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More than just a quick emergency room visit or short-term hospitalization may be needed after an auto accident causes injury to the neck or head. Cautious care with vigilant attention to details are immediate and vital needs. Loss of consciousness or a semi-conscious state (difficult to arouse, incoherent speech, dazed and confused) signal head trauma, but do not indicate severity or whether other injuries were sustained. Bloody or clear discharge from nose or ears are signs of probable cerebral hemorrhage or cerebrospinal fluid leakage, indicative of more severe trauma requiring quick emergency medical response. Pallor and diaphoresis (sweaty, yet cool to touch), uneven breathing (or sudden lack of it), deep cuts or lacerations which bleed profusely or puncture wounds also indicate serious injury. Care should be taken to not make conditions worse with well-meaning but ill-advised actions.

Fortunately, first responders usually provide appropriate medical intervention. Public awareness programs and Red Cross emergency response classes emphasize the ABC's (airway, breathing, and circulation) along with the importance of stabilizing the neck to prevent further injury. If neck fracture is suspected, the injured person should not be moved before paramedics arrive unless there is an immediately life-threatening situation, such as fire. Our 911 system makes it easy to obtain quick transport via trained paramedics to a hospital or trauma center, where further evaluation and treatment prevent complications. Staff are trained and have equipment enabling them to assess whether there are fractured vertebra, skull or facial bone fractures, or hematomas (blood-filled abscesses) within the skull. Depending on size and location,
hematomas can create additional damage to vital brain structures or impose life-threatening pressure due to overfilling the limited space within the rigid skull compartment. Emergency surgery may be needed to drain hematomas, to repair or prevent blood vessel hemorrhage or
cerebrospinal fluid leakage, or to stabilize fractures of vertebra, facial bones, and the skull. These bones are like medieval armor, normally protecting the spinal cord, brain and other sensitive structures like nerves and blood vessels. However, when fractured, sharp bone fragments may move, cutting or severely damaging what they usually protect.

Perhaps not as obvious, but just as important, continued caution and vigilance are vitally important in follow-up care. Hours or days after

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