Head Injuries:
Recognising and Responding to Head Trauma

Head injuries can range from minor bumps and bruises to serious brain injuries that require immediate medical attention. Any trauma to the head, whether caused by a fall, a blow, or an accident, should be treated with caution. Understanding how to provide first aid for head injuries is crucial for minimising complications and ensuring the person receives the appropriate care.

What is a Head Injury?

A head injury refers to any trauma to the scalp, skull, or brain. Head injuries can be classified into two main types:

• Closed Head Injury: The skull is not broken, but the brain may still be injured from a blow to the head, causing concussion or internal bleeding.
• Open Head Injury: The skull is fractured or penetrated, with the risk of damage to the brain and surrounding tissues.

Causes of Head Injuries

Head injuries can be caused by various incidents, including:

• Falls: Slipping, tripping, or falling from a height can result in head trauma.
• Car or Bicycle Accidents: Collisions can lead to head injuries, even if the person is wearing a helmet.
• Blows to the Head: Sports injuries, fights, or accidental strikes can cause head injuries.
• Physical Assault: Being hit or struck with an object can cause head trauma.
• Sports Injuries: Contact sports, such as rugby, football, or boxing, can lead to concussions or other head injuries.

Types of Head Injuries

• Concussion: A mild traumatic brain injury caused by a blow or jolt to the head. It can lead to temporary loss of brain function, such as confusion, memory loss, or dizziness.
• Skull Fracture: A break in one or more of the bones in the skull, which can cause damage to the brain or blood vessels.
• Scalp Wound: A cut or laceration to the scalp that may bleed profusely but does not always indicate a severe injury.
• Intracranial Haemorrhage: Bleeding inside the skull, which can put pressure on the brain and is a medical emergency.

Signs and Symptoms of Head Injuries

The symptoms of a head injury vary depending on the severity. Some symptoms may appear immediately, while others can develop over time.

Mild Head Injury (Concussion):

• Dizziness or light-headedness
• Confusion or difficulty concentrating
• Headache
• Nausea or vomiting
• Temporary memory loss (amnesia)
• Sensitivity to light or noise
• Blurred vision or seeing “stars”
• Brief loss of consciousness (in some cases)

Moderate to Severe Head Injury:

• Prolonged loss of consciousness
• Seizures or convulsions
• Clear fluid or blood draining from the nose or ears
• Unequal pupil size or unresponsive pupils
• Slurred speech or difficulty speaking
• Weakness, numbness, or difficulty moving limbs
• Severe headache that doesn’t improve
• Drowsiness or difficulty staying awake
• Confusion, irritability, or unusual behaviour
• Vomiting (especially repeated)

First Aid for Head Injuries

If someone has suffered a head injury, it is important to act quickly to assess the severity and provide appropriate care.

1. Assess the Person’s Consciousness:

• If the person is unconscious, check for breathing and pulse. If they are not breathing, begin CPR immediately and call 999 for emergency help.
• If the person is conscious, keep them calm and still. Monitor them closely for changes in their condition.

2. Call 999 for Emergency Help:

• Always call 999 if the person has lost consciousness, even if only briefly, or if they are displaying any signs of a serious head injury, such as confusion, seizures, or vomiting.
• Describe the injury to the emergency operator, noting any changes in the person’s condition.

3. Keep the Person Still and Comfortable:

• Encourage the person to remain still and avoid moving their head or neck, especially if a neck or spine injury is suspected. Support their head and neck in the position you found them if necessary.
• If the person is bleeding from the scalp, apply gentle pressure with a clean cloth to control the bleeding, but do not press hard if you suspect a skull fracture.

4. Monitor for Signs of Deterioration:

• Keep a close eye on the person’s condition, watching for any signs of confusion, drowsiness, or worsening symptoms. If their condition worsens, be prepared to call 999 again and provide additional information.

5. Treat Minor Head Injuries:

• For minor bumps or bruises, apply a cold compress (wrapped in a cloth) to the injured area to reduce swelling. Ice should not be applied directly to the skin.
• Over-the-counter pain relievers, such as paracetamol, may be given for a mild headache, but avoid ibuprofen or aspirin, as these can increase the risk of bleeding.

6. Place in the Recovery Position if Necessary:

• If the person is unconscious but breathing, place them in the recovery position to keep the airway clear and prevent choking in case of vomiting. Keep monitoring their breathing and pulse while waiting for emergency help.

Signs of a Concussion

Concussions are a type of mild brain injury, but they can still have serious effects. Look for the following symptoms if you suspect a concussion:

• Dazed or confused appearance
• Difficulty remembering events before or after the injury
• Feeling “foggy” or slow
• Clumsy movements
• Headache or pressure in the head
• Nausea, vomiting, or dizziness

Even if the person appears to recover, they should be seen by a doctor to assess for possible concussion and given instructions for care, including rest and monitoring for delayed symptoms.

When to Seek Medical Help

Always seek immediate medical attention if the person:

• Loses consciousness, even briefly.
• Has a severe headache that does not improve.
• Experiences confusion, drowsiness, or difficulty staying awake.
• Has clear fluid or blood coming from the nose, ears, or mouth.
• Has seizures or convulsions.
• Shows signs of weakness, numbness, or difficulty with coordination.
• Has a suspected skull fracture or spinal injury.

Prevention of Head Injuries

• Wear Helmets: Use helmets for activities such as cycling, skateboarding, skiing, or playing contact sports to protect against head injuries.
• Use Seatbelts: Always wear a seatbelt when driving or riding in a car, and ensure children are in appropriate car seats.
• Prevent Falls: Keep floors clear of obstacles, use handrails on stairs, and install safety gates for young children to prevent falls.
• Supervise Children: Ensure children are properly supervised when playing on playgrounds or engaging in activities with a risk of head injury.

Key Points to Remember

• Call 999 if the person loses consciousness or shows signs of a serious head injury, such as seizures, vomiting, or confusion.
• Keep the person still and monitor their condition closely for changes.
• Apply a cold compress for minor injuries, but avoid using ice directly on the skin.
• Always seek medical attention if the person has suffered a head injury, even if symptoms seem mild, as delayed complications can occur.