1. Contractor Safety Council Awareness Material TOPIC: Head Injury Prevention For more information on the CSC and other awareness topics, see www.cscpitcrew.com

2. Your Brain … Obviously rather important Weighs about 3 pounds About 75% water No pain receptors VERY FRAGILE

3. Your Skull … 22 bones Cranium vault is 8 bones Average skull thickness: Men: 6.5 mm Women: 7.1 mm

4. So …. The single most important part of your body is a lump of wet fatty tissues protected by about a quarter inch of bone… “A force of 73 Newtons is enough to cause a simple fracture, this force is the equivalent of walking into something solid. An unrestrained adult fall from standing has been shown to produce a minimal force of 873 N which is more than enough to produce a skull fracture.“ (mvm.ed.ac.uk) Just like your hand, there’s not too many places on your head you can hit, cut, bump, etc. with any real force or impact without it being serious

5. Where We’re At … 1.7 million people, including 475,000 children, sustain a TBI (traumatic brain injury) each year in the US 52,000 of those are fatal Leading causes are falls (35%), car accidents (17%), other workplace incidents (16%), and assaults (10%) CDC estimates the annual cost of TBIs at $76.3 billion/year

6. Injuries … Superficial: lacerations, abrasions… – Only 5 thin layers: skin, dense connective tissue, aponeurosis, loose connective tissue, pericranium – Profuse vasculature – Tough, yes, but … not that tough …

7. Injuries … Superficial: lacerations, abrasions… treatment – Treat for the presenting signs and symptoms Be aware of mechanism of injury … – General/basic first aid Staunch bleeding Keep the area clean Stitches/staples? Underlying complications?

8. Injuries … When the bone is involved… – There are NO bones in your head that you can break without it being serious – Non-penetrating impact: fractures the skull but doesn’t directly interfere with cerebral tissue Primary brain damage – tissue is crushed Secondary brain damage – tissue is damaged by swelling – Penetrating impact: an object either passes through, or gets lodged in, the brain pan Maybe it won’t kill you … – You’re going to bleed – You’re going to get an infection – It’s gonna be bad …

9. Injuries … When the bone is involved (or there’s an impact)… Treatment – This is a true emergency – Be aware of mechanism of injury Secure c-spine? Consciousness/shock/etc? – Seek additional care LOC Altered mental status Positive neuro exam Nausea/dizziness

10. Injuries … Of the 1.7 million TBIs that occur each year, 75% are “mild” (e.g.: concussion) – These are still serious injuries – The individual does NOT always lose consciousness

11. Injuries … MTBI… Recognition/Treatment – Signs of impairment Cognitive, physical, behavioral – True emergency – Always err on the side of caution

12. What to do… PREVENTION – Head injuries are not something you can “walk off” – Hierarchy of controls – Identify and remove the hazards – Raise awareness – Mitigate the hazards (guards, barriers, warning signs, etc.) DO NOT RELY ON PPE

13. What to do… RESPONSE – Trained on-site medics What to look for and what to do Advanced/escalated care (occupational medicine) – Aggressive case management Administrative management (light duty?) Appropriate follow up care Appropriate return to work process

14. Questions