Head injury and concussion

A guide for patients and carers

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What will happen at the hospital?

In the A & E or casualty department the person will be seen by the triage nurse, who will decide how urgently they need to be seen by a doctor. Some cases are obviously very urgent, whereas others - even though they may seem frightening to you - may not be as bad as they appear.

What will the doctor do?
First of all they will need a clear description of the accident from the injured person themselves, or from family members or anyone else who witnessed it. This gives the doctor information that may help in deciding what to do next. The injured person will then be examined to check whether the brain has been affected. This includes assessing their level of consciousness and checking their eyes, movements and the strength of their arms and legs, their reflexes and their responses. This can sometimes be difficult, particularly if the person has drunk a lot of alcohol.

What tests will be done?
This will depend on the severity of the injury. The doctor may order blood tests to see if there are any general medical problems or to check that the injured person’s blood will clot properly. X-rays may be needed to see if the skull has been fractured, or to see if there is any glass or metal in the wound if the skin is broken. In a number of cases a CT brain scan will be performed to see if there is any bleeding inside the head, or swelling of the brain.

Will the tests hurt?
Blood for testing is taken through a needle in the arm. This should not be too painful. X-rays do not hurt, but they do mean lying still for a few minutes. A CT scan is also painless. The person lies on a scanner couch, which slides them up to the machine. Their head goes inside the scanner, but they can easily see out. The scan takes between three and 20 minutes and will immediately give the doctor the information about what treatment the person need.

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