hospital.
  • Intracranial hematoma (ICH). There are several types of ICH, or blood clots, in or around the brain. The different types are classified by their location in the brain. These can range from mild head injuries to quite serious and potentially life-threatening injuries. The different types of ICH include the following:
    • Epidural hematoma. Epidural hematomas occur when a blood clot forms underneath the skull, but on top of the dura, the tough covering that surrounds the brain. They usually come from a tear in an artery that runs just under the skull called the middle meningeal artery. Epidural hematomas are usually associated with a skull fracture.
    • Subdural hematoma. Subdural hematomas occur when a blood clot forms underneath the skull and underneath the dura, but outside of the brain. These can form from a tear in the veins that go from the brain to the dura, or from a cut on the brain itself. They are sometimes, but not always, associated with a skull fracture.
    • Contusion or intracerebral hematoma. A contusion is a bruise to the brain itself. A contusion causes bleeding and swelling inside of the brain around the area where the head was struck. Contusions may occur with skull fractures or other blood clots such as a subdural or epidural hematoma. Bleeding that occurs inside the brain itself (also called intraparenchymal hemorrhage) can sometimes occur spontaneously. When trauma is not the cause, the most common causes are long-standing, high blood pressure in older adults, bleeding disorders in either children or adults, or the use of medications that cause blood thinning or certain illicit drugs.
    • Diffuse axonal injury (DAI). These injuries are fairly common and are usually caused by shaking of the brain back and forth, which can happen in car accidents, from falls or shaken baby syndrome. Diffuse injuries can be mild, such as with a concussion, or may be very severe, as in diffuse axonal injury (DAI). In DAI, the patient is usually in a coma for a prolonged period of time, with injury to many different parts of the brain.

What causes a head injury?

There are many causes of head injury in children and adults. The most common traumatic injuries are from motor vehicle accidents (automobiles, motorcycles, or struck as a pedestrian), from violence, from falls, or as a result of child abuse. Subdural hematomas and brain hemorrhages (called intraparenchymal hemorrhages) can sometimes happen spontaneously.

What causes bruising and internal damage to the brain?

When there is a direct blow to the head, shaking of the child (as seen in many cases of child abuse), or a whiplash-type injury (as seen in motor vehicle accidents), the bruising of the brain and the damage to the internal tissue and blood vessels is due to a mechanism called coup-countrecoup. A bruise directly related to trauma, at the site of impact, is called a coup (pronounced COO) lesion. As the brain jolts backwards, it can hit the skull on the opposite side and cause a bruise called a countrecoup lesion. The jarring of the brain against the sides of the skull can cause shearing (tearing) of the internal lining, tissues, and blood vessels that may cause internal bleeding, bruising, or swelling of the brain.

What are the symptoms of a head injury?

The person may have varying degrees of symptoms associated with the severity of the head injury. The following are the most common symptoms of a head injury. However, each individual may experience symptoms differently. Symptoms may include:

  • Mild head injury:
    • Raised, swollen area from a bump or a bruise
    • Small, superficial (shallow) cut in the scalp
    • Headache
    • Sensitivity to noise and light
    • Irritability
    • Confusion
    • Lightheadedness and/or dizziness
    • Problems with balance
    • Nausea
    • Problems with memory and/or concentration
    • Change in sleep patterns
    • Blurred vision
    • “Tired” eyes
    • Ringing in the ears (tinnitus)
    • Alteration in taste
    • Fatigue or lethargy
  • Moderate to severe head injury (requires immediate medical attention)–symptoms may include any of the above plus:
    • Loss of consciousness
    • Severe headache that does not go away
    • Repeated nausea and vomiting
    • Loss of short-term memory, such as difficulty remembering the events that led right up to and through the traumatic event
    • Slurred speech
    • Difficulty with walking
    • Weakness in one side or area of the body
    • Sweating
    • Pale skin color
    • Seizures or convulsions
    • Behavior changes including irritability
    • Blood or clear fluid draining from the ears or nose
    • One pupil (dark area in the center of the eye) is dilated, or looks larger, than the other eye and doesn’t constrict, or get smaller, when exposed to light
    • Deep cut or laceration in the scalp
    • Open wound in the head
    • Foreign object penetrating the head
    • Coma (a state of unconsciousness from which a person cannot be awakened; responds only minimally, if at all, to stimuli; and exhibits no voluntary activities)
    • Vegetative state (a condition of brain damage in which a person has lost his thinking abilities and awareness of his surroundings, but retains some basic functions such as breathing and blood circulation)
    • Locked-in syndrome (a neurological condition in which a person is conscious and can think and reason, but cannot speak or move)

The symptoms of a head injury may resemble other problems or medical conditions. Always consult your doctor for a diagnosis.

