Basilar skull fracture; Depressed skull fracture; Linear skull fracture
1. Check the airways, breathing, and circulation. If necessary, begin rescue breathing and CPR.
2. Avoid moving the victim (unless absolutely necessary) until medical help arrives. Instruct someone to call 911 (or the local emergency number) for medical assistance.
3. If the victim must be moved, take care to stabilize the head and neck. Place your hands on both sides of the head and under the shoulders. Do not allow the head to bend forward or backward, or to twist or turn.
4. Carefully check the site of injury, but do not probe in or around the site with a foreign object. It can be difficult to know if the skull is fractured or depressed (dented in) at the site of injury.
5. If there is bleeding, apply firm pressure with a clean cloth to control blood loss over a broad area.
6. If blood soaks through, do not remove the original cloth. Instead, apply additional cloths on top, and continue to apply pressure.
7. If the victim is vomiting, stabilize the head and neck (as outlined in number 3, above), and carefully turn the victim to the side to prevent choking on vomit.
8. If the victim is conscious and experiencing any of the previously listed symptoms, transport to the nearest emergency medical facility (even if the patient does not think medical assistance is necessary).
Biros MH, Heegaard WE. Head injury. In: Marx JA, ed. Rosen’s Emergency Medicine: Concepts and Clinical Practice. 7th ed. Philadelphia, Pa: Mosby Elsevier; 2009:chap 38.
Leveque JC. Hoff JT. Neurosurgery. In: Greenfield LJ, Mulholland MW, Oldham KT, Zelenock GB, Lillemoe KD, eds. Greenfield's Surgery: Scientific Principles and Practice. 4th ed. Philadelphia, Pa: Lippincott Williams & Wilkins; 2005:chap 114.
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