Category Archives: Head Injuries

Posted in Roy on Rescue • Training Questions • Accidents • Cold Related • Head Injuries • Trauma • Patient Assessment

How Do I Treat Neck Injuries On The Ice?

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In this episode we answer a question that was sent in by a Rescue Fan that wondered what the best course of action would be if a person suffered a neck injury on the ice. It’s important to remember that if the patient has any pain, movement minimization is the goal while maintaining the patients core body temperature while waiting for EMS to arrive. If the person doesn’t feel hurt, they may elect to slowly get to their feet and recover. If they do feel pain, numbness, tingling, weakness or loss of consciousness, the best course of treatment neck injuryin my opinion is to call 911 or EMS. I hope it helps.

Posted in Roy on Rescue • Head Injuries

What Is Cerebral Venous Sinus Thrombosis?

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Hello Rescuers!

I received an email from a RoyOnRescue friend who had suffered a head injury while playing a sport.  After being seen by the doctor he was diagnosed with Cerebral Venous Sinus Thrombosis or (CVST).  He had asked me if I would give my explanation of what it is and if it was something he should be worried about.  His doctor had exCSVTplained it but he was still a bit foggy regarding the diagnosis.  Well, after looking into it from the clinical perspective, I realized that it was a pretty big deal and in some cases may be fatal.  I researched multiple sources to gather credible information and when it all came down to brass tacks, I found that the Wikipedia explanation had done a pretty dog-gone good job of summarizing CSVT.  So, with all credit given to them for most of this article and a link back to their website, here it is.

I have personally responded and treated many different types of head injuries as a paramedic but had not researched this problem to this level.  Then, shortly after receiving this question, I read that  Secretary of State, Hillary Clinton was diagnosed and hospitalized with the very same problem secondary to her head injury!  Ironic.   So, I thought to myself, if two people experienced this problem secondary to a common traumatic head injury(concussion), there may be more with the same question.

Here’s my trimmed-down version of what it is, what it’s symptoms are, how to determine if it is truly CSVT and then what a person may want to do if they think they may be suffering from such a complication.  So let’s dig into some of the questions you may have!  P.S.  You’ll notice there are more links then usual in this article.  The topic is so complex and has so many different facets I thought it wise to allow you to do some of your own information mining and hope the links make it easier.

Q:  What is a cerebral venous sinus thrombosis anyway?

A:  A CVST is the presence of thrombosis (a blood clot) in the dural venous sinuses, which drain blood from the brain. 

Q:  What causes a CVST?

A:  There can be many causes of CVST.  Here is a few I included:

Q:  How might I know if I have a CVST?

A: Headache that may worsen over the period of several days, but may also develop suddenly.  Strangely the headache may be the only symptom of cerebral venous sinus thrombosis.  Stroke, 40% of all patients have seizures, Common symptoms in the elderly with this condition are otherwise unexplained changes in mental status and a depressed level of consciousness.  The pressure around the brain may rise, causing papilledema (swelling of the optic disc) which may be experienced as visual problems.  In severely raised intracranial pressure, the level of consciousness is decreased, the blood pressure rises, the heart rate falls.  This is a common symptom found in closed head injuries which makes sense as the mechanism is very similar.

Q:  How will the doctor know if this is what I have?

A:  The most commonly used tests are computed tomography (CT) and magnetic resonance imaging (MRI), both using various types of radiocontrast to perform a venogram and  visualise the veins around the brain

Q:  How is a CVST treated and cured?

A: Treatment is with anticoagulants (medication that suppresses blood clotting), and rarely thrombolysis (enzymatic destruction of the blood clot). Given that there is usually an underlying cause for the disease, tests may be performed to look for these. The disease may be complicated by raised intracranial pressure, which may warrant surgical intervention such as the placement of a shunt.

AmbulanceQ:  Can this be serious?

A:  Yes.  Like any illness or injury that causes a problem with the circulation of oxygenated blood to our tissues, this type of problem can be very dangerous if left untreated.  It also runs a risk of complication in that it raises the intracranial pressures which can act similar to a closed head injury and this too can cause severe injury or death.  If a person has any of the symptoms listed above, they should be seen as soon as possible to rule out this potentially life threatening disorder.  If a person is reacting with decreased level of consciousness, or any type of life threatening complications, activation of Emergency Medical Services or 911 should be immediate with life saving or time buying intervention given.

 

I hope this helps and keep well!

See Source:

http://en.wikipedia.org/wiki/Cerebral_venous_sinus_thrombosis

http://neurology.jwatch.org/cgi/content/full/2007/515/2

http://www.medscape.com/viewarticle/705510_3

 

 

Posted in Roy on Rescue • Sports Related • Concussions • Head Injuries

How to Hit Your Head on Pavement at 17MPH and Survive!

