Algorithm for providing assistance for traumatic brain injury. Emergency care for traumatic brain injury at the prehospital stage TBI first medical aid

When talking about head trauma, most people associate it with a concussion. Indeed, due to the predominance of size over the front part, the departments brain skull receive physical impacts much more often.

And, if the force of impact is high, the severity of the condition in case of brain damage, even a person’s life, may depend on the actions of people near him. Timely and correctly provided first aid for injury to the scalp can prevent possible consequences of general and neurological health and become a good basis for the rapid recovery of the victim.

Any traumatic brain injury, be it a concussion or otherwise, can occur as a result of strong blows, bruises or sudden movements of the head

The very definition of “first aid” does not imply the presence of special knowledge, much less devices for its implementation. Basic skills in determining basic vital parameters (pulse, breathing, state of consciousness), the ability to perform artificial respiration, and stop bleeding will be sufficient. And if the problem is not limited to a “bump,” you should call emergency medical services.

It should be taken into account that with traumatic brain injury (TBI) there is often confusion and the victim may not fully adequately assess his own condition. And with serious brain damage, there is a “bright period” when, after the initial clinical manifestations a period of imaginary prosperity begins.

Briefly about the types of head injuries

There are many various classifications damage.

The two large groups are:

• Facial injury - from the eyebrow line to the chin.
• Brain injury.

In both, physical factors operate:

• without damage to the covering layer – bruise, hematoma, dislocation, foreign body no penetration;
• with damage - abrasion, wound, burn; in separate groups animal bites and those resulting from the use of weapons are considered.

Traumatic brain injury is divided into:

1. closed (concussion, bruise, compression of the brain; fracture of the base of the skull) without compromising the integrity of the skin;
2. open - with a wound;
3. penetrating – with damage to the membrane of the brain.

Traumatic brain injury and first aid for it are the key to minimizing negative consequences for the patient and a way to save his life

First aid can vary significantly in scope, actions and further emergency measures, depending on the type of head injury or its combination with other injuries.

Basic principles of pre-medical intervention for head trauma

• Do no harm! Do not give (inject) to the victim medications. Do not change the position of his body (rotate) or segments (head, arms, legs) unless absolutely necessary. Do not try to remove the foreign body yourself.
• Assess the condition of the injured person. The brain's response to damage can be different: absence (under the influence of significant force), confusion (stunning), loss of consciousness. In determining the general status, the presence of cardiac activity (pulse) and spontaneous breathing is important. Assessment of the condition is complemented by identifying the leakage of blood or other fluids from wounds or the nose or ear.
• Carry out urgent measures. Providing first aid for injury to the scalp and facial part of the skull comes down to the feasible cessation of the action of the damaging factor, restoration of patency of the upper respiratory tract, fixing the head and neck with improvised means, stopping bleeding. In addition, maintaining contact is important - if the victim is conscious, it is advisable that he remains conscious.
• Organize the evacuation of the victim. Even minor cranial injuries involving the brain can cause mild disorientation - the injured person cannot be controlled vehicle. For more serious TBIs, it is recommended to call an emergency team. In the absence of consciousness and life-threatening situations, evacuation is carried out by an emergency specialized team.

Condition assessment criteria

When contacting the victim, his response can suggest how serious the injury is. Mild to moderate traumatic brain injuries are accompanied by confusion. The following may be observed: spatiotemporal disorientation, retardation, speech impairment, memory loss. Often concerned: severe headache, increased reaction to light or sound, tinnitus, dizziness, nausea and vomiting without relief. You can visually determine the pallor of the skin, increased sweating; twitching eyeballs(horizontal nystagmus), different pupil diameters; bleeding and other soft tissue damage.

Open injuries are those in which the soft fabrics heads

Severe and super-severe TBI lead to loss of consciousness, depression of cardiac and respiratory activity. The pulse is checked on the radial (on the inner surface of the forearm near the wrist joint, on the side of the thumb) or on the carotid (along the anterior edge of the neck muscle, just below the angle of the lower jaw) arteries. Breathing is determined by movement chest or tactilely, bringing the palm or forearm as close as possible to the mouth and nose of the injured person. Blood or colorless liquid may leak from the nose or ear. Convulsions are possible.

