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Head Injuries

Updated: Jun 22

Head injuries can be an extremely difficult situation for the first aider. They often impair* communication meaning it is much harder to gather relevant information, and can lead to distressing symptoms even if they are not severe.


Try not to move the casualty - they may have a neck or spinal injury*, and moving them could aggravate it and cause permanent damage.



Signs and Symptoms

  • Impaired response

  • Headache

  • Visible scalp wound

  • Dazed

  • Loss of memory regarding incident

  • Dizziness

  • Nausea/vomiting

  • Lumps/bumps


Stretch!

The brain has no pain receptors. Headaches occur when surrounding tissues, blood vessels, or nerves are affected.


In a more severe case, you may see:

  • Unresponsiveness

  • Inequal pupil size/response

    • When you shine a light on (not in) the eyes, the pupils dilate unevenly

  • Blood or watery fluid from ears/mouth/nose


Stretch!

Cerebrospinal fluid (CSF) leaking from the ears or nose suggests a skull fracture, usually at the base of the skull.


What to do:

If the casualty* is responsive:

  • Sit them down

  • Keep them calm

  • Apply ice pack

  • Apply pressure around the wound if it is visible

  • If it is mild, no need to call emergency services - stay with the casualty until they recover


While you do this, try to assess their level of response using the ACVPU scale. If they are conscious and alert - even if slightly drowsy or confused - their injury is likely mild. If they are unresponsive, very confused, or you are worried/don't know what to do - call emergency services and explain the situation.


Summary:

Head injuries can be difficult to assess because they make speaking difficult and cause scary symptoms, even when mild. Signs include headache, dizziness, memory loss, and nausea (feeling like you're about to vomit). More serious signs include unresponsiveness*, fluid from the ears or nose, and unequal pupil reaction. First aid involves keeping the casualty calm and still, applying an ice pack, and assessing their response using the AVPU scale.


Glossary:


Impair: damage, or make something worse


Spinal injury: an injury that affects the spine, especially the spinal nerve inside that lets us control our body.


Casualty: the person that's hurt in a first aid scenario.


Unresponsiveness: when someone becomes unconscious and doesn't respond to touch or sound.


For Older Learners

Use these questions to challenge yourself!

  1. Why is it important not to shine a light directly into someone’s eyes when checking pupil response?

  2. How could use of blood thinners (like warfarin) complicate a seemingly mild head injury?

  3. How might understanding the functions of different brain regions help predict the effects of a traumatic brain injury (e.g. speech difficulties, confusion, motor problems)?


 
 
 

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