Injuries to the head should always be treated seriously as there may be damage to the brain. Sometimes this damage may not be evident for hours after the injury occurs.

Head injuries such as concussion, brain compression, and skull fracture are difficult for a first aider to determine, and therefore all head injuries should be treated in the same way.

Fracture of the Skull
Fracture of the Skull
Back view of brain
Back view of brain

Symptoms and signs – Not all may be present

  • altered conscious state, often deteriorating over time
  • blurred or double vision
  • a thumping or pounding headache
  • nausea or vomiting
  • loss of balance and coordination
  • altered sensation in the fingers or down one side of the body
  • loss of short-term memory – e.g. recent events
  • noisy breathing
  • leaking fluid from the nose or one ear
  • history of a blow to the head

How you can help

1.    Assess the patient

  • Assess the patient’s conscious state.
  • If not fully conscious, place the patient on the side in a supported position.
  • Check that the airway is clear and for signs of life every few minutes.
  • If conscious, help the patient to rest in the position of greatest comfort.
  • Sometimes patients with head injury may become agitated. Enlist friends or family to calm and reassure the patient. Consider calling the police if the safety of the patient or others becomes threatened.

Call 111 for an ambulance.

2.    Give care until arrival of the ambulance

  • Cover any wound with a sterile dressing.
  • If there is any discharge from the ears or nose, cover the area with a sterile dressing.

DO NOT pack the ears or nose with dressings.

3.    Monitor the patient

  • DO NOT leave the patient alone and keep a constant watch on breathing and consciousness level.
  • Check for and treat any other injuries that may have been overlooked.

4.    Maintain body heat

  • Cover the patient lightly with clothing or a blanket and protect from extremes of temperature.

Always arrange for a doctor to check the patient in the case of a head injury even if it appears that a full recovery has occurred. In some cases the recognition of serious head injuries may be delayed for 24 to 48 hours due to a gradual increase in swelling or bruising around the brain.

  • Note: When a head injury is suspected in a player during contact sport, the first aider should recommend that the patient does not return to the game. The patient should be seen by a doctor for clearance to continue playing.

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