Head injury - first aid

Definition

A head injury is any trauma that injures the scalp, skull, or brain. The injury may be only a minor bump on the skull or a serious brain injury.

Head injury can be either closed or open (penetrating).

Head injuries include:

Head injuries may cause bleeding:

Alternative Names

Brain injury; Head trauma

Causes

Common causes of head injury include:

Most of these injuries are minor because the skull protects the brain. Some injuries are severe enough to require a stay in the hospital.

Symptoms

Symptoms of a head injury can occur right away. Or symptoms develop slowly over several hours or days. Even if the skull is not fractured, the brain can bang against the inside of the skull and be bruised. The head may look fine, but problems could result from bleeding or swelling inside the skull.

In any serious head trauma, the spinal cord is also likely to be injured.

Some head injuries cause changes in brain function. This is called a traumatic brain injury. Concussion is a mild traumatic brain injury. Symptoms of a concussion can range from mild to severe. 

First Aid

Learning to recognize a serious head injury and give basic first aid can save someone's life.

Get medical help right away if the person:

For a moderate to severe head injury, take the following steps:

  1. Call 911 right away.
  2. Check the person's airway, breathing, and circulation. If necessary, begin rescue breathing and CPR.
  3. If the person's breathing and heart rate are normal but the person is unconscious, treat as if there is a spinal injury. Stabilize the head and neck by placing your hands on both sides of the person's head. Keep the head in line with the spine and prevent movement. Wait for medical help.
  4. Stop any bleeding by firmly pressing a clean cloth on the wound. If the injury is serious, be careful not to move the person's head. If blood soaks through the cloth, do not remove it. Place another cloth over the first one.
  5. 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.
  6. If the person is vomiting, to prevent choking, roll the person's head, neck, and body as one unit onto his or her side. This still protects the spine, which you must always assume is injured in the case of a head injury. Children often vomit once after a head injury. This may not be a problem, but call a doctor for further guidance.
  7. Apply ice packs to swollen areas.

A more serious head injury that involves bleeding or brain damage must be treated in a hospital.

For a mild head injury, no treatment may be needed. Be aware though, symptoms of a head injury can show up later. Follow the instructions below under Home Care.

DO NOT

When to Contact a Medical Professional

Call 911 right away if:

Home Care

Friends or family may need to keep an eye on adults who have been injured after they are released from the emergency room or office. If the person is an athlete, follow the health care provider's instructions about when the person can return to sports.

Parents or caregivers of children will need to learn how to keep an eye on the child after a head injury. Follow the health care provider's instructions on when the child can go back to being active and playing sports.

After even a mild concussion do not do activities that can cause further head injury. Avoid tasks that require concentration or complicated thinking. These include reading, homework, preparing reports, and other kinds of brain stimulation. Also avoid bright lights and loud sounds. These can overstimulate the brain. Your health care provider can tell you more.

Keep all follow-up appointments with your health care provider. These help make sure you or your child is recovering well.

Prevention

Not all head injuries can be prevented. But the following simple steps can help keep you and your child safe:

References

Biros MH, Heegaard WG. Head injury. In: Marx JA, Hockberger RS, Walls RM, et al., eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 7th ed. Philadelphia, PA: Elsevier Mosby; 2009:chap 38.

Landry GL. Head and neck injuries. In: Kliegman RM, Stanton BF, St. Geme JW III, et al., eds. Nelson Textbook of Pediatrics.19th ed. Philadelphia, PA: Elsevier Saunders; 2011:chap 680.