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.

Symptoms and signs – Not all may be present

• falling level of consciousness
• headache that may become worse
• nausea or vomiting
• loss of balance and coordination
• loss of short-term memory – e.g. recent events
• 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 unresponsive and breathing normally. place the patient on the side in a supported position.
• Check that the airway is clear. If the airway is not clear, tilt the head back and lift the chin. An unconscious person is unable to control their tongue, and if the tongue falls back it can obstruct the airway and cause noisy, ‘snoring-like’ breathing. By tilting the head and lifting the chin the tongue is moved, and this helps open the airway.

Call 111 for an ambulance if the person is unresponsive. Give care until arrival of the ambulance

• If conscious, help the patient to rest in the position of greatest comfort.
• If there are any signs of concussion the person must be told to immediately stop activity (e.g. sport) that risks another concussion 
• Help the person to rest in the most comfortable position
•  If the person is in pain, provide simple pain relief such as paracetamol or an anti-inflammatory. Arrange for the person to see a doctor for a medical assessment before they continue with activity that risks another concussion. This is important because a second concussion that occurs before the brain has recovered can be serious.
• 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.

2.    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.

Call Healthline on 0800 611 116 if you are uncertain.

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