Broken head?

I was just called about a man 2.5 hours upriver... A huge branch fell on his head his family brought him to the small clinic up river in RumiTumi. He fell unconscious when he got to the clinic, so the technico there started and IV and then called me. He gave me the details... 48 yr old man, his scalp is split open... about 20cm, eye swollen shut, bleeding out of his ears, nose, mouth... um... is there a neurosurgeon in the house?? We don't even have an x-ray machine here. He woke from his coma/concussion after 20 minutes and was talking and recognized his family. I recommended some meds and passed the phone to Padre Jack to coordinate transportation. Because there is not a boat there, and since you can't travel by boat at night, we arranged to send a boat to pick him up the next morning and prayed that he continued to improve. The next morning he felt well and refused to come into the hospital. As long as doesn’t have a basilar skull fracture he should continue to improve. Close call! Toni