If you find a victim with a head injury in a serious or extremely serious condition, you should immediately call the ambulance and emergency medical service (mobile number 112 for all telecom operators and regions of the Russian Federation). The dispatcher will tell you the sequence of actions, remaining in touch until the doctors arrive.

Activities before the arrival of doctors

The patency of the upper respiratory tract is maintained by carefully turning the head to the side to avoid inhalation (aspiration) of vomit. In the absence of consciousness, the tongue may sink in - you need to place your palm on the victim’s cheek (the thumb will be on the cheekbone), with the pad of your index finger press on the corner of the lower jaw, which will move forward.

Emergency cardiopulmonary resuscitation is performed only in cases of significant absence of breathing and pulse. The victim should lie on his back, on a hard surface. The approximate ratio is 2 artificial breaths per 10 (for children), 15 (for adults) chest compressions. The condition is checked every 2-3 cycles.

The set of measures aimed at restoring the vitality of the body is called cardiopulmonary resuscitation

Open TBI is accompanied by bleeding. To stop (reduce) it at the first aid stage, applying a pressure bandage or manually pressing a clean cloth will be sufficient. In an emergency situation, with massive bleeding from a large vessel, it is allowed to press it into the wound with your fingers.

To fix the head and cervical segments, at the stage of pre-hospital emergency care, it is enough to apply an improvised cushion to prevent accidental movements.

Children's features

The child’s body has a high compensatory ability. This, on the one hand, protects the brain from serious damage due to frequent trauma. On the other hand, it can hide the true state. Changes in behavior and well-being as a result of a head injury should be regarded as a TBI. An urgent consultation with a neurologist is required.

The brain is a multifunctional organ that ensures the vital functions of the entire organism. Therefore, his safety and performance should come first for every person. Providing first aid for traumatic brain injury (TBI) is of paramount importance, since the damage can cause irreversible consequences, namely disruption of brain function and blood circulation, which significantly impedes the supply of oxygen to the vessels and tissues of the brain. This can cause extremely serious consequences, such as displacement of gray matter, cerebral edema, compression of blood vessels and other equally dangerous conditions, including death.

Based on the severity of injuries, 3 forms of injury can be distinguished:

1. Mild, when a person may lose consciousness, but quickly comes to his senses, no more than 20 minutes later. The patient has a typical traumatic set of symptoms: dizziness, nausea, and bouts of vomiting. Signs of hypertension or bradycardia may occur. Neurological symptoms include mild anisocoria or pyramidal insufficiency.
2. Moderate, in which loss of consciousness can last for several hours. After regaining consciousness, the patient experiences repeated vomiting attacks, possible memory loss, and mental disorders. On the part of vital function, persistent bradycardia or hypertension is possible. Neuralgic abnormalities are expressed by meningeal signs, asymmetry of muscle tone, paresis of the limbs and speech disorders are present.
3. In case of severe injury, the victim may remain unconscious for up to 1 month. There are very serious disturbances in vital functions, which pose a danger to the patient’s life. The primary manifestations here are brainstem manifestations, characterized by floating movements of the eyeballs and their divergence, respiratory disorders, bilateral mydriasis, pathological foot signs, paresis of the limbs, hormotonia, and convulsive attacks. The man is in a coma.

Injury can be of two types: open and closed.

An open injury is indicated by damage to the scalp, which may involve bone tissue and Gray matter.

If the injury involves only the skin without disrupting the aponeurosis, such damage indicates a closed head injury, which is much more common. It may be accompanied by a concussion, the severity of which is determined by partial amnesia and the length of time the victim remains unconscious.

If the patient is conscious, a concussion due to TBI will be indicated by such symptoms as paleness of the face, nausea and vomiting, cardiac arrhythmias and general activities.

In almost all cases, the consequence of brain contusion is necrosis of nerve tissue. If air gets in and internal hematomas form, the situation poses a danger to human life.

The victim is capable long time remain in a coma, then the situation may be aggravated by hemorrhage into the soft tissue of the brain.

