Head Injury

Both members of the public and SLS members on patrol, or competing in surf sports, have the potential to suffer a knock to the head and possible concussion – a form of traumatic brain injury.

A head injury should be suspected with any witnessed or reported knock to the head, as well as when signs and symptoms of a head injury are present.

Signs and symptoms

Signs and symptoms of a head injury may show immediately or may evolve over the hours or days following an incident. They may be obvious or more subtle. They include:

• altered state of consciousness
• appearing in a daze, blank/vacant stare
• bleeding from the head or face, or into the eyes
• bruises on the head or face
• confusion
• disorientation
• fluid discharge from ears, nose or mouth
• headache
• impaired vision, hearing or speech
• memory impairment
• nausea or vomiting
• neck pain
• notable changes in behaviour
• numbness or tingling in arms or legs
• seizure.

Management

1. Ask the person to lie down with their head and shoulders slightly raised.
2. Identify and control any bleeding with direct pressure if possible.
3. Provide spinal care using a trapezius grip to protect the person’s neck while maintaining the person’s clear airway for an appropriate period of observation.
4. Determine what advanced medical assistance is required:
   • send for help and request and ambulance if any of the following red flags are identified:
     • a deteriorating state of consciousness at any time, no matter how brief
     • an unusual behavioural change
     • disturbed hearing or vision
     • increasing levels of headache, confusion or agitation
     • neck pain
     • repeated vomiting
     • seizure
     • weakness, tingling or burning feeling in the arms or legs.
   • Refer the person to a medical practitioner as soon as possible for further assessment in all other cases.

Note

• A period of observation is recommended following the provision of emergency care. If, after an appropriate period of observation, the person has not shown any of the red flags noted above, it is reasonable to discharge the person from your care.
• Anyone with suspected head injuries should not resume any activity until cleared for participation by a medical practitioner.
• Any athlete participating in SLS surf sports with a suspected head injury is not allowed to return to sport that day and the sport’s referee needs to be informed of this decision. Refer to the Safety and Wellbeing module of this manual for more information on personal injury reporting.
• Any blood or fluid coming from the ear should be treated by securing a sterile dressing lightly over the ear and laying the person on their injured side where possible. This helps the fluid to drain out.
• Do NOT prevent fluid discharge from ears or nose.
• Refer to the Spinal Management module of this manual for more detail on spinal care and how to perform a trapezius grip.
• The possibility of spinal injury must be considered with any head injury (e.g., concussion, structural head injury).
• Refer to the latest ARC Guideline for Head Injury to learn more.