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Triaging head injuries is not easy, but there are some simple rules to follow. For anybody who has had a head injury, it is important to establish whether there has been a loss of consciousness. Also, if they present in a confused state, this may be due to any alcohol consumed, but it could be as a result of the head injury. It could also be as a result of low blood sugars, always good to check this. This patient had been consuming alcohol, he had been hit, he had lost consciousness, he had fallen to the floor.

So if he has lost consciousness and fallen into the floor, he won't have put his hands out to protect his head when he fell, so he has been hit by a punch and he has also been hit by his head possibly impacting the floor and anything else on the way down. So his neck is vulnerable when he has lost consciousness, always best to check for a C-spine tenderness and take the appropriate immobilisation measures necessary for this. And finally, with patients who have been punched or kicked anywhere around the lower face or anywhere their head really, good to check for dental trauma, any bleeding inside the mouth, any airway swelling or any swelling inside the mouth that may obstruct the airway. Also, if a patient has had a head injury, it is always best to check and palpate the skull or any bony for any bony tenderness, all the facial bones for any bony tenderness and bogginess that might indicate a more serious injury.