How are head injuries diagnosed?

The full extent of the problem may not be completely understood immediately after the injury, but may be revealed with a comprehensive medical evaluation and diagnostic testing. The diagnosis of a head injury is made with a physical examination and diagnostic tests. During the examination, the doctor obtains a complete medical history of the patient and family and asks how the injury occurred. Trauma to the head can cause neurological problems and may require further medical follow up.

Diagnostic tests may include:

  • Blood tests
  • X-ray. A diagnostic test that uses invisible electromagnetic energy beams to produce images of internal tissues, bones, and organs onto film.
  • Computed tomography scan (also called a CT or CAT scan). A diagnostic imaging procedure that uses a combination of X-rays and computer technology to produce horizontal, or axial, images (often called slices) of the body. A CT scan shows detailed images of any part of the body, including the bones, muscles, fat, and organs. CT scans are more detailed than general X-rays.
  • Electroencephalogram (EEG). A procedure that records the brain’s continuous, electrical activity by means of electrodes attached to the scalp.
  • Magnetic resonance imaging (MRI). A diagnostic procedure that uses a combination of large magnets, radiofrequencies, and a computer to produce detailed images of organs and structures within the body.

Treatment of a head injury

Specific treatment of a head injury will be determined by your doctor based on:

  • Your age, overall health, and medical history
  • Extent of the head injury
  • Type of head injury
  • Your tolerance for specific medications, procedures, or therapies
  • Expectations for the course of the head injury
  • Your opinion or preference

Depending on the severity of the injury, treatment may include:

  • Ice
  • Rest
  • Topical antibiotic ointment and adhesive bandage
  • Observation
  • Immediate medical attention
  • Stitches
  • Hospitalization for observation
  • Moderate sedation or assistance with breathing that would require being placed on a breathing machine, or mechanical ventilator or respirator
  • Surgery

Treatment is individualized, depending on the extent of the condition and the presence of other injuries. If the patient has a severe head injury, he or she may require monitoring for increased intracranial pressure (pressure inside the skull). Head injury may cause the brain to swell. Since the brain is covered by the skull, there is only a small amount of room for it to swell. This causes pressure inside the skull to increase, which can lead to brain damage.

How is ICP monitored?

Intracranial pressure is measured in two ways. One way is to place a small hollow tube (catheter) into the fluid-filled space in the brain (ventricle). Other times, a small, hollow device (bolt) is placed through the skull into the space just between the skull and the brain. Both devices are inserted by the doctor either in the intensive care unit (ICU) or in the operating room. The ICP device is then attached to a monitor that gives a constant reading of the pressure inside the skull. If the pressure goes up, it can be treated right away. While the ICP device is in place the patient will be given medication to stay comfortable. When the swelling has gone down and there is little chance of more swelling, the device will be removed.

Lifelong considerations for a person with a head injury

The key is to promote a safe environment for children and adults and to prevent head injuries from occurring in the first place. The use of seat belts when riding in the car and helmets (when worn properly) for activities, such as bicycle riding, in-line skating, and skateboarding may protect the head from sustaining severe injuries.

Persons who suffer a severe brain injury may lose muscle strength, fine motor skills, speech, vision, hearing, or taste function, depending on the brain region involved and the severity of brain damage. Long- or short-term changes in personality or behavior may also occur. These persons require long-term medical and rehabilitative (physical, occupational, or speech therapy) management.

The extent of the person’s recovery depends on the type of brain injury and other medical problems that may be present. It is important to focus on maximizing the person’s capabilities at home and in the community. Positive reinforcement will encourage the patient to strengthen his/her self-esteem and promote independence.

