Traumatic brain injuries, diagnosis, symptoms of concussion and contusion of the brain, first aid and field transportation.

Traumatic brain injuries most often occur in car accidents, falling from a height, or falling stones, or any other heavy objects on the head, when turning the boat (raft) on rifts and rapids. 

Traumatic brain injuries, diagnosis, symptoms of concussion and contusion of the brain, first aid and field transportation.

Classification of head injuries.

With a closed head injury to the head, bones and skin integuments are not damaged. This form includes concussion (mild damage) and brain bruises. In another (more severe case) hemorrhage occurs in the cranial cavity, which may have a different origin..

and breathing, inconstancy of pupil reactions to external light stimuli is noted. Reacts to pain stimuli with a grimace or twitching of limbs.

7. Coma. Complete immobility and lack of reaction to all types of stimuli, all reflexes completely disappear, the pupils dilate, breathing is disturbed, pronounced cardiovascular insufficiency appears.

If traumatic brain injuries are accompanied by a prolonged loss of consciousness, then a complete loss of orientation in time and the absence of memories of the moment of injury are possible. Symptoms are also manifested, such as visual, hearing, speech impairment, impaired coordination of movements, impaired heart rate, body thermoregulation, respiratory failure, and vomiting occurs. These are the first signs of serious complications..

Symptoms of a concussion.

Complaints of a pressing headache in the temples, heaviness or aches in the head, burning and painful pulsation in the temporal or frontal region.
From a few seconds to 1-3 minutes, short-term memory loss for events preceding the injury, or the time immediately after it, but the general condition is satisfactory.
Often there are delayed reactions to irritation, up to a severe degree of stupor, weakness.
Immediately after the injury, repeated vomiting, which does not bring relief; persistent nausea.
There may be double vision in the eyes of the front sight, sometimes asymmetry of facial expressions.
The skin is normal or slightly pale, followed by redness.
Heart rate is normal or with a slight deviation, which quickly recovers.
There are no signs of hemorrhage and hemorrhage, no damage to the bones of the skull.

With such an injury, the restoration of a normal state without outside intervention will occur within 1-3 weeks.

Symptoms of a brain contusion.

Complaints of a sharp pressing or throbbing headache, ringing in the ears, double vision in the eyes, vomiting that does not bring relief.
Loss of consciousness from a moderate degree of stunning to a coma, depending on the severity of the injury. Loss of memory can affect a fairly large period of time 1-2 hours, loss of orientation.
Speech impairment, divergent strabismus, facial asymmetry, impaired motor functions and motor coordination, normal or pale skin integuments, followed by redness.
With a severe degree of damage, pallor or sticky cold sweat is observed, which, with penetrating wounds, indicates severe blood loss.
With a mild to moderate degree of brain contusion, the cardiovascular system is normal, but short-term heart rate disturbances may also be observed..
With a severe bruise of the brain, a persistent disturbance of the heart rhythm occurs, and with cerebral edema due to compression of the medulla oblongata, cardiac arrest and breathing may occur (in a deep coma).

After the victim is withdrawn from a coma, his breathing, expressed as a spasm of the bronchi and glottis, may be impaired.
Possible leakage of blood and mucus into the respiratory tract; sudden vomiting does not bring relief. Often there is increased mobility of the muscles of the neck and legs (in the form of a spasm).
Often, a brain contusion can occur both independently and accompany all cases of fractures of the base and cranial vault..
With mild to moderate damage, the restoration of all functions occurs for at least 4 weeks.
With a severe degree accompanying open brain injuries, the condition of the victim becomes life threatening, in this case the development of cerebral edema, its compression and wedging of the brain into the occipital foramen are possible, which leads to death.
In addition, with open injuries, an intracerebral infection may occur, which leads to the development of meningitis or meningitis encephalitis.

Features of transportation of a victim with a traumatic brain injury in the field.

Transportation of a victim with a traumatic brain injury in all cases from mild to severe is carried out in the supine position, without full mobilization of the body. The victim can be transported on a soft stretcher, in a cocoon, in a sleeping bag, through which a stick is inserted, depending on the circumstances. In winter, it’s more convenient to use a drag or ski drag for transportation.

In order to avoid pressure sores, you need to put soft things under the ankles, knee joint, hip, elbow and wrist joint of the back of the arm and under the head. In winter and in the glacial zone, this is especially important.. During transportation of the victim, nutrition depends on his general condition. If he is conscious, then you can feed him in the usual way. If he has vomiting, then the liquid is injected into him in the form of an enema (if there is one), in extreme cases, pour water into the mouth in small portions between the vomits. And you will have to give up solid food for a while.

If there is a first aid kit, then for pain it is necessary to give the patient painkillers analgesics, gradually increasing the dose and changing drugs. Antispasmodics are also desirable.. Traumatic brain injuries require peace and quiet, the light should not be bright. Sleeping pills are advisable at night. When warm (a tent, a hunting hut, etc.), the victim’s head must be covered with something cold, for example, with bags or bags of snow, ice, but in each case this is decided individually, depending on the condition of the victim and his body temperature.

The choice of driving order depends on the severity of the injury and the condition of the person. In severe traumatic brain injury, especially when the victim is in an unconscious state, you need to transport as quickly as possible. Since the victim does not need rest, it is necessary to carry him as much time as the carriers have enough strength, including at night, if the terrain allows and it is possible to ensure complete safety of movement.

If the victim is conscious and with more minor injuries (for example, a concussion), during transportation rest is still necessary for both the victim and the group members. For an overnight stay in such a situation, prepare in advance and dawn. First of all, the most convenient conditions for the victim are created.. Be sure to drink it with hot tea and cook light food.

For the entire rest time, the victim needs complete rest. During each shorter stop, the victim needs to massage those parts of the body where pressure sores are possible. Particular problems arise during the administration of natural needs (defecation, urination), as well as in the case of the collection of copious vomit. If there are plastic bags, use them if there is no underwear (like rags), and rinse with water.

Based on materials from the book Encyclopedia of Survival.
Chernysh I. V.

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