Your Treatment Rights
Anyone suffering from a head injury has a right to the best medical care, set out below are the signs and symptoms you should be aware of and further information on head injury treatment by medical professionals.
Signs and Symptoms
Head injury signs – call an ambulance
- Unconsciousness or barely conscious
- Difficulty understanding, speaking, reading or writing
- Loss of feeling in part of the body
- Problems with balance
- General weakness
- Changes in eyesight
- Problems walking
- Clear fluid running from the nose or ears
- Black eye with no damage around the eye
- Bleeding from one or both ears
- New deafness in one or both ears
- Bruising behind one or both ears
- Penetrating injury signs
- Visible trauma to scalp or skull
- Seizures, convulsions or fit after the injury
- High-energy head injury eg pedestrian struck by motor vehicle; driver or passenger ejected from motor vehicle; high-speed motor vehicle collision; bicycle collision; fall from height of greater than 1m or more than 5 stairs; diving accidents, any other accident involving a potentially high-energy mechanism
Head injury signs – refer to hospital emergency department
- Amnesia
- Persistent headache since the injury
- Vomiting since the injury
- Previous brain surgery
- History of bleeding or clotting disorder
- Currently taking anticoagulants eg warfarin
- Intoxicated by drugs or alcohol
- Aged 65 years +
- Suspicion of non-accidental injury
- Altered behaviour
Initial Head Injury Treatment Assessment
- If a patient presents with signs of a head injury via a telephone advice service (eg NHS direct or emergency department helpline) they should be immediately referred to the emergency ambulance service (eg 999) for emergency transport to the nearest accident and emergency department for treatment
- Upon entering an A&E department with a head injury you should be assessed by a trained member of staff within a maximum of 15 minutes of arriving at the hospital
- Anyone entering the emergency department with a GCS of less than 15 must be seen and treated immediately by a medical professional
- The assessment should establish if you are high or low risk for brain and/or cervical spine injury
- A patient should be assessed using the Glasgow Coma Scale (GCS) which is a based on total score of 15
Treatment of high risk head/brain injuries
- High risk victims should receive a full clinical examination to establish the need and urgency for a CT scan of the head or cervical spine
Treatment of low risk brain/head injuries
- Low risk victims should be re-examined within 1 hour by an emergency department clinician and re-evaluated as to the need for a CT scan
Brain Injuries Diagnosis
- The primary investigation of choice is a CT scan
- An MRI scan can also help to detect a patient's prognosis
- X-Ray should NOT be used to diagnose brain injuries without prior discussion with a neuroscience unit
When is a CT scan needed immediately?
- If the GCS is less than 13
- If the GCS is less than 15 at 2 hours after injury
- Suspected open or depressed skull fracture
- Signs of basal skull fracture are present eg: panda eyes, clear fluid leaking from ear or nose, haemotympanum or battle signs
- Seizure following the accident
- Focal neurological deficit
- Have vomited more than once
- Amnesia for event more than 30 minutes before impact and/or
- Aged 65 years +
- History of bleeding, clotting disorders or are being treated with warfarin
- Involved in High-Energy Impact
Head Injuries - Hospital Admissions
Admitting victims to hospital
If you have any of the following you should be admitted to hospital:
- New or significant abnormalities on a CT scan
- If your GCS has not returned to 15
- If a CT scan cannot be done within the specified time
- If you experience vomiting or severe headaches
- If you show source of concern eg: drug or alcohol intoxification; shock; suspected non-fault injury; meningism (eg intolerance of bright light and headaches) or clear fluid leak from nose or ears
Treatment Whilst in Hospital
Observation of admitted head injury victims
- You should only be admitted into the care of people capable of dealing with your injuries
- When observing, an appropriate medical professional should at minimum always check: GCS; pupil size and reactivity; limb movements; respiratory rate; heart rate; blood pressure; temperature and blood oxygen saturation
- Observations should be performed and recorded ½ hourly until GCS equals 15
- Frequency when GCS is equal to 15 should be:
- ½ hourly for 2 hours
- 1 hourly for 4 hours
- 2 hourly thereafter
- If GCS falls below 15 at any point observations must revert back to ½ hourly
Discharging head injury victims
- Victims CANNOT be discharge until they have achieved a GCS equal to 15
- Upon discharge you should receive verbal and written head injury advice which should be full explained to you and/or your carer
- You should only be allowed home if there is somebody suitable there to supervise you
- Low-risk patients should only be discharged if no other risk factors are present and there are appropriate supervision structures in place
- A head injury victim with a normal CT scan, a GCS of 15 and no other signs of risk can be discharged only if appropriate support and supervision structures are in place
Outpatient Treatment
- Anyone who has undergone a CT scan and/or been admitted to hospital should be referred to their GP for a follow-up within 1 week after discharge
- If you experience persisting problems you should have the opportunity to be referred for an outpatient appointment with a professional trained in assessment and management of brain injury
Make an enquiry
Our dedicated team of head injury solicitors want to help improve your quality of life and give you the financial support you need. Contact us now by calling 0845 858 3200 or use the online enquiry form and we will call you back.
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