How to determine whether you have a TBI

If the injury is of an open type, then diagnosing it will not be difficult, they will tell you about it external signs. If the resulting damage is of a closed type, then it will be more difficult to diagnose. However, there is a certain list of symptoms, based on which, a type of TBI can still be detected.

Signs of closed TBI:

• drowsiness;
• dizziness and severe weakness;
• headache;
• loss of consciousness;
• constant feeling of nausea and bouts of vomiting;
• amnesia - the victim cannot remember under what circumstances he was injured;
• paralysis is considered one of the most severe outcomes, which occurs due to a prolonged state of unconsciousness.

First aid - where to start

Considering the seriousness of the possible outcome due to traumatic brain injury, the following measures should be the first aid:

• after injury, it is important to immediately place the victim on a hard surface; until the ambulance arrives, it is necessary to continuously monitor his heartbeat and breathing;
• if a person is unconscious, then he should lie on his side, this will prevent the tongue from sinking and the airways clogging with vomit;
• provision of first aid in the presence of a traumatic brain injury should be accompanied by the application of a sterile bandage to the damaged area;
• if the wound is open, then its edges must be covered with a bandage, and only then proceed directly to applying a bandage;
• if there is no pulse, chest compressions should be started without delay;
• in the absence of breathing, perform artificial ventilation of the lungs (mouth-to-mouth artificial respiration);
• Apply a cold object, preferably ice, to the damaged area.

There should be no doubt about whether to call emergency care for a mild traumatic brain injury. The patient should be examined by medical personnel in any case, especially when it comes to the following manifestations:

• bleeding, including from the nose and ears;
• lack of breathing;
• numerous bouts of vomiting;
• if the loss of consciousness exceeds several seconds;
• confusion;
• unbearable headache;
• weakness in the limbs or immobility in one of them;
• unclear speech.

If the victim has received an open head injury, he must be examined by a doctor, even if he assures that he is feeling normal. First health care with this type of traumatic brain injury is required.

How to avoid mistakes

To help and not harm the victim, first aid for a traumatic brain injury must be correct. To do this, you should know what not to do before the doctors arrive and provide first aid:

• the victim should not be in a sitting position even if he feels normal;
• It is also impossible to change the position unnecessarily, since due to the injury the victim’s condition is unstable, unnecessary movements can significantly worsen it;
• You should not remove foreign objects (if any) from the wound, this may cause bleeding;
• the victim must be constantly in sight, since his condition is unstable and can worsen at any moment;
• Painkillers should only be administered by a medical professional; you should not do this yourself.

Providing first aid to children

The mobility of children often causes injuries. In most cases, they are injured due to a fall from a height or damage during training, but there are many other reasons.

Fortunately, children have some advantages over adults. Their skull is more plastic, and the brain tissue contains more water, which, of course, plays to the benefit of the child, softening the severity of injury when falling. The compensatory capabilities of a young body are also higher than those of adults, so most cases of brain injuries in children have a favorable outcome.

If a child is injured, emergency assistance must be called immediately. Before the doctors arrive, it is important to assess the general condition of the little person; the following signs should immediately alert you:

• deviation of consciousness, even the most short-term;
• gagging and feeling of nausea immediately after injury or after some time;
• lethargy and drowsiness;
• perspiration or cold sweat;
• memory loss;
• loss of balance;
• coordination problems.

Before the medical team arrives, the baby should be laid on a hard surface. If he is unconscious, it is important to check his breathing. To avoid asphyxia, the baby should be turned on its side.

For bleeding, only sterile dressings should be used.

It is important to understand that even in the case of a favorable outcome and the absence of visible injuries in the child, he must be examined by a doctor. If there is any suspicion of pathology, the baby will be prescribed necessary examination which will help avoid further complications.

Learning to provide first aid for TBI is the responsibility of every adult. After all, the ability to navigate in extreme situations can save a human life.

Head injuries occur due to severe damage to the skull. They can be different types, depending on the severity of the wound received. First aid for a traumatic brain injury can not only improve a person’s condition, but also save his life. The most common causes of injury are:

• car crashes;
• a strong blow to the head against something hard (ice, stone);
• falling off a bike.

How does traumatic brain injury manifest?

