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Emergency First Aid for Head Injuries

If you suspect serious head injury, you need to take care of three things right from the start:

Observe for signs of shock, a concussion, or a skull fracture.

Position the victim so he or she is immobile, in order to prevent further damage to both the brain and the spinal cord.

Treat scalp cuts and wounds for bleeding to avoid infection.


Do not give a person who has suffered a head injury any food or water. Both can induce vomiting—which can create breathing problems in a semiconscious or unconscious person. Note that ice packs won't help either. The best medicine is to get the person to a hospital—fast.

If you're in a situation where you need to provide help to a person who has experienced a severe head injury, take care to lend the following first aid:

  1. Immediately call for help.
  2. See if the injured person is unconscious. Note the length of time the unconsciousness lasts.
  3. Look for bleeding from the eyes, nose, or ears. This doesn't have to be bright red blood; it can be something like brown discoloration around the rims of the eyes. This bleeding can be a sign of internal hemorrhaging. Keep the injured person in a prone position, face up.
  4. If the injured person is conscious and does not appear to have a neck injury, place a pillow under his head and turn his face to the side.
  5. While you are waiting for help, treat any scalp wounds. Clean cuts thoroughly, cover them with gauze, and apply tape that's firm but not constricting.
  6. Look for outwardly physical signs of brain injury. These can include:
  7. Severe headaches Convulsions
    Slurred words Vomiting
    Loss of vision or double vision Loss of short-term memory
    Bruising behind the ear or around the eyes Clear or bloody fluid seeping from the ear, nose, or mouth
    Unequal pupils Weakness or paralysis in limbs
  8. If any of the signs described in step 6 appears before an emergency medical team shows up, immobilize the injured person (see Bandaging Wounds). This is crucial for preventing any more damage to the brain, spinal cord, or neck.
  9. After the injured person has been released from medical care, he or she should be watched for the symptoms described in step 6 for at least 48 hours. If the symptoms recur, the victim should again seek emergency medical care as quickly as possible.

If the person you're helping has been knocked unconscious by the head injury, do not be surprised if she is in a highly agitated state when she becomes conscious. People who have been unconscious don't just open their eyes and yawn—contrary to what you see in Hollywood movies. They usually shake their heads and kick their feet, and they might pull at tubes that are hooked up to them. And, more than likely, they won't have a clue as to where they are or what happened—or even who you are sitting in the corner with tears in your eyes.

The longer a person is unconscious, the more agitated he or she may be upon recovery. Believe it or not, this is a characteristic you want to see. Agitation implies brain activity. Because the injured person is moving, shaking, and acting up, you know that she is alive and that the brain is functioning. Try to keep the person calm and still until medical help arrives. On the other hand, if the injured person doesn't move when she wakes up, or if her eyes stay focused in the distance, the head injury has probably caused damage to the brain.

More on: First Aid

Excerpted from The Complete Idiot's Guide to First Aid Basics © 1996 by Stephen J. Rosenberg, M.D. and Karla Dougherty. All rights reserved including the right of reproduction in whole or in part in any form. Used by arrangement with Alpha Books, a member of Penguin Group (USA) Inc.

To order this book visit Amazon's web site or call 1-800-253-6476.


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