Head Injuries:
How to Recognise and Respond to Head Trauma

Head injuries are a common occurrence and can range from minor bumps and bruises to serious trauma that affects the brain. It is important to treat all head injuries with caution, as symptoms may not always be immediately obvious. Proper first aid can prevent further damage and ensure the casualty receives the appropriate medical care.

Types of Head Injuries

• Minor Head Injuries: These usually involve bumps, bruises, or cuts on the scalp and are not life-threatening.
• Concussion: A mild traumatic brain injury caused by a blow to the head that affects brain function, often temporarily.
• Skull Fractures: A break in one or more of the bones in the skull, which can be very serious.
• Severe Head Injuries: Injuries that involve bleeding in or around the brain (intracranial haemorrhage) or significant trauma to the skull and brain tissue.

Signs and Symptoms of Head Injuries

Minor Head Injuries:

• Mild headache.
• Dizziness or feeling light-headed.
• Nausea (feeling sick).
• A bump or bruise on the scalp.
• Minor cuts or grazes.

Concussion:

• Brief loss of consciousness or confusion.
• Difficulty remembering events before or after the injury.
• Headache, dizziness, or balance problems.
• Blurred vision or sensitivity to light.
• Nausea or vomiting.
• Feeling dazed, confused, or disoriented.

Severe Head Injuries:

• Loss of consciousness or difficulty waking up.
• Seizures or convulsions.
• Clear fluid (cerebrospinal fluid) or blood leaking from the ears or nose.
• Severe headache that gets worse over time.
• Difficulty speaking or slurred speech.
• Weakness, numbness, or paralysis in the limbs.
• Unequal pupil size or unresponsive pupils.
• Bruising behind the ears or around the eyes (known as “raccoon eyes” or “Battle’s sign”).
• Sudden drowsiness or confusion.

If any of these symptoms are present, seek immediate medical attention, as they may indicate a serious injury to the brain.

First Aid for Head Injuries

For Minor Head Injuries:

1. Assess the Injury:
   • If the person has a minor bump or bruise, assess whether they are alert and responsive.
   • Ask them how they are feeling and watch for signs of dizziness, nausea, or confusion.
2. Clean Any Wounds:
   • If there is a minor cut or graze on the scalp, clean it gently with water and apply a sterile dressing or plaster.
3. Apply a Cold Compress:
   • To reduce swelling, apply a cold compress or ice pack (wrapped in a cloth) to the injured area for 10-15 minutes.
   • Do not apply ice directly to the skin.
4. Monitor for Symptoms of Concussion:
   • Keep an eye on the person for the next 24-48 hours, even if the injury seems minor. Watch for signs of concussion, such as confusion, dizziness, or vomiting.
   • If they develop symptoms of concussion or their condition worsens, seek medical advice.

For Concussion:

1. Monitor the Person:
   • Concussions can cause delayed symptoms. Keep the person awake and alert for several hours following the injury.
   • If the person has lost consciousness, even briefly, or shows signs of confusion, drowsiness, or memory loss, seek medical help.
2. Advise Rest:
   • Encourage the person to rest and avoid strenuous physical or mental activities for at least 24 hours following a concussion. This includes avoiding screen time, reading, and exercise.
3. Seek Medical Help:
   • If symptoms persist or worsen, such as prolonged headaches, dizziness, or vomiting, seek medical attention. A doctor may perform a scan or further tests to assess the injury.

For Severe Head Injuries:

1. Call 999 Immediately:
   • If the person is unconscious, confused, or shows signs of a severe head injury (such as bleeding from the ears or nose, seizures, or unequal pupils), call for emergency help immediately.
2. Keep the Person Still:
   • Encourage the person to lie down and remain as still as possible. Do not move them unless absolutely necessary, especially if you suspect a spinal injury.
3. Control Bleeding:
   • If there is bleeding from a wound on the head, apply a sterile dressing or clean cloth and press gently to control the bleeding. Avoid putting pressure on any part of the skull if you suspect a fracture.
4. Support the Head and Neck:
   • If the casualty must be moved, ensure their head and neck are supported and kept in line with the spine to prevent further injury.
5. Monitor for Breathing and Consciousness:
   • Keep a close watch on the casualty’s breathing and consciousness level. If they stop breathing or become unresponsive, be prepared to start CPR.

When to Seek Medical Attention

• The casualty has lost consciousness, even briefly.
• There is bleeding from the ears, nose, or mouth.
• The person is experiencing seizures or convulsions.
• There is clear fluid leaking from the ears or nose.
• The casualty is confused, drowsy, or difficult to wake.
• They show signs of concussion, such as dizziness, vomiting, or memory loss.
• The person has difficulty speaking, moving their limbs, or has unequal pupils.

Prevention Tips for Head Injuries

• Wear Helmets: Use helmets when riding a bike, motorcycle, or engaging in contact sports to protect your head from injury.
• Safety at Home: Ensure that your home is free of tripping hazards, such as loose rugs or clutter, especially for children and the elderly.
• Seatbelts and Car Seats: Always wear a seatbelt when driving or riding in a vehicle. Use appropriate car seats for young children.
• Proper Supervision: Always supervise young children during play and ensure they play in safe environments, free from objects that could cause falls or head injuries.

Key Points to Remember

• For minor head injuries, apply a cold compress and monitor for symptoms of concussion.
• For any loss of consciousness, confusion, or signs of severe injury, call 999 immediately.
• Do not move the casualty if you suspect a spinal injury and keep their head still.
• Always seek medical attention if you are unsure about the severity of a head injury, especially if symptoms worsen over time.