Traumatic brain injury can be identified by its distinctive symptoms, which usually appear gradually. As a rule, after receiving an injury, a person loses consciousness for some time.

After the patient regains consciousness, he will experience aching severe nausea and vomiting. In more severe cases, the person has difficulty speaking and walking. At the same time, his speech will be incoherent, and his face will acquire a reddish tint. When suddenly standing on his feet, he will feel dizzy and his limbs will go numb.

If the skull bones or soft tissues are severely damaged, a hematoma may form on the head or bleeding may occur. Bone fragments may also be visible. If a person has been damaged in the temporal lobe of the head, he may have seizures, partial or complete loss of memory and sensitivity (the patient will not feel pain). If first aid for head injuries is not provided in a timely manner, the patient may develop mental pathologies, strabismus, hearing or vision impairment.

First aid

Quite often, people get confused when they see an injured person, because they simply don’t know what to do in case of a traumatic brain injury. The first aid technique involves the following actions:

1. Carefully place the injured person on a flat surface with their back down.
2. If a person is unconscious or fainting, then he must be slowly turned onto his right side to allow the vomit to escape safely (so that the person does not suffocate while lying on his back),
3. Examine the wound. If it bleeds, then apply a clean (preferably sterile) bandage on top. If bone fragments are visible from the wound, then you need to apply a bandage around the wound, without touching the protruding particles.
4. Feel the pulse and heart rate.
5. Check the patient's airways for blood clots, broken teeth, etc., which may interfere with normal breathing. If there are any, then carefully remove them from the oral cavity.
6. If a person does not have a pulse, then an indirect cardiac massage should be performed.
7. If the wound (hematoma) is closed, apply cold. It will help reduce pain and swelling.

Rules for transporting a patient with brain injury

In order not to harm a person, after a traumatic brain injury it is necessary to transport him only in a supine position. In this case, the person must be securely secured to the couch with straps, otherwise, in the event of a seizure, he may fall or harm himself.

When to call an ambulance

What to do if you have a head injury? Call ambulance it is necessary at the first suspicion of, especially if it is accompanied by manifestations in the form of bleeding, convulsions, severe pain in the head or speech disorders. The danger of such an injury is that sometimes it can appear only after a few days, so it is better to avoid complications and consult a doctor in a timely manner. After a TBI, nausea or vomiting may appear a few days later. In this case, you should urgently call an ambulance.

What not to do if you have a traumatic brain injury

In case of a traumatic brain injury, it is very important not to harm the patient. To do this, you need to remember that the victim should not be lifted or tried to sit down. He should be in a lying position.

It is also important to remember that even if a person claims that he feels fine, he should not get up, since in a state of shock the patient simply may not feel the symptoms of injury.

If the victim has foreign objects (glass, iron) or bone fragments protruding from the wound, there is no need to remove them yourself, as this can cause severe bleeding.

It is also important not to leave the patient without constant supervision, since at any moment his condition can change dramatically (it can happen heart attack, loss of consciousness, occur convulsive syndrome). First aid for traumatic brain injury is aimed at stabilization general condition person.

Important! Carry out independent drug therapy (give the victim painkillers or administer painkillers medicines) is strictly prohibited, as only an experienced doctor should prescribe medications.

It is very important when providing first aid for traumatic brain injury to use sterile dressing, otherwise you can introduce an infection into the brain tissue, which will cause blood poisoning.

Every conscious person should know the basic rules for providing emergency care for a traumatic brain injury in order to be able to help the victim if necessary. After assistance is provided, the victim should be observed by a doctor. If there was, parents should carefully monitor his condition.

The brain is protected from external (mechanical) factors better than any other organ. In addition to the bones of the skull, the meninges protect it from damage. The fluid that bathes the brain also acts as a shock absorber. However, traumatic brain injury (TBI) is one of the most common reasons for seeking help from medical institutions. In the general structure of injuries, TBI accounts for over 50% of cases, and, in last years there is a tendency to increase their number, as well as to worsen the injuries themselves. This is not least due to the increase in the pace of life (especially in cities) and the increase in the number of vehicles on the roads. Treatment of traumatic brain injury is the task of traumatologists and neurosurgeons. In some cases, patients require the help of neurologists and even psychiatrists.

