Head Injury, Age 4 And Older: Emergencies

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Emergencies

• Breathing stops for longer than 15 seconds. See the topic Dealing With Emergencies.
• Unconsciousness develops at any time after the injury.
• The head injury caused a deformity of the skull, such as a sunken spot (depression), bone fragments, or exposed brain (open head injury).
• An obvious wound penetrates the skull, such as a knife or gunshot wound (open head injury). Do not remove objects from the wound.
• A seizure occurs. Protect the person from injury during the seizure.
• Signs of shock are present.
• Severe bleeding does not slow during the first 15 minutes of direct pressure. See how to stop bleeding.
• Signs of a serious spinal injury are present, including:
  • Inability to move any part of the body (paralysis), and the inability to move is not caused by a direct injury to that part of the body or severe pain.
  • Severe pain in the neck or back.
  • Weakness, tingling, or numbness in the arms or legs.
  • Loss of bowel or bladder control.
• Signs of a serious head injury are present, such as:
  • Memory loss (amnesia).
  • Confusion or not acting normal. A child with a head injury may be very fussy, fretful, or may cry constantly.
  • A severe headache, or a headache that continues to get worse.
  • Difficulty waking up or extreme sleepiness.
  • Difficulty speaking or slurred speech.
  • Loss of vision in one or both eyes, changes in the size or shape of the pupils and the reaction to light or abnormal eye movements, such as jerking motions or the eyes not working together.
  • Dizziness, vertigo, or unsteadiness that prevents standing or walking.
  • Persistent nausea and vomiting.
  • Severe stiff neck.

Last updated:	July 09, 2008
Author:	Jan Nissl, RN, BS
Reviewed By:	William M. Green, MD - Emergency Medicine, H. Michael O'Connor, MD - Emergency Medicine
Editors:	Susan Van Houten, RN, BSN, MBA, Tracy Landauer