You've been injured--don't go to sleep! But why not?

Weird title, sorry. But anyways:

If you get clonked on the head, get hypothermia, or get a really bad injury, you are yelled at, pinched, slapped, and otherwise forcibly kept awake until you can reach medical help–where, if it’s really bad, they promptly sedate you anyways.

Why shouldn’t you fall asleep? What’s the reason behind this?

It’s mostly for the rescuers. If they can keep you awake, then it’s less likely you’re rapidly expiring. If you’re completely out of it despite stimuli, chances that you’re about to cash in your chips rise rapidly, which may lead to earlier drastic intervention.

For Example: If you’re trapped in a car wreck surrounded by broken glass and razor-sharp metal, but still talking, they’ll wait for the jaws of life to get you out. But if you lose consciousness, the paramedics may take drastic action to try to get to you to start IV fluids.

There was just column about this, but I can’t find it.

Many thanks, Qadgop “Lord of the ‘Lord of the Rings’” the Mercotan! :wink:

Kel, do you think you could dig it up for me?

I remember that thread. I think it was a GQ thread about concussions. Hmm… searching

I thougt it was one Cecil’s (or maybe Staff report). Maybe I am just losing it because I can’t find it.

Sorry. It was about overdoses.

http://www.straightdope.com/columns/041126.html

I see a LOT of head injuries. The old saw that Grandpa or Little Josie have to be kept awake after they bang their head applies mainly to this scenario. It’s very widely believed, but not exactly true.

Hypothermia or “really bad injuries” (including bad head injuries) are ones that also affect “level of consciousness”. This is a term used by doctors that includes normal or alert (can move okay, open eyes sponstaneously and talk well), stuporous, drowsy, comatose, etc.

Paramedics and doctors prefer patients which are alert – the injury is less likely to be severe, the patient is less likely to need intubation (comatose patients may choke on their own vomit), alert drunks can be discharged from hospital more safely than stuporous ones, drowsy folks who have been clonked on the head might need a CT. Failing this, they monitor the consciousness (google “Glasgow Coma Scale” if you wish) and see if it is improving (the patient is “rousable”), or not.

Minor head injuries (child falls from slide, baby from sofa, Grandma from toilet) require 12-24 hours of observation, since bleeding inside the head may not produce symptoms right away. It is important to wake minor head injury patients up every 2-3 hours. But it is normal to feel drowsy after you have banged your head, and you can sleep safely if you are awakened regularly. Many folks incorrectly believe instead that sleep is not permitted.

Dr_Pap, ER guy

In ICU speak, that would be CTD (Circling the Drain) As opposed to DRT Dead right there

Thank you, all! smooches to everyone

This gets me curious:

Exactly why do you feel so drowsy after being conked on the head? Hypothermia I can sort of understand, but a concussion? I’d expect massive amounts of pain instead…

It might be a good way to force a person to not furhter hurt themselves. A lot of times an injured a person will just panic and make things worse. Perhaps, evolution led to greater survival for people who would just stop.

Hmmm. You can think of the brain as an organ floating in a little CSF liquid in a hard skull container. When the head gets banged hard, the brain can get bruised. This is most clear in “traumatic brain injury” – car accidents and the like can cause permanent brain damage and lower levels of consciousness (coma, etc).

Milder injuries are now thought to also represent concussions and less severe brain injury, some with milder “brusing” to the brain. The damage is mild, but there may still be an intermittent, lower level of consciousness, such as drowsiness.

Interestingly, if you get hit near the left ear with a golf club, for example, the area of the brain that may get bruised can be on the right side (a contrecoup injury) since the fluid, etc. can push the brain until it hits the hard right side of the skull.

There is IMHO, no evolutionary reason for it. A concussion is a blow that causes the brain to hit the inside of the skull (usually – there are some oddball concussions that hit, e.g the tentorum, but I don’t recall their proper names or even whether they are still considered legitimate; as a young man, I was a master of medical trivia and obscurata)

The brain has been variously described as having the texture and consistency of day old soggy oatmeal, extra firm tofu, etc. and is normally suspended within several protective layers plus a permanent waterbed. It’s not accustomed to impacts, and doesn’t tolerate them well.

I don’t believe, however, that the drowsiness is intended to allow the brain to rest; IMHO, impaired function probably causes the drowsiness – i.e. it is a neurological effect, not a functional physiological mechanism. After most seizures [inappropriate medium- to large-scale neuronal firings which usually cause no new physical damage to the brain}, there is usually a very strong drowsiness, called the post-ictal state. This is often used to diagnose a seizure, after the fact.

That is only my impression. Some researchers somewhere may have evidence to the contrary.

As a general rule, it is a serious mistake to attribute reasons to evolution. That’s not how/why evolution works.