1. Nursing Instruction
  2. Overview
  3. Emergency and Critical
【Major Points】
  1. I will be able to know the common symptoms after head injury.
  2. I will be able to know when to seek immediate medical attention.
  3. I will be able to know how to observe and relieve the symptom of head injury.
What is head injury?
Injuries caused by any external force within the head region, e.g. fall, traffic trauma, or fall from a height, etc.
 
What are the common symptoms? 
Depending on the severity of head trauma, symptoms may be minor or as fatal as cerebral hemorrhage. It is recommended to go to a hospital for examination and evaluation as soon as possible with or without obvious injury.

Minor symptoms usually improve spontaneously within minutes or hours, but some may persist for weeks to months, especially in elderly or unexpressed patients, which may be easily overlooked, including the following:
  1. Mild headache, nausea, vomiting, dizziness, unsteady gait, sleepiness, short-term memory loss, etc.
  2. Appears to be grumpy, irritable, or inconsolable crying which cannot be comforted (often in infants).
 
What are the common treatments?
After the head injury, continuous observation and resting are very important. A good rest and symptomatic treatment can improve symptoms after the head injury:
  1. Continuous observation:
    1. After discharge, the patient should still be monitored for at least 3 to 7 days.
    2. Have someone to keep the patient accompanied within 24 hours.
    3. Check on the patient hourly, and wake the patient up every 2 to 4 hours.
    4. Do not stay at home alone within the first 48 hours, be accompanied by others, and make sure to have immediate contact with the outside world.
  2. Rest:
    1. Quiet and adequate resting can help improve symptoms after head injury.
    2. Avoid strenuous physical activities or any other exercise that will increase your heart rate.
    3. Avoid activities that require a lot of attention or long-term concentration.
    4. Do not ride or drive any vehicle until fully recovered.
    5. Avoid exercise that may cause bumps in the body (e.g. basketball, or football) within the first three weeks, and do not do any exercise until you get the doctor's permission.
  3. Symptomatic treatment:
    1. Pain medication can be used as prescribed when having a headache.
    2. Please visit a neurologist in the clinic when the symptoms have not been improved. (Request an appointment: Neurosurgery/Pediatric Neurosurgery)
  4. Avoid drugs or foods that may impact the state of consciousness:
    1. Do not take over-the-counter medicines or Chinese herbal medicines, and avoid taking non-prescribed sleeping pills.
    2. Avoid drinking alcohol within the first two days after injury.
    3. Please consult your physician for any questions about diet or medication.
  5. Care principles:
    If the patient has the following conditions, please go to the emergency department immediately:
    1. Persistent dizziness, vomiting, or worsening headache that cannot be improved after resting.
    2. Altered state of consciousness, e.g. drowsiness, nonresponsive, or slurred speech.
    3. Seizure (involuntary muscle contractions).
    4. Fever combined with a stiff neck and pain.
    5. Blurred vision or seeing distorted objects.
    6. Weakness in body or limbs, numbness sensation, or unsteady gait.
    7. Urinary or bowel incontinence.
 
Reference
  1. Evans, R. W., & Whitlow, C. T. (2022). Acute mild traumatic brain injury (concussion) in adults. UpToDate. Retrieved February 22, 2022, from https://www.uptodate.com/contents/acute-mild-traumatic-brain-injury-concussion-in-adults?
  2. Silverberg, N. D., Iaccarino, M. A., Panenka, W. J., Iverson, G. L., McCulloch, K. L., Dams-O’Connor, K., Reed, N., & McCrea, M. (2020). Management of concussion and mild traumatic brain injury: A synthesis of practice guidelines. Archives of Physical Medicine and Rehabilitation, 101(2), 382-393.https://doi.org/10.1016/j.apmr.2019.10.179
  3. Silverberg, N. D., Duhaime, A. C., & Iaccarino, M. A. (2020). Mild traumatic brain injury in 2019-2020. The Journal of the American Medical Association , 323(2), 177-178.https://doi.org/10.1001/jama.2019.18134
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    Taipei Veterans General Hospital 
    No.201, Sec. 2, Shipai Rd., Beitou District,  3e72dadb9904d06fa0fb3744e4ed2612.png
    Taipei, Taiwan 11217, R.O.C.
    Tel: +886-2-2871-2121 #04
    • Smoking and chewing betel nut significantly induce oral cancer. Obesity will potentially increase the risk of breast cancer and colorectal cancer. Please control body weight and keep away from tobacco and betel nut.
    • Information provided above can’t overcome physician's treatment and replace physician patient relationship.
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