Immediate stopping of arterial or venous bleeding from the scalp is a priority when providing first aid to a victim of an accident, since the abundant blood supply to the head creates a direct threat to life due to rapid blood loss. According to clause 2.1.6 Traffic rules and the methodological recommendations of the Ministry of Internal Affairs, the driver is obliged to immediately begin rescuing the wounded person, using sterile bandages and tourniquets, if necessary, but strictly following the algorithm of actions for traumatic brain injury. Any delay or incorrect application of the dressing may lead to hypovolemic shock or worsening brain damage.
A traumatic brain injury, accompanied by a violation of the integrity of the skin, requires composure and strict adherence to instructions from the person providing assistance, since an error in assessing the condition can cost the victim his sight, hearing, or even life. The driver who witnessed the accident acts as the first link in the chain of survival, and the further prognosis of treatment in the hospital depends on his competent actions in the first minutes. It is important to understand that help algorithm when wounding the scalp, it has its own specific characteristics that distinguish it from the treatment of wounds of the limbs or torso.
Assessing the victim’s condition and diagnosing TBI
The first step in providing care is a quick but thorough assessment of the victim's consciousness and breathing, since traumatic brain injury is often accompanied by loss of consciousness or stupefaction. It is necessary to call the person loudly, shake him by the shoulders and check the reaction of the pupils to light using a flashlight or headlights if it happened in the dark. Lack of response to painful stimuli or inappropriate behavior indicates severe damage to the central nervous system.
A visual examination of the head can reveal skull deformations, gaping wounds or protruding bone fragments, which requires a special approach to applying a bandage. If there are symptoms of TBI, such as nausea, vomiting, facial asymmetry or convulsions, it is strictly forbidden to give water, food or medications to the victim, as this may cause aspiration of vomit during loss of consciousness. Diagnosis of the condition is carried out exclusively visually and tactilely before the arrival of the ambulance team.
⚠️ Attention: If you notice the discharge of light or bloody fluid from the ears or nose, do not try to stop this flow with tamponade, as this is a sign of a fracture of the base of the skull and the release of cerebrospinal fluid.
Particular attention should be paid to the color of the skin and the pulse in large arteries, since pallor and thread-like pulses indicate developing shock. The driver must constantly monitor the victim’s breathing, since in case of severe TBI, respiratory arrest is possible, requiring the immediate initiation of resuscitation measures. Timely detection These signs allow the ambulance dispatcher to correctly classify the call and dispatch a specialized team.
Technique for stopping bleeding from the scalp
Stopping bleeding from the scalp requires applying pressure directly to the wound, since the vessels of the head have a dense wall and do not collapse on their own when damaged. To do this, use a sterile gauze pad or clean cloth, which is pressed tightly against the wound with the palm of your hand, and a pressure bandage is applied on top. Pressure bandage should be applied with sufficient force to stop bleeding, but not cause tissue necrosis or excessive pain.
If the bleeding is profuse and pulsating, which is typical for damage to the temporal artery, finger pressure on the vessel above the wound is allowed until a tourniquet or pressure bandage is applied. A tourniquet for head injuries is used extremely rarely and only in exceptional cases when other methods are ineffective, applying it using the sling method or using a special head tourniquet. Incorrect overlay tourniquet may lead to constriction of the airways or deterioration of blood supply to the brain.
☑️ Algorithm for stopping bleeding
In this case, a roll of bandage or cloth is placed around the object, and a bandage is applied over the roll, creating pressure on the edges of the wound, but not on the object itself. Pulling out a foreign body may cause immediate and unstoppable bleeding.
| Type of bleeding | Characteristics | Stop method | Features of TBI |
|---|---|---|---|
| Arterial | Pulsating jet, bright scarlet color | Finger pressure, tourniquet (with caution) | High risk of rapid loss of consciousness |
| Venous | Even flow, dark cherry color | Pressure bandage | Requires tight bandaging |
| Capillary | Blood beads or oozes | Antiseptic bandage | Often accompanied by scalp wounds |
| Mixed | Combination of features | Combined method | Most common in road accidents |
Rules for applying the “Cap” bandage
The most effective and proven way to fix the dressing on the scalp is the “Cap” type bandage, which provides reliable pressure and prevents the bandage from slipping. To perform this procedure, the end of a bandage about 15-20 cm long is left free and lowered down near the victim’s ear, after which the first circular turn is made around the forehead and back of the head. Bandaging technique requires that each subsequent turn overlap the previous one by two-thirds of its width, moving from bottom to top or top to bottom, depending on the location of the wound.
The free end of the bandage, lowered at the ear, is thrown over the opposite parietal-temporal area and passed under the chin, then raised again to the starting point, creating a crosshair that secures the bandage. This technique is repeated several times, changing the angle of the bandage to cover the entire wound surface and create the necessary pressing effect. The bandaging is completed with a circular turn around the forehead and back of the head, tying the ends of the bandage or securing them with a pin.
If you don't have a sterile bandage on hand, use a clean, preferably ironed, cloth, but avoid using cotton wool directly on the wound, as its fibers are difficult to remove with treatment.
When bandaging, it is necessary to ensure that the bandage does not completely cover the eyes and ears, unless this is directly necessary, in order to be able to control the condition of the victim. Movements with a bandage should be smooth, without jerking, so as not to cause additional pain and not to displace bone fragments in case of a skull fracture. Properly applied cap holds even with active head movements and does not require constant adjustment.
