One of the most important phases of emergency
care is to clear the upper respiratory passage of any
obstruction.
If the fractured jaw interferes with
breathing, pull the lower jaw and the tongue well
forward and keep them in that position.
Apply a four-tailed bandage, as shown in figure
4-41. Be sure that the bandage pulls the lower jaw
forward. Never apply a bandage that forces the jaw
backward, since this might seriously interfere with
breathing. The bandage must be firm so that it will
support and immobilize the injured jaw, but it must not
press against the victim’s throat.
Be sure that the
victim has scissors or a knife to cut the bandage in case
of vomiting. Treat the victim for shock and evacuate as
soon as possible.
Skull Fracture
When a person suffers a head injury, the greatest
danger is that the brain may be severely damaged;
whether or not the skull is fractured is a matter of
secondary importance. In some cases, injuries that
fracture the skull do not cause serious brain damage;
but brain damage canand frequently doesresult
from apparently slight injuries that do not cause
damage to the skull itself.
It is often difficult to determine whether an injury
has affected the brain because the symptoms of brain
damage vary greatly. A person suffering from a head
injury must be handled very carefully and given
immediate medical attention.
Some of the symptoms that may indicate brain
damage are listed below.
However, you must
remember that all of these symptoms are not always
present in any one case and that the symptoms that do
occur may be greatly delayed.
Bruises or wounds of the scalp may indicate that
the victim has sustained a blow to the head.
Sometimes the skull is depressed (caved in) at
the point of impact. If the fracture is open, you
may find glass, shrapnel, or other objects
penetrating the skull.
The victim may be conscious or unconscious. If
conscious, the victim may feel dizzy and weak,
as though about to faint.
Severe headache sometimes (but not always)
accompanies head injuries.
The pupils of the eyes may be unequal in size and
may not react normally to light.
There may be bleeding from the ears, nose, or
mouth.
The victim may vomit.
The victim may be restless and perhaps confused
and disoriented.
The arms, legs, face, or other parts of the body
may be partially paralyzed.
The victim’s face may be very pale, or it may be
unusually flushed.
The victim is likely to be suffering from shock,
but the symptoms of shock may be disguised by
other symptoms.
It is not necessary to determine if the skull is
fractured when you are giving first aid to a person who
has suffered a head injury. The treatment is the same in
either case, and the primary intent is to prevent further
damage to the brain.
Keep the victim lying down. If the face is flushed,
raise the head and shoulders slightly. If the face is pale,
have the victim lie so that the head is level with, or
slightly lower than, the body. Watch carefully for
vomiting. If the victim begins to vomit, position the
head to prevent choking on the vomitus.
If there is serious bleeding from the wounds, try to
control that bleeding by the application of direct
pressure, using caution to avoid further injury to the
skull or brain. Use a donut-shaped bandage to gently
surround protruding objects. Never manipulate those
objects.
Be very careful about moving or handling the
victim.
Move the victim no more than is
4-51
Figure 4-41.—Four-tailed bandage for the jaw.
