Head Injury and Concussion - How to Tell If It's Serious and When to Go to the ER!

Most of us visited the local emergency department for one or the other. It brings their elderly neighbor ER after a fall, or that your child be evaluated after a hard hit on the football field, you'll probably visit a local urgent care or emergency department at least twice in his life. Occasionally, we hear the news of celebrities dies after head injury. As a result of media hype, my ER with everyone else in the United States sees the immediate spike in emergency room visits for minor head trauma patients out of fear. That's fine with me, as a part of my job is to give you peace of mind, and to tell you that they will not die from it a little bump on your head.

But 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 ERS are expensive and crowded, and sometimes wait to see it can be 4-6 hours. Nobody wants to spend 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.

Is there a laceration? If there is 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 3mm 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 falls where the head strikes the ground, table or some other inanimate object. Do not let these variables dictate whether to go to the ER or not. The drop height, or velocity of an object striking a person, not a reliable indication of the potential below the injury. When in doubt, see your doctor.

Is it 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, right brain injury or brain hemorrhage, may cause death or significant life long disability. So how can you tell if it happens? Let's start with the simple definition potres.Potres is simply an injury that 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 even worse, axonal shearing, which can be regarded as nerves literally torn in half. Symptoms of concussion can range from mild dizziness and headache to severe vertigo and vomiting with confusion and inability to walk or remember the event. Either way, in most cases, a concussion is a condition where the patient is fully recovered with little or no lasting 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 the laboratory that will tell people concussed. This is strictly a clinical decision by looking at the symptoms, if symptoms are severe enough, you need to consider and explore the possibility of more severe head injuries.

brain bleed on the other hand is an urgent medical emergency. Blood in the rivers of 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 hemorrhage first experience a severe headache and vomiting, followed by neck stiffness and other neurological symptoms similar to stroke, and eventually death. If the patient has significant symptoms after the first few "golden hour", chances are better to have a simple concussion, and does not bleed.

I need a CAT scan? lump on the skin is like a bruise that swells beneath the scalp, but above skullbones. This does not mean that it is bleeding inside the skull. However, because bleeding in the brain case may be so severe, often get a set of computer x-ray call CT.Medicinskim standards of care for CT in head injury is basically this: If the patient is unconscious or is knocked suspected intracranial bleeding or fractures CT is necessary. So you can see that some wiggle room for personal judgments about medical services. Keep in mind though, studies show that during a head CT examination, a person is exposed to the brain equivalent to 300 Xrays! When I make CT of the brain and skull, I highly doubt the true 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 decision. Basically, if anything to fix the wounds or broken bones, and the patient denies a significant headaches, and walking and talking as usual, they are likely to have intracranial bleeding. If you are not sure, 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 PA is not only to treat patients and prescribe medication, but set your mind at ease that they will be fine.