Consequences of traumatic brain injury

A victim may experience the following as a result of a head injury:

• mechanical disruption of the integrity of brain tissue;
• disturbance of cerebrospinal fluid dynamics;
• hemodynamic disorders;
• neurodynamic disorders;
• formation of scars and adhesions.

During concussions, reactive and compensatory changes develop at the level of synapses, neurons and cells.

Bruises are characterized by the presence of visible lesions and hematomas.

If during a traumatic brain injury there is damage to the stem structures or the hypothalamic-pituitary system, a specific stress response develops due to a disturbance in the exchange of neurotransmitters.

The cerebral circulatory system is particularly sensitive to traumatic injuries. With TBI, spasm or dilation of regional vessels occurs, and the permeability of their walls increases. A direct consequence of vascular disorders are disorders of liquorodynamics.

Dysmetabolic disorders and hypoxia develop against the background of TBI. Severe injuries can provoke respiratory and hemodynamic disorders.

The so-called “traumatic disease” includes 3 periods:

• spicy;
• intermediate;
• remote.

Depending on the severity and type of TBI, the duration of the first period is from 2 weeks to 2.5 months. Acute phase determined by a combination of damaging factors and defense reactions. This is the time interval from the onset of exposure to a traumatic factor until the restoration of body functions or death.

IN intermediate period the processes of lysis and repair actively occur in damaged areas. At this stage, compensatory and adaptive mechanisms are activated, contributing to the return of impaired functions to normal indicators(or permanent compensation). The duration of the second period can be from 6 months to 1 year.

Final (remote) period characterized by the completion of degeneration and recovery. In some cases they continue to coexist. The duration of the phase against the background of clinical recovery is 2-3 years, and with further development of the process it is very uncertain.

Classification of traumatic brain injury

Note:injuries in this category are divided into closed, open and penetrating.

Closed TBI– these are head injuries accompanied by the development of clinical symptoms, but without serious damage to the skin.

Open– these are injuries with damage to the layers of skin and aponeurosis of the skull.

Penetrating injuries characterized by a violation of the integrity of the hard shell.

Condition assessment

During the initial examination and examination of the patient in a medical facility, the following factors must be taken into account:

The severity of a traumatic brain injury is assessed by 3 factors:

• state of consciousness;
• vital functions;
• neurological symptoms.

Severity of TBI

1. Satisfactory The patient’s condition is considered if he has clear consciousness, there are no violations of the most important functions, there are no primary and secondary neurological Clinical signs. With timely and correctly carried out therapeutic measures, nothing threatens life, and working capacity is fully restored.
2. For moderate injuries consciousness is clear or there is some stupor. Vital functions are not affected, but the number of heartbeats may decrease. Individual focal signs can be diagnosed. There is virtually no threat to life if prompt care is provided. qualified assistance. The prognosis for full recovery after such a traumatic brain injury is quite favorable.
3. In severe condition The patient experiences severe stupor or develops stupor - depression of consciousness, in which loss of voluntary activity occurs and reflex activity persists. Impaired respiratory and circulatory functions are recorded, and neurological symptoms are present. Paresis, paralysis, etc. are possible. The threat to life is quite obvious, and the degree of danger is determined by the duration of the acute phase. The prospects for full recovery after severe TBI are rather doubtful.
4. Signs very serious condition are coma, inhibition of a number of important functions and pronounced neurological symptoms (both primary and secondary). The threat to life is very serious, and full recovery from injury usually does not occur.
5. The most dangerous condition –terminal . It is characterized by coma, critical impairment of vital important functions, as well as deep stem and cerebral disorders. Unfortunately, it is extremely rare to save the victim in such a situation.

Symptoms of traumatic brain injury

Clinical symptoms allow us to draw preliminary conclusions about the nature of the traumatic brain injury.

Concussion is accompanied by reversible cerebral disorders.

Characteristic symptoms:

• short-term darkening or (up to several minutes);
• slight stupor;
• some difficulties with orientation in space;
• loss of memory of the period of time after the injury;
• motor agitation (rare);
• (cephalgia);
• (not always);
• decreased muscle tone;
• nystagmus (involuntary eye vibrations).

