The emergency care of an individual with a head
injury consists of the following:
1. Maintain an open airway.
2. Control the bleeding.
This procedure allows trapped air to escape when the
casualty exhales and prevents air entry when the
3. Cover skull wounds with sterile dressings.
4. Give the casualty oxygen if it is available. If a
lung is injured, more oxygen will be needed to
compensate for the injury.
4. Keep the casualty lying down.
5. Place the casualty on the wounded side unless
5. Give no medications.
6. If necessary, administer cardiopulmonary
When controlling bleeding, do not use direct
pressure or tie any knots over the wound. If there is a
skull fracture, you would not want to force parts of the
skull into the brain. When laying a person down, try to
keep the head slightly elevated. If there is an injury to
the back of the head or bleeding into the throat and
mouth, position the casualty on his side so that blood
can drain out of the mouth, not down the throat. (Try to
keep the neck stiff.) Never raise the feet of a head
there is back injuries. By placing the patient on the
wounded side, you will keep the good lung up so
breathing will be easier. If the casualty is having
difficulty breathing while on the wounded side, you can
place him/her in a sitting position. This may help to
make breathing easier.
6. Watch the casualty closely for signs of
respiratory difficulty or shock. Treat accordingly.
7. Do not give a casualty with chest injuries
anything to eat or drink.
8. Immediately transport the casualty, wounded
side down, to a medical facility.
CHEST WOUNDS.All chest injuries are
serious. They can cause severe breathing and bleeding
problems. Any casualty showing signs of difficulty in
breathing without signs of airway obstruction must be
inspected for chest injuries. One of the most serious
chest injuries is the sucking chest wound. This is a
penetrating injury to the chest that produces a hole in
the lung, causing the lung to collapse, and thus
preventing normal breathing. Immediate medical aid
must be provided. The sucking chest wound will result
in death if not treated quickly.
The procedures described above are also followed
when treating a lung injury from the casualtys back.
ABDOMINAL WOUNDS.Many vital organs
are located in the abdominal area, so a deep wound in
the abdomen is likely to constitute a major emergency.
Abdominal wounds usually cause intense pain, nausea
and vomiting, spasms of the abdominal muscles, and
severe shock. Immediate surgical treatment is almost
always required, so the casualty must receive medical
attention at once. Give only the most essential
treatment, and concentrate your efforts on getting the
casualty to a medical facility.
A casualty with an open chest wound gasps
for breath, has difficulty breathing out, and may
have a bluish or grayish color to his face. When you
remove clothing over the area, you may or may not
hear a sucking sound at the wound site. Frothy
blood may bubble from the wound during
The general procedures for treating an abdominal
wound are as follows:
1. Keep the casualty lying on his/her back. If the
intestine is protruding or exposed, the patient may be
more comfortable with the knees drawn up. Place a coat,
a pillow, or some other bulky cloth material under the
knees to help maintain this position. Do not attempt to
push the intestines back in or to manipulate them in
any way. Do not try to clean dirty intestines; this will be
done thoroughly at the hospital.
To treat a casualty of a sucking chest wound:
1. Remove any clothing from the chest area.
2. Immediately seal the wound with your hand or
any nonporous (airtight) material such as aluminum foil
or plastic wrap (cellophane).
3. Wipe the blood from the surrounding skin while
holding the airtight material over the wound. Apply tape
(wide and nonporous, if possible) to all sides of the
material, leaving one corner of the dressing unsealed.
2. If the intestine is not exposed, cover the wound
with a dry, sterile dressing. If the intestine is exposed
(fig. 13-10), apply a sterile bandage moistened with
sterile water. If no sterile water is available, clean sea
water or any water that is fit to drink may be used to
moisten the bandage. The bandage should be large
enough to cover the wound and the surrounding area.