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  1. Loss of blood or fluid from the eye
  2. Unusually profuse tears
  3. Impaired or loss of vision
  4. Pain


  1. Cover the affected eye with a pad and bandage lightly
  2. Do not put pressure on the eye
  3. Ask the casualty to keep his eyes still, and suggest focusing on a point in the distance
  4. Refer to medical assistance
  5. If an object is protruding from the eye DO NOT attempt to remove it.
  6. Stabilize the object (e.g. with a paper cup) before bandaging.

 A foreign object on the surface of the eye should be flushed.


  1. Tilt the head with the injured eye down and flush downwards.
  2. Chemicals in the eye must be flushed until the ambulance arrives


  1. In trauma or accidental injuries to the upper part of the body, importance should also be given to any fluid or blood coming out of the ear. It indicates injury to the inner ear or brain.
  2. In any management of a wound to the ear, it is important not to plug the ear.
  3. Allow the fluid to drain, catching it in a pad.
  4. Bandage lightly and monitor the casualty’s condition. 
  5. Call an ambulance immediately.



Head injuries are very crucial while evaluating any casualty. Injury to the head may cause loss of consciousness, and damage to the brain, eyes, ears, teeth, airways, and mouth. Severe head injury may lead to death or permanent brain damage. The maintenance of a clear airway is the first priority in the care of a head injury casualty and takes precedence over the management of associated injuries.

Head injury may be associated with

  1. Altered level of consciousness.
  2. Damage to the upper airway.
  3. Spinal and other injuries.

Casualties suffering from a head injury may be having Straw-colored or clear fluid coming out from the nose or ear. The casualty who has not lost consciousness due to a head injury requires urgent medical assessment if any of the following symptoms are displayed.



The casualty may

  1. Become unconscious, drowsy, or vague
  2. Have memory impairment
  3. Appear agitated or irritable
  4. Have slurred speech
  5. Show in coordination or loss of power in limbs
  6. Complain of headache or giddiness
  7. Vomit or complain of nausea
  8. Have a seizure
  9. Have bleeding or fluid discharge from nose, ears, or mouth
  10. Develop changes in the size of the pupil


Management of unconscious casualty is to follow DRABCD.

The First Aider should

  1. Turn the casualty onto the side and obtain a clear airway
  2. Check for breathing
  3. Check and control bleeding and cover wounds
  4. Arrange transport to the hospital by ambulance

While waiting for an ambulance you should note any:

  1. Change in level of consciousness
  2. Bleeding from ears, nose mouth
  3. Seizures

While regaining consciousness after a head injury a casualty may:

  1. Vomit
  2. Have blurred vision
  3. Be irrational or uncooperative
  4. Have memory lapse
  5. Be dizzy
  6. Unable to recall events surrounding the accident

The casualty should not be left alone.

If consciousness returns, the casualty should be given reassurance, kept lying down at rest and an ambulance called.


  1. From scalp and facial wounds
  2. Inside the skull
  3. Under the skin
  4. There can be significant blood loss from scalp and facial wounds.
  5. Obvious bleeding can be controlled by direct pressure using a dressing and bulky padding, where those are available.
  6. Serious bleeding can occur beneath the skin, especially in children, producing a large lump (hematoma). This bleeding should be controlled by direct pressure.
  7. The effect of bleeding inside the skull put pressure on the brain of the casualty; it is indicated by the deterioration of the casualty’s condition. For this reason, the casualty’s conscious state should be monitored continuously.
  8. Bleeding from the ear canal may indicate a fracture of the skull. The ear canal should not be plugged, but the external ear may be loosely covered with a dressing. If bleeding from one ear only, place the bleeding ear down to allow drainage.

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