hello there and welcome to the hospital so sorry to hear about the bump to the head
i'm going to take some notes so can you tell me what time this happened please when did it occur?
and how did the accident occur?
okay have you experienced any vomiting or dizziness since the accident?
has there been any changes or loss of vision in either eye?
have you noticed any double vision either horizontally vertically or diagonally?
have you noticed any flashing lights in your vision or an increase in floaters?
okay how are you feeling at the moment?
okay so i see you've placed a plaster
over the wound. What i'm going to do is i'm going to remove the plaster
have a little look at the wound and just document. Before doing anything let's remove this plaster
okay let's have a little close-up inspection of the world
i can see that it is weeping
right side of the forehead
approximately three millimeters in width
the height of the wound two millimeters
as I say it's just weeping and bleeding a little bit still so the clotting hasn't
fully worked yet but we're getting there
okay just raise your eyebrows for me, okay now blink, smile,
turn to the right and turn to the left
full range of movements there
okay
i'm just going to take a tissue just gently dab the wound
I won't be applying much pressure, i'm just going to absorb some of the excess here
okay it's a fairly deep wound but i don't think we need stitches
okay so that's got a little bit of the excess there right
i can have a little look in the first aid kit here take out all the equipment required
let's have a look
i have the scissors
i have a little wound dressing here a little wound dressing for you
we are going to need some
micro porous tape
to apply the addressing to attach it safely
and we just need to give the wound a little clean with this non-sting wound cleansing wipe first
okay let's begin
okay just again just going to dab
the area just surrounding the wound the right side of the forehead there
i'm just going to get it as clean as possible
just cleaning off the blood plasma
hopefully that'll be the end of the weeping
okay let's get the wound dressing prepared attach that with some tape,
it's a good idea to leave the dressing on for about five days and try not to get it wet
when you're cleaning your face just clean around the dressing please
and obviously just be very careful when you're washing your hair
so the surrounding area is nice and clean there
okay let's access the wound dressing this is a five by five centimeter one
there you go that is the wound dressing for you
just take a little bit of microporous tape
okay there we go
let's just apply this over the wound for you
okay that's looking fine it's going to wipe, just on the nose a little bit of blood there
okay so the wound dressing is applied we have the microporous tape there, leave on for five days
a little bit of information,
this leaflet here just reiterates what we've gone over this, is the wound care leaflet to take away
now if you experience any dizziness or vomiting in the next week you must come straight back to A&E
and we'll investigate. likewise if you experience any loss of vision changes to your vision,
double vision whether it's like this this this or this or if you experience any flashing lights
or an increase in floaters that could be a retinal issue. you must go straight to your optometrist
if those symptoms occur okay? so before i let you leave i'm going to get the doctor just to do a few
checks so just have a seat in the waiting area and he'll be with you very shortly. Hello there i'm
the doctor, I just want to do a few checks before we let you leave so how did this accident happen?
is your vision okay? no double no flashing lights? no floaters? let's have a little inspect there so
the nurse has bandaged you well so we'll just do a few brief medical checks and then i'll let you go
okay just looking over my shoulder into the distance
right keep looking into the distance please
the pupils are looking fine, there's no anisocoria and they work
normally to light. now your job is to follow the light here keeping your head steady
good
okay just follow my finger this time tip of the finger
good okay looking into the distance you'll see that there's a letter chart
just there. i'm just going to start by covering your left eye, i want you to look at the chart,
read down as far as you can for me please, tell me when you can't go any further
anymore? are you sure? okay let's go with the other eye
looking at the chart through the left eye
read down as far as you can for me please and tell me when you can't do any more
all right do you wear spectacles for your distance? it might be worth an appointment with
your optometrist to see if they can improve your vision a little bit because that wasn't so good
right what do we have next?
let's have a little look at the back of the eyes with the ophthalmoscope. just involves me coming
a little bit closer just to ensure that there's no such issues as detachment
retinal haemorrhages
and all those nasty things that can occur as a result of head trauma
okay your job is to look straight ahead to begin with
right a little closer please
not seeing any swelling the back of the eye there, just looking into the light,
the macular is fine looking right
up and right, up to the ceiling, up and left
left hand side, down and left, straight down, down and right, look straight ahead again please
it's looking fine through the right eye
let's observe the left keep looking straight please
now look into the light
look to your right hand side, up and right, straight up to the ceiling, up and left,
directly left, down and left, down to the floor, down and right, look straight ahead again,
take a blink, retina is intact optic nerve looks fine as does the macula right eye and left
okay so i'm sure the nurse has given you a little bit of information about returning
if you experience any additional problems. The wound should completely heal within 10 to 14 days
if it continues to weep, bleeds more, have any double vision, loss of vision,
give us a call and we'll try and see you but that's everything today and i'll let you go now