During the neurological examination, instability in the Romberg position may be noted. Symptoms usually regress quickly. Organic signs disappear without a trace in the next 3 days, but vegetative disorders persist much longer. The patient may complain of vascular symptoms - decreased or increased blood pressure, coldness and blue fingers, as well.

Bruises (UGM)

Clinically, there are 3 degrees of UGM – mild, moderate and severe.

Signs of a mild brain injury:

• loss of consciousness (up to 20-40 minutes);
• vomit;
• amnesia;
• cardiopalmus;
• (may be missing).

Moderate neurological symptoms regress within 2-3 weeks after such a traumatic brain injury.

Note:The fundamental difference between a bruise and a concussion is the possibility of fracture of the bones of the vault and the presence of subarachnoid hematomas.

Signs of moderate UGM:

A neurological examination reveals meningeal and brainstem symptoms. The main organic manifestations disappear within 2-5 weeks, but some clinical signs of a traumatic brain injury make themselves felt for a long time.

Signs of severe UGM:

• consciousness is absent for up to several weeks;
• there are life-threatening impairments of essential functions;
• motor agitation;
• paralysis;
• hypo- or hypertonicity of muscles;
• convulsions.

The reverse development of symptoms is slow, and residual disorders often occur, including mental disorders.

Important:a sign that is 100% likely to indicate a fracture of the base of the skull is the release of cerebrospinal fluid from the ear or nose.

The appearance of symmetrical hematomas around the eyes (“glasses”) gives reason to suspect a fracture in the area of ​​the anterior cranial fossa.

Compression

Compression often accompanies bruises. The most common causes are hematomas various localizations and damage to the bones of the arch with their depression. Less commonly, damage is caused by swelling of the brain tissue and pneumocephalus.

Symptoms of compression can increase sharply immediately after a traumatic brain injury or after a certain (“bright”) time period.

Characteristic signs of compression:

• progressive impairment of consciousness;
• cerebral disorders;
• focal and stem signs.

Possible complications of TBI

The greatest danger in the acute phase is from dysfunctions of the respiratory system (respiratory depression and gas exchange disorders), as well as problems with central and regional (cerebral) circulation.

Hemorrhagic complications are cerebral infarctions and intracranial hemorrhages.

With severe traumatic brain injuries, dislocation (displacement) of parts of the brain is possible.

Against the background of TBI, the likelihood of complications of a purulent-inflammatory nature is quite high. They are divided into intra- and extracranial. The first group includes abscesses, and, and the second, for example,.

Note:Possible complications include post-traumatic and.

First aid for traumatic brain injury

Important: first aid in case of traumatic brain injury is to provide the victim with complete rest. He needs to be given a horizontal position with his head raised. If the patient is unconscious, he cannot be moved, since the possibility of spinal injury cannot be ruled out. It is advisable to apply a heating pad to the head with cold water or an ice pack. If breathing or cardiac activity stops, before the ambulance arrives, it is necessary to carry out resuscitation measures– indirect cardiac massage and artificial respiration.

Primary care for patients is provided in the nearest medical institution. The scope of primary care is determined by the severity of the patient’s condition and the capabilities of physicians. The primary task of doctors is to maintain respiratory and circulatory functions. It is extremely important to restore the patency of the airways (it is often impaired as a result of aspiration of blood, secretions or vomit).

Treatment of any traumatic brain injury is carried out in an inpatient setting. Depending on the nature and severity of the injuries, they resort to conservative tactics or perform neurosurgical intervention.

In case of psychomotor agitation or convulsions, relaxants are administered intravenously (for example, Diazepam). Symptoms of compression are a good reason to prescribe diuretics. If there is a threat of edema, osmodiuretics are used and the victim is immediately taken to the neurosurgical department.

To stabilize blood circulation, vasoactive pharmacological agents are administered, and if there is a likelihood of hemorrhage in the subarachnoid space, hemostatic agents are indicated.

In the treatment of traumatic brain injury, neuroprotectors, neurometabolic stimulants, vitamin preparations and glutamic acid. To combat disorders of liquorodynamics, dehydration drugs are needed.

