A crew member recently suffered a serious head injury after a slip and fall down some stairs onboard. This resulted in him being in Intensive Care for a month followed by surgery. After his medical repatriation back to the Philippines, he required further surgery and a rigorous plan of physiotherapy, occupational therapy and rehabilitation.

Occurrences like this are common place. The UK Club receives notifications of slip, trip and fall incidents totaling an average of USD 15m every year. Many of these involve head injuries. In these circumstances, quick action can often alleviate a risk of the injury turning serious.

Crew Health consultant Dr. Abeyna Jones provides us with an insight into lessening the risk of aggravating an injury and immediate first aid for head injuries.

"Head injuries can be serious due to the risk of hidden bleeding beneath the skull resulting in loss of consciousness and death - this can happen over several hours or sometimes days. The chances of this occurring are higher in situations where there is significant force and/or the individual is intrinsically vulnerable to injury due to pre-existing health conditions causing thinning of the bones or blood.

Symptoms and signs associated with a head injury include: confusion dizziness, nausea, loss of consciousness, headache, loss of recent memory and scalp wounds.

Scalp wounds can bleed profusely resulting in a significant loss of blood if not controlled; hence, it's important that direct pressure is applied to the area as soon as possible. You may need to use several packs of gauze or other material to achieve this in addition to applying direct manual pressure."

Immediate life saving actions for head injuries:

• Ensure the area is safe and the risk of further harm is reduced.
• Check AVPU:
  
  Alert – Are they alert, eyes open and responding to questions?
  Voice – If not alert or eyes closed, do they respond to questions or follow instructions?
  Pain – If you pinch them gently, or press hard on a part of their body, do they open their eyes, withdraw or respond accordingly?
  Unresponsive – If you shake gently, do they respond at all? If unresponsive, assess their airway and breathing, if you feel competent to do so.
• Seek medical help immediately and communicate your findings. If you are waiting for help to arrive, it’s important to repeat the AVPU checks at regular intervals as the situation can deteriorate quite rapidly.
• Assess for bleeding from scalp wounds and apply direct pressure if appropriate.

For further information, please refer to pages 45-52 of our publication: Risk Consolidated 2016 – Slips, Trips and Falls

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