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Chelyabinsk, Russia – December 5, 2015: mixed martial arts fighter (MMA) stands in corner ring. lost fight. defeat of an opponent during Cup of Russia MMA

Why people are scared of carrying out cardiac arrest

For people who suffer cardiac arrest outside of a  hospital, the biggest difference between those who survive and those who don’t is that a bystander performed CPR on the survivors.

The difference is that stark. CPR can double or even triple the chance of survival. And for those who suffer cardiac arrest outside of a hospital, surviving often means getting CPR from a passing layperson who may not be a medical professional.

That’s why it’s so essential for everyone to get trained in CPR, and be willing to deliver it if need be. But the tragic thing is that cardiac arrest victims don’t get CPR from bystanders as often as they could. Bystanders are often reluctant to perform CPR—even if they’ve gone through training, and even though they could save a life.

Here are some common misconceptions and fears that keep people from providing lifesaving care when the chips are down.

Fear of hurting the victim.

Many people hesitate to perform CPR because they worry that they may do more harm than good. They may even break a rib.

The thing is, if you’re doing CPR right, it’s likely to break ribs. Compressions should be at a depth of about two inches on a full-grown adult in order to get the blood moving in the body. That takes about 60 pounds of force.

According to a 2015 study, as many as 86% of men and 91% of women experienced a bone injury in the chest after receiving CPR—including sternum fractures, rib fractures, and sternocostal separations.

However, these injuries are survivable. Cardiac arrest isn’t, unless the victim gets immediate lifesaving care. Most people would agree that a few broken ribs are preferable to death.

Fear of being sued.

That’s all well and good—but what if, after saving someone’s life by delivering CPR, that person turns around and sues you for your actions?

It’s possible, but unlikely. Good Samaritan laws vary by state, but all have protections for bystanders delivering CPR. It’s in the interests of the country to encourage people to provide CPR, and the law reflects that.

As long as you’re responding the way a reasonable person would, providing care according to your level of training, and are not being compensated for your actions, these laws should protect you from a lawsuit.

Fear of catching a disease.

It’s not unusual to have an instinctive ick-factor reaction when it comes to mouth-to-mouth resuscitation. For many, the possibility of catching a contagious disease stops them from helping a cardiac arrest victim—even when they know CPR.

You can contract bacteria and viruses through mouth-to-mouth contact with an infected person. Chances are low that this will happen during rescue breathing, but it’s possible.

However, you don’t need to give rescue breaths in order to deliver effective CPR. Recently, the AHA released new guidelines for hands-only CPR that require lay rescuers only to “push hard and fast in the center of the chest,” to the tune of “Stayin’ Alive” by the Bee Gees. You can skip the mouth-to-mouth part altogether.

Hands-only CPR has been shown to be just as effective as traditional CPR in bystander rescue situations. In some studies, it’s even more effective—possibly because people are more willing to give this type of CPR in the first place.

Fear of doing it wrong.

Studies have shown that about 70% of Americans don’t have the confidence to perform CPR in an emergency situation—and would be reluctant to provide it for this reason.

Again, that’s where hands-only CPR comes in. It’s far less complicated than the traditional version—there’s no need to try to remember the ratio of compressions to rescue breaths, or slow down your compressions to provide breaths.

Hands-only CPR is very easy to learn and administer—even for people with no medical training. There’s really only one step—push hard and fast in the center of the chest.

Today, anyone can learn and administer CPR—and the learning process only takes minutes.

Fear of inappropriate touching.

According to a study conducted by researchers at UPenn, women are less likely to receive CPR than men—because some rescuers are afraid to touch a female victim’s chest.

This has real-world consequences. The study found that men were 23% more likely to survive cardiac arrest than women, because rescuers were more reluctant to deliver CPR to women. In examining over 20,000 cases nationwide, the study found that only 39% of women in cardiac arrest outside of a hospital got bystander CPR—as opposed to 45% of men.

Over 350,000 people suffer cardiac arrest in America each year outside of a hospital setting. Approximately 90% of them do not survive. Those numbers could be improved with CPR training—and the knowledge to overcome these misconceptions.