The duration of treatment depends on the type and severity of TBI and the dynamics of the recovery process. Even with mild concussions, the patient is advised to remain on bed rest for one and a half weeks.

Plisov Vladimir, medical observer

The brain is the “control center” of all human life support systems. Any injuries associated with blows, bruises or the head area cause poor blood supply to brain cells and cause disruption of its functions.

Traumatic brain injury is a head injury that disrupts the integrity of the bones and skin skull, brain functioning. Such violations are always accompanied characteristic symptoms neurotic character. For traumatic brain injury, first aid helps prevent serious consequences of injury, facilitating treatment and recovery. Sometimes prompt medical intervention saves the patient’s life.

Damage to the skull and their characteristics

The causes of injuries of this type are mechanical effects on the cranial vaults. The main provocateurs of TBI are the following factors:

• Road traffic accidents and other accidents involving vehicles;
• Injury at work;
• Damage at home;
• , resulting in damage to the head area.

It is important to know that the specific manifestations of injury are determined by the severity of the TBI, as well as its type. Sometimes the symptoms are so nonspecific that making a diagnosis without appropriate diagnostics is also difficult for experienced physicians. Due to the frequent latent (“light”) periods when the patient feels relief due to the cessation of symptoms, many people who have been injured do not want to see a doctor. However, this is a big mistake. After 2-3 hours, a concussion again makes itself felt with a sharp deterioration in well-being.

To understand what first aid to provide for a scalp injury, you need to clearly distinguish between the types of concussions.

The presence or absence of changes in the integrity of muscle and bone tissue There are 3 types of TBI:

1. Closed craniocerebral injury;
2. Open skull injury;
3. Penetrating damage.

First you need to understand what a closed traumatic brain injury is. Statistics show that closed type damage occurs most often. They affect exclusively the skin, preserving the integrity of the aponeurosis. This type of injury often results in a concussion, which includes unconsciousness and amnesia.

An open TBI is easy to recognize: it is accompanied by serious damage of the skin with the participation of the aponeurosis. Possible injury to bone and gray matter.

With penetrating injury, the lining of the brain is directly injured.

Features of providing first aid for head injuries also depend on the type of injury. This characteristic of TBI is considered to be prevalent, having specific symptoms and condition of the victim.

Let us consider the manifestations of each of them, highlighting the characteristic symptoms.

Shake

Considering that macrostructural pathologies are not recorded in it, concussion is a reversible process: damage affects only the cellular level. During hardware examination (CT and MRI), no deviations from the norm are recorded.

Characteristic symptoms:

• , the duration of which does not exceed 2-3 minutes or only a few seconds;
• Short-term memory loss;
• Development of nausea, turning into vomiting.

After regaining consciousness, the patient experiences dizziness, headache, “spreading” over the entire head area, excessive sweating. There may be a short-term visual impairment, manifested by double vision or flashing “spots”.

With timely primary care, the main symptoms that this brain injury causes disappear within 6-8 days.

Injury

In case of a brain contusion, serious macrostructural changes in the brain substance are clearly recorded, the manifestations of which include hemorrhage and destruction. They are often accompanied by a fracture of the base of the skull, which causes numerous hemorrhages.

The victim’s condition is characterized by the severity of these two interrelated factors. The peculiarities of their manifestation make it possible to divide brain contusions into 3 groups. It can be mild, moderate and severe.

1. Mild degree.

Lack of consciousness lasts no more than 20 minutes. After a person comes to his senses, characteristic symptoms appear:

• Dizziness;
• Memory loss;
• Bradycardia;
• Trembling of hands and chin;
• Walking on tiptoes;
• Hypertension;
• Headache, “spread” over the entire head area;
• Involuntary repetitive eye movements;
• Pyramidal insufficiency may occur.

2.Medium degree.

Lack of consciousness is recorded for more than 3 hours. Having regained consciousness, the patient suffers from painful bouts of vomiting. There are obvious mental disorders and deep memory lapses.

Symptoms are pronounced:

• Significant;
• Weak heartbeat;
• Throwing back the head;
• Manifestations of uneven distribution of muscle tone;
• Inability to move limbs;
• Speech disorders.

