How long is a person supposed to stay awake after sustaining a head injury. I can’t remember if it’s twelve hours or twenty-four.
Also, what would happen if one did not stay awake for the proscribed length of time?
Actually, It is now considered ok to let the victim sleep. The person is no more likely to die sleeping than awake.
Sorry about the quote. No need to post it. This is an old habit of mine I need to break
Are you sure it’s OK to let the victim sleep? I was walking home one night, and was involved in a hit-and-run a couple of years ago. After getting home disoriented I was rushed to hospital and told that if I fell asleep there was a good chance I could have fallen into a coma. (I hardly remember getting home, all I remember is wanting to sleep.)
There are a at least a couple of reasons for keeping a patient conscious after injury:
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[li]So that the condition of the patient can be observed (if you let them sleep, you can’t tell so easily whether it’s natural rest or unconsciousness due to some internal injury).[/li][li]Because the patient’s blood pressure drops when they become unconscious with lowered blood pressure, an unconscious person’s body may simply ‘give up’ - some involuntary actions like breathing may stop. (this is the basis of why you see people saying ‘hang on, stay with me’, trying to keep injured people conscious in films)[/li][li]Hi Opal[/li][/list=1]
This may not apply to an obviously serious head injury, but I can tell you what happened when my 4 year old fell off the upper bunk bed.
He was in a bedroom on the second floor. I was doing laundry in the basement and heard the crash. (He fell hard.) He was conscious and crying when I got there, but I couldn’t know whether he might have been knocked out for a few seconds because of the time it took get to him.
He then proceeded to vomit and fall asleep. I was, of course, completely panicked, because I was sure this was a very dangerous sign. We took him to the doctor, who checked him over and found him to be perfectly fine. He told us that vomiting and sleeping were very normal reactions to trauma in children and didn’t necessarily mean anything. He told us to wake him every few hours that night to confirm that he was lucid, but we didn’t have to try to keep him awake constantly.
When my now 9 year old was about 2, I was chasing her, trying to catch her to put her in for a nap. She ran right into a wall head first, and a welt the size of a golf ball swelled out of her forehead. We called her doctor immediately, and while we waited for him to call back she decided it was time for her nap. Mrs. KVS desperately tried to keep her awake, but it didn’t work. The doctor finally called, and he told us to ice the swelling, let her sleep, and wake her in two hours. We did, and she was fine.
BTW, do you remember the MASH episode where Hawkeye was driving a jeep and it crashed? He had a head injury, so he kept himself awake in a Korean home with a monologue until someone showed up to rescue him. One of the best episodes ever.
It’s been said twice already, but it’s worth emphasizing … signs of concussion and/or brain damage from significant head trauma can show up many hours later. Some of the early signs are confusion, loss of short-term memory, and other things that are very hard to observe in a sleeping victim. That doesn’t mean you can’t let them sleep, but you should wake them periodically and ask them a few simple questions to make sure that their brain is still working properly. (How simple the questions should be depends a lot on how deep a sleeper they ordinarily are. 
) If they don’t know who or where they are, who you are, what day it is, etc. when you wake them up, it’s time to haul them back to the ER and have the doc take another look.
I’d say 9 hours. This agrees with what the doctor did in '99 with my friend, kept her up 8-9 hours.
A few years ago, I walked backwards off the first floor of my house and fell into the basement, (no steps installed) landing on my back, then apperantly smacked my head upon the cold hard concrete. I was out for 20 mins, then had 5 hours of psudo awake. I was instructed to stay awake for 8 hours, (after I was alert) then my SO was to wake me every hour for the first night, to see if I could answer questions. Name, SSN things like that. I didn’t want to stay awake, as I was injured, and rather sleepy, however, if I slipped into sleep, and not able to be awaken easily, I was to be transported to the ER. Ice was applied to both my head and back. So IMHO Keep em awake, it’s much easier to determine the status of their minds and body.
Just my $0.02.
Dan
robinh:
(Emphasis mine; I would consider these to be ominous symptoms. Sure, they could be meaningless symptoms, but they could be an indication of a deadly condition.)
danvanf:
Both of these stories seem scary to me. Did a doctor do a CT scan in either of these cases? In Dan’s case, did the doctor do a CT of your neck and back? At the very least, IMHO, these two should have been held overnight in the hospital for neurological evaluation.
People who develop subdural hematomas (bleeding from the veins around the brain) after head injuries appear perfectly normal- at first. Usually, the person is “knocked out” by the injury, even for only a few seconds, but then may feel just fine. After a while, the person becomes confused and combative and can rapidly suffer severe, permanent brain damage or death if not treated.
I just find it hard to believe that a doctor wouldn’t choose to observe a patient in the hospital after a potentially severe head injury.
Thank you all for the replies.
This is story research. Shall I round it up to twelve hours?
Rilchaim:
Depends on how accurate you want your story to be. For example, in both The Dead Zone and Desperation, Stephen King depicted characters talking while on the ventilator. This is completely impossible, but he got away with it- I suppose most people don’t realize that this is completely and utterly impossible. Since the “stay awake after a head injury” myth is ingrained in public perception, you can do with it what you wish. Falling asleep after a head injury will not increase the injury: it only makes it more difficult for others to tell how badly off you are.
I would suggest, though, that you do a little research on head injuries and the signs/symptoms of neurological injury. For example, even in Desperation, King accurately depicted the pupillary changes that occur with massive head trauma. A nice touch might be to mention the CSF (cerebrospinal fluid) test in which the nurse soaks up the discharge from the patient’s ear (or nose) when the ear (or nose) is bleeding. If CSF is present (indicating some major skull damage) the CSF will form a yellowish ring on the gauze around the spot of blood.
Bleeding from the ears (or nose) indicates basilar skull fractures. I once cared for a woman who had such horrible basilar skull fractures that maggots infected her brain. She’d lain in a ditch for many hours (nobody knows how long, but the engine block of her car was cold by the time she was found) and she was “locked in”: she could think and understand, but she could not move any muscle in her body except her eye muscles. To communicate, she could look up for “yes” or down for “no”. She could not breathe, swallow, or feel a thing above the level of her cheekbones. Flies laid eggs in her sinuses while she lay in the ditch, causing quite a ruckus on the unit when literally hundreds of maggots poured out of her nostrils. <shudder>
If there’s something specific I can answer for you, please ask.
Thank you for the info, Holly. And the anecdote.
:::Rilchiam goes to scrub with lava soap:::