What if

[Yarrow]

The other day I was called by my eldest son's (21 yo) boss where he had been injured...

scene... he works with heavy equipment... was undoing towing chains on the trailer and boss left the bucket of the loader down as my son was coming up... bad, very bad collision with his head and the loader bucket..

next scene... blacks out.. and sees stars... can't see straight and slurs words... boss and wife contact me and take him to the nearest emergency room...

hospital scene.. two sets of xrays and cat scan... secure neck in a neck brace... seems okay and sent home...

NOW.. in a SHTF situation... how would one know if and how severe the damage would have been... and how should one handle it???

I mean... head injuries for the most part shouldn't be played with... and fortunately outside of a severe headache for 3 days now... and very sore back... he is going to be okay... but I still wonder how to handle this situation in a backwoods situation...

any thoughts would be appreciated...

[Craig]

Here is what I would do. I dont for a moment suggest its the the only way.


Assuming the story is similar to your sons case.

I would support his airway and breathing until he was fully awake, and immobilise his cervical spine also.

Once he woke up fully I would clear is c-spine clinically ie. no midline pain / fully conscious / no deformity / no altered neurology.

If unable to clinically clear it, in the absence of any chance of x-ray, I would make a clinical guess and decide either to clear it or phili collar (or similar) for a few weeks

Then your stuck with observing him. If anything bad is going to happen 99 + % will happen in the first 24 hours, most within the the first 4-6.

We CT scan people way too much. If your son had come to my hospital, and was fully conscious when he arrived, there is a good chance he wouldnt have been scanned. Its not because we dont have easy access, just because the indication in a young person with brief loc and now fully conscious is very debateable.

Assuming he was ok - nothing more to do. Good chance of ongoing headaches, concentration problems for a few weeks - but no intervention required

However if he got more drowsy or fitted or had a very serve headache, things are abit more difficult. If you dont have an operating theatre - you are screwed really - just have to wait and see. If you had enough knowledge and the right story for an extradural you could attempted to drain the clot - but chances are you might kill them. Having said that - trephenation (cutting a hole in the skull) is one of the oldest surgical procedures and many a ancient skull has been trephened and evidence the patient survived.

So in summary. Minor head injury - no problems. Major head injury - you are in trouble.

cheers

Craig

[rd_rnr]

Ditto on what Craig said.

[Yarrow]

thanks guys for the ideas .... just want to cover my bases if shtf ... heads will still get bumped...

again, thanks... yarrow