I will try and answer your question looking from a sports medicine perspective. In regards, to initial assessment/ management follow all elements of the primary survey ‘DRSABCD’ of first aid.
Before I give an example I will say that traumatic head injuries are complex, require comprehensive assessment and appropriate referral. I will also assume that you mean acute first aid management rather than managment of a student that has been showing possible signs/ symptoms of neurological damage.
I will use the example of a ‘head knock’ in football, where there may or may not have been loss of consciouness. Asking the individual to remain where they are, you can ask questions to assess whether there may be a suspected spinal injury, such as; Any neck pain? Any pins/ needles, numbness? You can also assess to see if they have any muscle weakness or loss of sensisation. If there is any inclination of a suspected spinal injury it requires stabilisation of the spine and an ambulance call.
After these questions you can ask other questions relating to responsiveness (search the acronym AVPU); do you know what happened? What half are we in? What's your date of birth? Do they seem responsive and alert or not? Once you have deemed safe to move the individual you would normally do a more detailed assessment. There are numerous tools used for head injury and concussion assessment in both children and adults (i.e. SCAT 3) which incorparate aspects such as; signs/ symptoms, memory, balance, cognitive function, level of consciousness (using GCS similar to AVPU but more advanced) and motor function tests. Other important findings are changes in mood and/ or speech which are harder to pick up, if you don't know the individual that well.
Take home messages: (from a parent, coach or first aid point of view)
- ASSESS - Individuals may have neurological damage if they have or experience any signs/ symptoms (headache, blurred vision etc.) or impairment with several other aspcts (balance, muscle weakness, noticable changes with mood etc.)
- MONITOR - don't leave them by themselves and monitor for changes in signs/ symptoms
- REFER EARLY - If you have any feeling that there may be a more serious injury, refer straight away
Suspected spinal injuries require an ambulance; other head injuries or concussion may still require paramedical input or referral to a GP. They will need further neuropsychometric testing and scans (MRI/ CT) to rule out injury to the brain.
Hope that helps
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