3. Severe degree.

Lack of consciousness continues for weeks, and can last up to 1 month. Depression of respiratory and circulatory functions is recorded, which can lead to fatal outcome sick. The patient falls into a coma, which is manifested by the following symptoms:

• Floating rotation of the eyeballs;
• Immobilization of limbs;
• Attacks of convulsive contractions.

Compression

Pressure on the brain occurs due to hematomas that are located above the brain. Their development is provoked by broken bones of the skull. The symptoms are the same as for a brain injury. However, the pressure of hematomas has an important feature: the presence of a “light” period, when all signs disappear and the patient feels absolutely healthy.

However, rapid swelling of the brain, accompanied by an increase in its volume, again leads to a coma.

Regardless of the type and degree of damage encountered, after providing first aid for head injuries, you should immediately contact a health care facility for full examination and prescribing appropriate treatment.

Specifics of emergency measures before hospitalization

In case of traumatic brain injury, emergency care consists of using observation techniques, recording indicators important for maintaining a person’s life, and, if necessary. The main task lifesaver is to maintain functioning important organs and systems of the patient.

In case of TBI, immediately call a team medical workers carried out if the patient has one of the following symptoms:

• Impaired breathing and circulation;
• Continuous from the wound;
• Bleeding from the ears and nose;
• Being unconscious for more than 30 seconds;
• Unbearable headache;
• Unclear consciousness;
• Loss of balance and orientation;
• Frequently repeated;
• Continuous vomiting;
• Inability to move an arm or leg;
• Slurred speech.

Note!

The presence of an open skull injury requires immediate hospitalization!

Very important!

During the conversation with the ambulance dispatcher, describe in detail the condition of the victim, the presence or absence of bleeding.

The emergency care algorithm consists of quick and consistent actions:

1. The patient is placed on a flat, hard surface.
2. Inspect the site of injury to determine the type and nature of the injury.
3. They determine the stability of the heart and lungs by measuring the pulse and controlling breathing.
4. If a person is in a deep faint, his body is turned on his side to avoid the penetration of vomit into the esophagus and the retraction of the tongue.
5. If the patient has an open head wound, bandaging and disinfection are mandatory conditions for providing first aid for a traumatic brain injury. Before doctors arrive, the wound (its edges) must be treated with a disinfectant solution to prevent infections. To do this, the edges of the damaged area of ​​the head are first covered with soft bandages, and then the bandage itself is used. It should be tight enough to stop bleeding, but not so tight that it puts pressure on the soft tissue.
6. Apply cold to the injured part of the head.
7. Immobilize the neck by covering it with rollers.
8. If necessary, first aid of a resuscitation nature is provided: indirect cardiac massage and artificial respiration.

Before medical personnel arrive, you should not leave the scene of the incident: at any moment the person may fall into unconsciousness again.

In case of a traumatic brain injury accompanied by a wound, first aid is provided according to the same principle as for an open type of injury.

Important information

Help with a head injury does not require special skills, but an inexperienced person may become confused, especially if there is a large loss of blood when the skull is damaged. Therefore, it is important for the rescuer to stop panicking and strictly follow the instructions outlined above. Moreover, mistakes made can cause serious consequences of a traumatic brain injury, only aggravating the condition of the victim.

We list the actions that are prohibited to perform at the stage before hospitalization:

• Trying to sit the patient down;
• Move the victim, abruptly changing his position;
• Offer to the patient medications or food;
• Leave the person alone until paramedics arrive;
• Try to straighten the bone fragments protruding from the wound yourself;
• Remove foreign objects from the wound.

The victim must be examined by doctors. After this, the person is hospitalized. The doctor warns the patient about possible consequences serious injury if he refuses to go to the hospital.

Treatment for traumatic brain injuries is tailored to the extent and type of injury. Most often, therapy consists of actions aimed at improving cerebral circulation and prevention of cerebral edema. Strict adherence to bed rest and complete rest is mandatory. For this purpose, sedatives are prescribed.

At severe forms TBI treatment consists of emergency surgical intervention, with the help of which accumulated hematomas are removed.

Remember that with a head injury, the lack of timely assistance leads to death in 70% of cases. Moreover, inaction in such a situation provides for criminal penalties.