The head injury could occur due to the vehicle accidents on the road or due to the falls from heights at home. The victim may either be conscious or be comatosed. In some intracranial bleeds, the victim is unconscious initially, recovers consciousness but later lapses back into a coma. There may be an open wound on the skull or it may be intact. If a wound is present, there may be moderate or profuse bleed. Skull fracture may be associated. There may be black eye seen. Ear, nose or throat bleed may be present. There may be vomiting, or convulsion. Even if the victim has no complaints after the head injury, he/she should be observed for atleast 48 hours for development of new signs. The following danger signals should be looked for:

 

1.Bleeding from nose, ear or throat. This implies basilar skull 2.fractures and calls for proper medical attention.

3.Drowsiness or deepening of the coma.                           4.Vomiting                                5.Convulsion

While dealing with such cases, the following should be adhered to:

1.Wash your hands first. Wear disposable gloves and press a clean pad / gauze firmly and evenly over the wound to control bleeding. Bandage the head to keep pad in place.

2.Check the patient's conscious level, heart rate & respiratory rate.

3.Look for ENT (ear, nose or throat) bleed.

4.Ask for nausea, vomiting, dizziness and headache. These, if present, means a bad sign and points towards an intracranial complication. (as mentioned previously).

5.Always suspect associated neck injury and be careful during the transport of the victim from the site of injury to the hospital.

Neck Injury

	Do not move patient. Minimal handling is the rule.
	If CPR is required, support neck & move the patient as a whole. Head, neck & spine should be aligned. Use jaw thrusts for positioning head for CPR.
	Before transport, use bandages to support neck & head.
	Urgent orthopedic or neurosurgery opinion is required.

Sprains

	It is vital to give rest to the part. Immobilize the joint with crepe bandage. This will take care of the swelling as well as the pain.
	Ice application may be useful.
	Keeping the limb elevated also aids in early decrease of the edema.
	For ankle sprains that are common, a figure of '8' bandage gives a lot of relief.

Dislocation of Joint
In this, there is displacement of the bone from the joint. The victim has severe pain and inability to move the affected limb. There may be an obvious deformity. The most common joints to dislocate are the shoulder, elbow, thumb and the jaw.

The victim should be reassured. Some mild analgesics can be provided to diminish the felt pain. The limb should be supported in the most comfortable position. Bandages and slings may be used for the purpose. Shift the patient to the hospital. Do not try to relocate the dislocated joint as it may further aggravate the dislocation.


 Muscle strain
In this, the muscle is overstretched and torn. There is severe local pain and swelling. The part is painful during movements.

The part affected should be immobilized and elevated. Place it in the most comfortable position. Ice can be applied. If in doubt, consider an associated fracture. Shift to hospital immediately.


 Muscle Cramps
These are due to faulty use of the muscles. Excessive loss of salt in the sweat and vomiting and loose motions could also lead to cramps. There is severe pain and the victim cannot move the affected part. The contracted muscles fail to contract.

1.The patient should be reassured.

2.Analgesics should be given.

3.The part should be supported and massaged.