When There's a Knock to the Noggin: Dealing With a Head Injury

A blow to the head can result in something as simple as a goose egg or as severe as internal bleeding. Most of the millions of head injuries Americans receive every year are not serious and do not require treatment. But how can you tell the minor from the major? And what are the appropriate first steps to take?

It's important to know the answers to these questions. In some situations they may mean the difference between life and death.

When to get immediate medical help
Call 9-1-1 to get emergency medical attention if someone has a head injury and:

• Loss of consciousness
• A seizure
• Problems seeing or speaking
• Bleeding from the eyes, ears or mouth
• Behavior changes such as sleepiness, confusion or irritability
• Fluid coming from the nose
• Repeated vomiting
• Abnormal breathing or heart rate
• Is under the influence of alcohol or other drugs
• Is under age 2
• Weakness or numbness in the legs
• One or both pupils are larger than normal
• Trouble walking

Note: Symptoms may occur right away or may appear later.

While you wait for medical help:

• Keep the injured person still, lying down and quiet. Do not move the person unless necessary. Try not to move the neck.
• Stop any bleeding by pressing down on the cut with a sterile gauze pad or clean cloth. If blood soaks through the cloth, do not remove it. Place another cloth on top of it. Do not apply pressure if the skull looks broken or deformed.
• If the person is vomiting, roll the head, neck and body as one unit to prevent choking and to protect the spine.
• Apply ice packs to swollen areas.
• Do not remove anything sticking out of the wound.
• Do not try to remove a helmet.
• Check breathing and circulation. If you've been trained, do CPR if needed.

First aid for minor head injuries
If there are no signs (listed above) of a serious head injury:

• Apply ice or a cold pack (wrapped in a cloth) to the injured area to help reduce swelling.
• If there is bleeding, apply pressure and a sterile bandage.
• When the bleeding has stopped, gently wash the wound with soap and water.
• Observe the person carefully for the next 24 hours to 72 hours. If sleeping, wake him or her every two or three hours and ask questions like, "What's your name?" and "Where are you?" to check for alertness. If any signs of serious injury (listed above) develop, call your doctor or 9-1-1 for emergency treatment.

Related Articles Taking One for the Team: Concussions and Hard-Hitting Sports First Aid for Common Emergencies What Is Traumatic Brain Injury (TBI)?

External Sources American Academy of Family Physicians. Head injuries: what to watch for afterward. Accessed September 24, 2007. Centers for Diseases and Conditions. National Ag Safety database. First aid for head injuries. Accessed September 24, 2007. Adelson PD, Bratton SL, Carney NA, et al. Indications for intracranial pressure monitoring in pediatric patients with severe traumatic brain injury. Pediatric Critical Care Medicine. 2003;4:S19-S23.

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