Most of us visited the local emergency department for one or the other. It brings its older neighbor ER after a fall, or that your child be evaluated after a hard hit on the football field, you'll probably visit the local urgent care or emergency department at least twice in his life. Occasionally we hear the news of famous people dying after a head injury. As a result of media hype, my ER with everyone else in the U.S. see the immediate spike in emergency room visits for minor head trauma patients with fear. That's fine with me, as a part of my job is to give you peace of mind, and tell you that is not going to die from that little bump on your head.
However, when head injury occurs when you go to the ER and what can you expect? How do you know whether it is really "serious" head injury? Everyone knows that the ERS are expensive and crowded, and sometimes the wait to see it can be 4-6 hours. Nobody wants to waste time and money, but if your child falls and bangs his head on the table, and you'll grow purple lump on my head, what else do you do? Is it necessary to go to the ER for X-rays or CAT scan? Here are some points to consider when deciding whether to rush to the ER or not.
Does the wound? If there was a wound on his face, you should go. This is true for lacerations, and periorbital trauma (trauma to the eye socket) and nasal or oral trauma. Scalp lacerations less than 3 mm can usually be managed at home if there is significant bleeding.
What is the mechanism of injury? The vast majority of head injuries come from a fall where the head hits the ground, table or some other inanimate object. Do not let these variables dictate whether to go to the ER or not. The height of drop, or velocity of an object striking a person, not a reliable indication of potential under the injury. When in doubt, see your doctor.
is a concussion or brain injury? This is the million dollar question, and the real purpose behind this article. While moderate facial lacerations and trauma can affect some cosmetic and functional outcome, the real brain injury or brain hemorrhage, can cause death or significant life long disability. So how can you tell if it happens? Let's start with a simple definition potres.Potres is simply an injury which occurs in the brain from a blow to the head. The brain literally gets hit around the skull and can cause bruising of the brain, or worse, axonal shearing, which can be thought of as the nerve is literally torn in half. Symptoms of concussion can range from mild headaches and dizziness to severe dizziness and vomiting with confusion and inability to walk or remember events. Anyway, in most cases, a concussion is a condition in which the patient fully recovers with little or no permanent posljedice.Lukav part in claiming that someone earthquake lies in the fact that there is no test for most mild to moderate concussions. There is no black and white images or laboratories that will tell people concussed. This is strictly a clinical decision by looking at the symptoms, if symptoms are severe enough, you have to consider and explore the possibility of more serious head injuries.
of the brain bleed on the other hand is an urgent medical emergency. Blood streams into the skull putting pressure on mozak.Mozak then literally forced down into the foramen magnum, the hole where the spinal cord exits the skull. The result is that the cerebellum, a brain region responsible for respiration and cardiac function, literally gets smashed through the foramen magnum, killing the patient. As expected, patients with brain haemorrhage first experience a severe headache and vomiting, followed by neck stiffness and other neurological symptoms similar to stroke and ultimately death. If the patient has significant symptoms after the first few "golden hours", the chances are better that they are simply a concussion, and do not bleed.
I need a CAT scan? lump on the skin like a bruise that swells underneath the scalp, but above skullbones. This does not mean that bleeding inside the skull. However, because bleeding in the brain there can be so severe, often get a computer set of x-rays of the call CT.Medicinska standard of care for CT in head injury is basically this: If the patient was knocked unconscious, or is suspected of intracranial hemorrhage or fracture CT is necessary. So you can see there is some wiggle room for personal judgments about medical services. Keep in mind that studies show that during a head CT examination, a person exposed to the brain equivalent to 300 Xrays! When I order CT of the brain and skull, I highly doubt a real injury (or high suspicion of responsibility I am sorry to say!). With this in mind, if the patient has no brain bleeding symptoms, CT is not justified as exposure to high doses of radiation increases the chances of cancer and other complications.
So what's the bottom line? How do you know if you need to go to the ER? Look at the whole situation and make your own decision. Basically, if nothing to fix, such as wounds or broken bones, and the patient denies a significant headache, a walking and talking as usual, they probably do not have intracranial hemorrhage. If you are unsure, however, see a doctor! It is the court calls on your side, and no one to blame for erring on the side of caution. You can never be too careful, and as I said before, my role as a trauma and it is not only to treat patients and prescribe medications, and set your mind at ease that it will be ok.
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