Transportation and body position for traumatic brain injury
Proper positioning of a TBI victim is critical to prevent brain swelling and aspiration of vomit, especially if the person is unconscious. If the victim is conscious and there is no suspicion of a spinal injury, he should be given a semi-sitting position with the head end raised, which promotes the outflow of blood from the head. In the event of loss of consciousness or vomiting, the person must be immediately placed on his side in a stable position, with his head tilted back to ensure airway patency.
Such patients should be transported as carefully as possible, avoiding shaking and sudden movements, which can increase intracranial pressure. If there is a suspicion of injury to the cervical spine, which often happens with head impacts, it is necessary to secure the head and neck with your hands or a homemade collar until doctors arrive. Immobilization head prevents secondary damage to the spinal cord due to displaced vertebrae.
⚠️ Attention: It is strictly forbidden to move a victim with severe TBI unless absolutely necessary, if there is a risk of worsening the spinal injury or if the wait for an ambulance will take no more than 10-15 minutes.
While waiting for medical help or during transportation by your own transport, you must constantly monitor your breathing and pulse, and be ready to begin cardiopulmonary resuscitation at any moment. Cold applied to the head (an ice pack wrapped in a cloth) helps reduce swelling and pain, but should not be kept for more than 20-30 minutes without a break. Condition monitoring carried out every 2-3 minutes, recording any changes in the reaction of the pupils or skin color.
Nuances of neck fixation
To temporarily support the neck, you can use rolled towels or clothing, placing them on the sides of the neck and head to limit lateral movement.
Common mistakes when providing first aid
One of the most common and dangerous mistakes is trying to wash a deep head wound with water or antiseptics, which can lead to infection in the deep tissues or even in the cranial cavity during a fracture. It is also considered a gross mistake to remove large foreign bodies, protruding fragments or knife wounds from a wound, since these objects can block bleeding from damaged vessels. Retrieving Items only permissible surgically in an operating room.
Many drivers mistakenly believe that in case of a TBI it is necessary to give the victim painkillers, which is strictly prohibited due to the risk of blurring the clinical picture and suppressing the respiratory center. In addition, you should not allow the victim to sleep or lose consciousness “just lie down,” since a decrease in the level of consciousness may be a sign of an increasing brain hematoma. Constant contact with the victim, conversations and questions help to assess the dynamics of his condition.
Incorrect application of a tourniquet to the head, bandaging too tightly, blocking the blood flow completely, or using dirty materials are also critical errors that worsen the prognosis. Any rash action can be fatal in the event of such a serious injury as traumatic brain injury.
The main rule: Do no harm. If you are not sure of your actions, it is better to limit yourself to calling an ambulance, stopping the bleeding with clean pressure and providing rest to the victim.
Legal aspects and actions of the driver according to traffic rules
According to clause 2.6 of the Russian Traffic Regulations, a driver involved in an accident is obliged to provide first aid to the victims, call an ambulance and the police. Refusal to provide first aid without good reason may entail criminal liability under Article 125 of the Criminal Code of the Russian Federation “Leaving in danger” if it is proven that the driver could have helped, but did not. Legislation clearly regulates the actions of participants in road accidents, placing human life and health above material values.
The driver has the right to transport the victim to the nearest medical facility using a passing vehicle or his own transport only in extreme cases, when waiting for an ambulance is impossible, and the condition of the victim requires immediate intervention. In this case, you must leave a note at the scene of the accident indicating your location and return back. Legal literacy helps the driver not only save lives, but also correctly fill out documents for the insurance company and the investigation.
It is important to record the circumstances of assistance, perhaps using a video recorder or witness testimony, in order to further prove the integrity of your actions. Cooperation with arriving doctors and police, as well as providing accurate information about the first aid measures taken, is the final stage of the driver’s actions at the scene of the accident. Compliance traffic rules algorithm guarantees legal protection and moral satisfaction from the fulfilled duty.
Is it possible to give water to a victim with a TBI?
No, giving water, food or medications to a victim with a traumatic brain injury is strictly prohibited, as this can provoke vomiting and aspiration, as well as complicate emergency surgery under anesthesia.
What to do if the bandage is soaked in blood?
If the bandage is soaked in blood, it cannot be removed, as the resulting blood clot can be broken and bleeding can resume. It is necessary to apply a new layer of bandage or cloth over the old one and increase the pressure.
How do you know if a head injury is serious?
Signs of severe injury include: loss of consciousness (even briefly), vomiting, severe headache, different pupils, seizures, blood or fluid coming from the ears/nose, and difficulty speaking or coordinating.
Should a motorcyclist's helmet be removed if they have a TBI?
It is not recommended to remove the helmet yourself unless there is a threat to life (for example, respiratory arrest) and removal skills are available, since inept actions can damage the cervical spine. It's better to wait for the rescuers.
How long does a tourniquet on the head last?
A tourniquet on the head, as a rule, is not applied in the classic form due to anatomical features. If a pressure bandage is used, it can remain until doctors arrive. If a tourniquet is nevertheless applied, the application time is fixed, and in the summer it lasts up to 1 hour, in the winter - up to 30 minutes.