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Imagine riding your road bike and as you near a curve in the bike trail hitting speeds of around 17 miles per hour your front tire instantly goes flat.  Now you’re trying to corner on a metal rim sliding across the pavement which has as much traction as an ice skating rink.   This is exactly what happened to Tom Monett, cycling enthusiast, big mountain skier, hiker and mountain climber.  As Tom’s bike slid out from underneath him, he didn’t have enough time to catch himself let alone think about what was about to happen.  As his head hit the pavement, and his ribs began to break, his wisdom to ride with personal protective equipment most likely made the difference between life and death.  Watch this episode of royonrescue to see the full interview and hear his story about surviving a high speed cycling crash.

Concussion

Warning!  Video contains graphic pictures of injuries and accidents.

Video Gallery of Actual Bike Accidents

Posted in Roy on Rescue • Sports Related • Broken Bones • Broken Ribs • Concussions • Head Injuries • CPR for Instructors • CPR for Providers • Patient Assessment

“Head and Shoulders, Knees and Toes…”

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A student emailed a question regarding the Head to Toe exam.  Though this is normally performed as a secondary survey in a more advanced setting, I do think there are times where knowing how to check a person for other injuries is a good idea.  Take a look at the video blog and I hope this helps.
Best Wishes,
Roy

Posted in Roy on Rescue • Accidents • Concussions • Head Injuries • CPR for Instructors • CPR for Providers

Concussion vs. Closed Head Injury

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Ever see someone hit their head very hard?   Wonder if it’s just a minor “Knock on the Noggin” or could it be a serious head injury?  In this Roy On Rescue Video Blog entry, Roy Shaw, EMT-Paramedic answers those questions with directives on how to assess, stabilize and treat a person for a serious head injury or minor. There’s nothing worse than sitting with a crying child or an injured adult and wonder if we are over reacting by calling 911, or under reacting by not doing more. Watch this video blog for some interesting insights straight from the Paramedics mouth on what to do.

Don’t miss this entry where Roy puts a common sense spin on how to handle the next event where someone hits their head and no one knows if they should go in to the hospital or just sleep off the headache.

Watch the video below if you would like to see a video animation of what happens in the skull when a person hits their head.

A website that shows a video explaining a traumatic closed head injury is located at: http://www.youtube.com/watch?v=AmAML1-F2LE

Posted in Roy on Rescue • Accidents • Concussions • Head Injuries

What To Do If A Person Falls and Hits Their Head

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A concerned Good Samaritan(G.S.) wrote me a question and I thought it would be good to share it with you on RoyOnRescue(ROR).

G.S.: “In my scenario, the person fell down hit their head twice and then fell onto the floor face down. I am now wondering if we did the right thing. We picked the person up and carried her outside for fresh air where she revived immediately. We  then monitored the person but nothing else seemed to be wrong with her.”

ROR:  It sounds like the story ends well regardless of the treatment given which is always great!  There may be a few things that we cold improve upon for the future. Let’s analyze what happened and what we might be able to do differently next time to protect and help the fall victim even more.

Whenever a person falls, there is a risk for head and neck injury. As stated in your scenario, this particular person did  hit their head… twice.  This would be enough mechanism of injury that instead of moving the person right away, we would want to minimize movement while assessing the person for any signs or symptoms of other injuries.  We can minimize movement by softly but confidently speaking to the patient who is either conscious or unconscious and place one hand carefully on the victims forehead to help remind them and us not to move their head and neck.   Try to find out  if the person is breathing on their own and if their skin color is somewhat normal while they are lying in the position found. If they are breathing and skin color is good, we do not have to move the person before Emergency Medical Services arrive.

If assessing the person’s airway is impossible in this position,(face down) we may need to carefully roll the person over onto their back even if we suspect that there may be a serious neck or back injury.  We do not move spinal chord injury patients unless they need cpr, their airway is compromised or they are in danger due to the environment.

If we determine that we must roll, or move a person with a suspected spinal chord injury, utilize several people if available,  in order to minimization spinal movement.  If you are the only person, then do the job the best way you can and follow the “Life Over Limb” philosophy.  If the person wakes and is not complaining of any pain or numbness and they don’t allow you to minimize movement because they want to get up, they should be allowed to do so.  It is not wise to hold the person down as this can complicate injuries the patient already sustained trying to wrestle.  Keep encouraging the person to stay still until help arrives by the ambulance service. Keep the person in a position of comfort with confident words of encouragement like, you are in good hands, I’m going to take good care of you and help is on the way.  If they still refuse treatment, there is little you can do at that point other than inform  911 of what has happened.

It sounds as though you did the best you could for this person at the time.  Remember,  most people don’t even get involved when someone needs help.  The fact that you did get involved and tried to help makes you a natural rescuer!

I thought a video clip of all different fainting episodes would not only get my point across that falls can cause injuries to the person even if the fainting spell or the reason they fell wasn’t serious. I hope you don’t feel faint watching others faint but if you want to see what happens to people when they fall from standing up, take a look at the clip below.

P.S. One of the most effective rescue moves for a person who is starting to faint, is to simply help them to the floor before they fall!

Best Wishes,

Roy On Rescue