TREATING HEAD INJURIES
Section I. OPEN AND CLOSED HEAD INJURIES
A head injury may be the only injury (such as a single blow to the head from a
blunt instrument) or it may be combined with other injuries (such as head and body
injuries caused by an explosion). A head injury may consist of a cut of the scalp, a
concussion, a contusion, a fracture of the skull with injury to the brain, or a
combination of these injuries. If the skin has been broken, it is called an open head
injury. If the skin has not been broken, it is a closed head injury. Both open and
closed head injuries can be severe and life threatening.
IDENTIFY SIGNS OF AN OPEN HEAD WOUND
Bleeding from the scalp, visible skull fracture, and visible brain tissue are signs
of an open head injury. You may not be able to evaluate the seriousness of a head
injury by its appearance. A lacerated scalp may appear to be very serious due to
profuse bleeding, but the bleeding can be controlled with a dressing. What appears to
be a minor injury could be accompanied by injury to brain tissue that results in
increased intracranial pressure, which can be fatal. The open wound may be a
penetrating wound (entry wound with no exit wound) or a perforating wound (both an
entry and an exit wound).
IDENTIFY SIGNS AND SYMPTOMS OF A CLOSED HEAD INJURY
Signs and symptoms of a closed head injury include the following.
a. Deformity of the head (skull fracture).
b. Clear or bloody fluid (cerebrospinal fluid) leaking from the nose and/or ear.
c. Periorbital discoloration ("black eyes" or "raccoon eyes").
d. Bruise behind one or both ears over the mastoid process (Battle's sign).
e. Slow pulse rate (may not be present if there is significant bleeding
f. Mental confusion or memory loss.