Trauma to the head.
Brain injury; concussion - first aid; injury to
The signs and symptoms of a head injury may
occur immediately or develop slowly over several hours.
Most head injuries are minor. The skull provides the brain with considerable protection
form injury. Most head injuries are mild, but head injury may be a serious problem when it
occurs. Accidents are the leading cause of death or disability of men under age 35, and
over 70% of accidents involve head injuries and/or spinal cord injuries. Common causes of
head injury include traffic accidents, industrial/occupational accidents, falls, physical
assault, and accidents in the home.
If a child begins to play or run immediately after getting a bump on the head, serious
injury is unlikely. However, the child should still be closely watched for the next day,
since sometimes symptoms of a head injury are delayed.
When encountering a victim of a head injury, try to find out what happened. If the victim
cannot tell you, look for clues and ask witnesses.
Even if the skull is not fractured, the brain can bang against the inside of the skull and
be damaged. If there is bleeding inside the skull, complications may follow.
Injury or trauma to the head can result in
- concussion--the head sustains a hard blow
- intracranial hematoma--blood vessel ruptures between the skull and the brain (see
- skull fracture
- altered level of consciousness
- breathing slowed
- fracture in the skull
- fluid drainage from nose, mouth, or ears (may be clear or bloody)
- headache (may be severe)
- increased drowsiness
- initial improvement followed by worsening symptoms
- loss of consciousness
- personality changes
- slurred speech
- stiff neck
- swelling at the site of the injury
- vision difficulties
- vomiting (may be severe and persistent)
- wound in the scalp
- pupil changes
Treatment varies according to the severity of
the injury, type and location of injury, and development of secondary complications. For
mild head injury, no specific treatment may be needed other than observation for
complications. Over-the-counter analgesics may be used for headache. Aspirin is usually
discouraged because prolonged use increases the risk of bleeding.
For moderate to severe head injury, urgent treatment is required. The following first aid
treatment is indicated if the victim is comatose or symptoms are severe.
1. Check the victim's airway, breathing, and circulation. If necessary, begin rescue
breathing and CPR.
2. If the victim's breathing and heart rate are satisfactory but he or she is unconscious,
treat him or her as if there is a spinal injury. Stabilize the head and neck by placing
your hands on both sides of the victim's head, keeping the head in line with the spine and
preventing movement. Wait for medical help.
3. Unless there has been a skull fracture, attempt to stop any bleeding by firmly pressing
a clean cloth on the wound. If the injury is serious, be careful not to move the victim's
head. If blood soaks through the cloth, don't remove it; just place another cloth over the
4. If you suspect a skull fracture, do not apply direct pressure to the bleeding site and
do not remove any debris from the wound. Cover the wound with sterile gauze dressing and
get medical help immediately.
5. If the head wound is superficial, wash it with soap and warm water and pat dry.
6. If a victim is vomiting and you don't suspect a spinal injury, turn his or her head to
the side to prevent choking. Children often vomit once after a head injury. But even if
the child does not vomit again and is not behaving differently, contact a doctor.
7. Apply ice packs to swollen areas.
8. Over-the-counter pain medicine usualy helps reduce headache.
9. Over the next 24 hours, observe the victim for any signs of a serious head injury.
During the night, awaken the victim every 2 to 3 hours and check for alertness. Ask the
victim specific questions, such as an address. If the victim becomes unusually drowsy,
develops a severe headache or stiff neck, vomits more than once, or behaves abnormally,
get medical help immediately.
10. Refrain from vigorous activity for 24 hours after a serious head injury.
- DO NOT remove the helmet of a victim if you suspect a serious head injury.
- DO NOT wash a head wound that is deep or bleeding profusely.
- DO NOT remove any object sticking out of a wound.
- DO NOT move the victim unless absolutely necessary.
- DO NOT shake the victim if he or she seems dazed.
- DO NOT let other, more obvious, injuries distract you from the head injury.
- DO NOT pick up a fallen child with any sign of head injury.
- DO NOT consume alcohol within 48 hours of a serious head injury.
Call immediately for emergency medical
- there is severe head or facial bleeding.
- there is a change in the victim's level of consciousness (such as confusion or
- there is any cessation of breathing.
- you suspect a serious head or neck injury.
- Always wear a helmet when biking.
- Make sure that children have a safe area in which to play.
- Provide adequate supervision for children of any age.
- Be visible. Don't ride a bike at night.
- Obey traffic signals when riding a bike. Be predictable so that other drivers will be
better able to determine your course.
- Use appropriate safety equipment (such as hard hats, bicycle or motorcycle helmets, and
seat belts) when involved in activities that could result in head injury.