Head Injuries 455A – Paramedic Head Trauma

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Introduction + Lecture 01 + Lecture 02

Things You Need To Know About Head And Spinal Injuries


Summary: The following article includes the causes, signs and symptoms, vital signs and the first aid treatment of the head and spinal injuries.


Introduction: Any injury that results in the trauma to the brain, scalp or skull can be called as a head injury. The injury may be a negligible bump or may be a serious brain injury.

Head injury can be classified into two types depending upon the injured area.

An open head injury or a closed head injury.

A closed head injury is the non-penetrating or non –missile injury in which the Dura mater remains intact and the injury does not penetrates the skull.

An open injury is a penetrating injury in which the skull is broken and an object penetrates into the Dura mater and inside the brain. This is a serious condition and most likely results in the death. The reasons for this type of injury include moving at a high speed i.e. in a high speed vehicle and going through the windshield or a gunshot wound to the head.

Signs and symptoms: The head injuries may lead to bleeding in the brain the surrounding layers. The symptoms for the head injury can occur immediately or may develop slowly over a longer period of time ranging from several hours to several days. The signs and symptoms involves

  • Leakingcerebrospinal fluid from nose ear or mouth indicate a basilar skull fracture and the destruction of sheaths that surrounds the brain and may lead to brain infections.
  • Visible deformity or depression in the head or face.
  • An eye that cannot move or is deviated to one side.
  • Wounds or bruises on the scalp or face.

Spinal Injury: In addition to the head injury in case of any accident or assault, the spinal injury may also be present. In case of spinal injury patient must be treated with the spinal precautions. These precautions involve stabilizing of the head and neck by placing both your hands on each side of the injured person’s head. The head should be kept in line with the spine and prevent any movement and wait for the medical help. A full spinal immobilization is an essential precaution in this case.

Levels of Spinal Injury: In case of the spinal injury the higher the injury on the spinal cord the more dysfunction it causes. Thus the severe cases of the spinal injuries are those which involve the injury of the cervical spine. It is classified into two sub categories

Higher spine injury includes spinal disc from C1 to C4 and most severe spinal injuries occurs in this section causing paralysis of hands, arms, legs and trunk. Patient may also lose the involuntary functions like breathing, coughing bowel control or bladder movements. The speech is also disturbed. The patients require complete assistance in its daily routine activities such as getting in bed, bathing, walking, dressing and even eating. The patient would not be able to drive a car and needs a 24 hour personal care.

In case of low cervical injury (From disc C5 to C8), the person may be able to breathe on their own and can speak normally. The breathing maybe weakened. Remaining problems will be present.

The injuries in the mid thoracic spine will affect the trunk and legs also known as paraplegia. Muscles, upper chest, abdominal muscles and mid-back may also be affected. But arm and hand functions remain normal.

Loss of Sympathetic Tone: The spine injuries of cervical and thoracic region may also result in the loss of sympathetic tone which is caused due to disruption in the autonomic pathways within these parts of the spinal cord. This results in vasodilation and pooling of blood in the lower extremities and consequently results in the hypotension and slowed heart rate.