H/o. vomiting H/o. Convulsions H/o. Bleeding through Ears, Nose or mouth
Examine Scalp for
- Hematoma – Boggy swelling - Bruising. - Black eye
Look for bleeding or CSF leak (thin watery blood) from ears & Nose.
Examine & note –
- size and reaction of pupil - Level of consciousness - Neurological weakness in limbs - Pulse rate.
Examine Head to toe-for any other injury.
Head injury alone does not cause low Blood pressure if BP is low, examine carefully for 1) internal hemorrhage in chest or abdomen and 2) Spinal cord injury.
Treatment:
Inj. T.T. ½ cc IM stat +2nd dose after 6 wks (14-7i) Inj. Novalgin 3cc IM stat if Pain. (Metamizole – 3A-1) or Tramadol
Do not give Morphin/Norphin/Pethidine, which will interfere with papillary changes. Tab. Combiflam 1 tds for pain (3c-3) Inj. Or Cap. Baciclox 500mg tds x 5 (Antibiotic =7A)
If there is CSF leak, use higher antibiotic e.g. Inj. Cefentral 1g I.V. 12hyrly (Cefotaxime = 7A-IIIa) Inj. Decadron 2cc I.V. 8hrly x 3-4 days x if evidence of cerebral edema/injury (injectible steroids =9A-2)
Locally – Dressing of abrasions
- Suturing of CLWs - Cold compresses to Hematoma & black eye
I.V. fluids – generally avoided.
- Ringer’s lactate if Hypotension.
Ask for C.T. scan if patient develops
1. Limb weakness (In unconscious patient, look for asymmetrical movements of limbs on giving a painful stimulus.) 2. pupils become unequal. 3. Bradycardia –esp if <60/min.
Decrease in level of consciousness.
Inj. T.T. ½ cc Inj. Novalgin Tab. Combiflam Inj. Or Cap. Baciclox Inj. Cefentral Inj. Decadron
