Head Trauma, First Aid

Who's At Risk?

Anyone can be at risk for head trauma. People who play sports and young children, particularly those learning to walk, are especially prone to head injuries.

Signs & Symptoms

Head trauma can present in many ways depending on the severity and type of injury. Symptoms of head trauma may include:

• Bleeding, denting, and other obvious signs of trauma, including bleeding from the ears, nose, or mouth. (Note: The amount of blood from the injury is not necessarily indicative of the severity of the injury.)
• Severe headache.
• Persistent vomiting.
• Decreased alertness of the individual, including lapses in consciousness, drowsiness, or slurred speech.
• Stiff neck.
• Convulsions.
• Unequal pupil size.
• Unusual eye movements.
• Weakness or inability to use an arm or leg.
• Slow breathing.

In infants, look for swelling of the head, particularly in the soft spot in the skull (the fontanel) at the top of the head. If a child gets a bump on the head and then shows any of the above symptoms or is acting less energetic in the next 24 hours, it may be a sign of a more serious injury.

Self-Care Guidelines

First Aid Guide
If you suspect a serious head or neck injury, contact emergency medical services.

In the case of a potential neck injury, it is very important to not move the person unless it is absolutely necessary. The following first aid steps should be taken while awaiting emergency medical care:

1. Check the person’s airway, breathing, and circulation (ABCs).
2. Encourage the person to lie still if they are conscious. If the person is unconscious, stabilize their head and neck by holding your hands on either side of the head and preventing any movement.
3. If there is any bleeding, attempt to stop it.
   • For superficial trauma to the scalp, use a clean bandage and apply direct pressure.
   • For a suspected fractured skull, cover the wound with a clean bandage without applying pressure. Note: Do not attempt to remove any foreign object that may be in the wound.
4. If the person vomits, as is common after head trauma, attempt to protect their airway so they do not choke or inhale the vomit.
   • If the person is conscious and neck injury is not suspected, lean them forward and place support on their forehead.
   • If the person is conscious and a neck injury is suspected, support their neck and head and roll them on their side.
   • If the person is unconscious, assume they have a neck injury, and while supporting their neck and head, roll them on their side.
5. If there are signs of swelling on the head, apply ice.

In the case of a suspected minor head injury, such as a bump on the head in the case of a child, apply ice to the area of swelling and watch them for at least 24 hours. Symptoms may be delayed in some cases of serious head trauma. During the 24-hour observation period:

• Ask the person what their symptoms are, if possible.
• If the person wants to sleep, allow them to do so, but wake them every 2-3 hours and check for alertness by asking questions such as what their address or phone number is.
• Have the person eat easy-to-digest foods and avoid nonprescription medications.
• Continue to observe the person for signs of more serious injury (eg, vomiting more than once, confusion, severe headache, stiff neck, excessive drowsiness, or otherwise behaving abnormally).

Note: Do not allow the person to drink alcohol within 48 hours of their head trauma.

Treatments

Treatment for head trauma varies widely depending on the severity and location of the injury.

For minor head trauma, the medical professional will likely numb and clean any cuts and search for any foreign objects in the affected area. If necessary, any cuts will be closed with stitches, staples, or a special kind of glue. The medical professional may prescribe a pain reliever and may recommend bed rest, ice for any swelling, and fluids.

Severe head trauma will require observation and tests. Internal injuries can cause pressure in the skull, which can be very dangerous and even cause death. The medical professional will probe to check for such pressure. Surgery may be needed in such a case.

Seizures may result from head trauma and will be treated accordingly.

The medical professional may give a tetanus vaccination if there is a wound that is dirty or deep or if the previous vaccination was more than 5 years ago. If infection occurs at the wound site, antibiotics will be prescribed.

Visit Urgency

If the head trauma is severe and/or a neck injury is suspected, seek emergency medical care.

If the head trauma does not appear to be severe and no neck injury is suspected, observe the person as specified in the above self-care measures. If severe symptoms develop over the next 24 hours or later, seek medical help immediately.

While children are particularly resilient to minor head trauma, it is important to watch their behavior carefully following an injury to the head since they often can’t express their symptoms in words. For example, if the child is not acting normally shortly after the injury or any time within the 24 hours following the injury, seek medical attention.

Trusted Links

• MedlinePlus: Head Injuries