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Head and Face Injuries

Head and Face Injuries. Cerebral Concussion. Definition: immediate and transient posttraumatic impairment of neural functions Estimated 250,000 or more a year Can take up to 30 minutes or 1 hr for symptoms to appear

destiny-mcgowan
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Head and Face Injuries

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  1. Head and Face Injuries

  2. Cerebral Concussion • Definition: immediate and transient posttraumatic impairment of neural functions • Estimated 250,000 or more a year • Can take up to 30 minutes or 1 hr for symptoms to appear • There are a variety of grading scales and return to play criteria. It is best to have a protocol determined by your athletic staff, ATC and physician. • Always handle head trauma with great caution

  3. For more information on concussions or health issues go to www.cdc.gov • There is a Free CDC Tool Kit on Concussions for High School Coaches! • If your athlete sustains a head injury and there is no medical professional, it is always best to treat the situation with the most conservative care possible. • Each situation will be different and you may have to obtain parents consent when dealing with a minor. • An MD clearance note should always be encouraged

  4. Cerebral Concussion • Signs and symptoms: • Dizziness • Disorientation • Headache • Amnesia • Tinnitus (ringing in the ears) • Balance problems • Nausea/vomiting • Change in personality

  5. Cerebral Concussion • American Academy of Neurology Concussion GradingScale • Grade 1 (mild) Transient confusion; no LOC*; symptoms and mental status abnormalities resolve <15 min • Grade 2 (moderate) Transient confusion; no LOC; symptoms and mental status abnormalities last >15 min • Grade 3 (severe) Any LOC *LOC indicates loss of consciousness

  6. Cerebral Concussion • What do you do? • #1: sit athlete down and ask questions and observe signs and symptoms - ask questions related to memory and orientation to rule out amnesia • Questions: • Do you know where you are? • Can you tell me what happened? • Do you know who we are playing? • Do you have pain in your neck? • Do you remember who we played last week?

  7. Cerebral Concussions • Observe and check: • PEARL • Balance • Memory • Retrograde Amnesia - can’t remember anything that occurred immediately before injury • Anterograde Amnesia - can’t remember anything that occurred after injury • Athlete must sit 15-20 minutes and then reevaluate

  8. Cerebral Concussion • Symptoms subside - they may return to activity - “mild head injury” • Symptoms remain - they are out for the game or practice and must be cleared by a physician to return • Any loss of consciousness (LOC) - keep athlete where they are, do not move and call 9-1-1

  9. Cerebral Concussion • Expected return to play: • Many different scales (clearance by MD) • Grade I = one week asymptomatic • Grade 2 = clearance by a physician, usually one to two weeks asymptomatic • Grade 3 = clearance by a neurologist, usually one to three months or more depending on severity

  10. Cerebral Concussion • Home care instructions • Make sure parents/guardians know situation and what happened • Make sure roommates or friends know and monitor • Have someone watch for: • Increasing headache • Disorientation • Vomiting • Impairment of consciousness • Unequal pupils • Fluids from nose and ears • If these appear, then get to MD or call 9-1-1 • Controversies: • Sleep vs. no sleep: many MD’s recommend to let the athlete sleep so they can get rest but you should have someone check on them every couple of hours • Medications: make sure athletes do not take anything because it will mask the symptoms

  11. Post-Concussion Syndrome • Post-concussion syndrome may appear for a variable amount of time following injury • Athlete has problems with attention (especially trying to concentrate), anxiety, abnormal giddiness and headaches

  12. Second Impact Syndrome • Cause = due to rapid swelling and herniation of the brain after a second head injury • S&S = within 15 sec - min, the condition worsens rapidly, dilated pupils, LOC • Care = CALL 9-1-1

  13. Facial Injuries • Jaw fracture (mandible fx): 2nd incidence of all facial fractures • Cause = blow to jaw - lower more common • S&S = deformity, loss of occlusion of teeth, pain when biting, bleeding around teeth, numbness • Care = cold packs and refer to ER or MD - rule out head injury. Full activity resumed in 2-3 months

  14. Facial Injuries • Zygomatic (cheekbone fracture): Third most common facial fracture • Cause = blow to cheek • S&S = deformity in cheek region, crackling (crepitus) when you push on cheek, nosebleed, diplopia • Care = cold packs and referral - rule out head injury, healing usually takes 6-8wks

  15. Orbital hematoma (black eye) • Reduce inflammation (ice and compression), check for concussion • Orbital fracture (blowout fx) • Fracture of the bones that surround the eye • S&S: restricted movement of eye, diplopia (double vision), swelling, hemorrhage, numbness • Management = ice, refer for xray * If very painful, cover both eyes and transport in recumbant position (call 9-1-1)

  16. Skull fracture Cause = direct trauma S&S = severe headache, nausea, blood in ear canal, bleeding from nose • Raccoon eyes = ecchymosis around eyes • Battle sign = ecchymosis behind the ears • Cerebrospinal fluid = straw colored fluid in nose or ear Care = call 9-1-1, do not move athlete, monitor vitals and ABC’s

  17. Facial Injuries • Dental Trauma • Tooth Fracture = very sensitive and painful (nerve exposed) - stop bleeding and if able athlete can return and see dentist after the game (24-48 hrs) • Dislocated tooth = rinse tooth and place back in socket, keep in saline (salt water) or milk, store in tooth savor • Need to see dentist within 30 minutes - refer immediately

  18. Facial Injuries • Nasal fracture: most common fracture of the face • S&S = nose bleed, swelling, deformity, abnormal ability or crepitus • Care = control bleeding, refer to physician • Usually can play when symptoms subside and proper protection is maintained

  19. Facial Injuries Nosebleed: • How do I stop bleeding? • Ice • Have athlete lean forward and pinch bridge of nose • Place noseplug, gauze, or tissue up into nostril • Place skin lube or vaseline on noseplug to aid in clotting • Place a rolled piece of gauze under upper lip

  20. Eye Injuries • Corneal abrasion: foreign object usually rubbed - athlete complains of pain, watering and eye spasm that won’t subside - refer to eye physician • Retinal detachment: painless, but athlete complains of seeing specks, flashes of light or blurred vision, usually lose part of visual field - immediate referral to eye physician

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