Guide · First aid

Head injuries

Most bumps to the head are minor, but some cause bleeding or swelling inside the skull that can become serious over hours. Call your local emergency number (112 in Europe and many other countries, 911 in North America) if the person was knocked out even briefly, or has any of the warning signs below.

Warning signs: call for help

• Unconsciousness, even for a moment, or not remembering what happened
• Drowsiness, or being hard to wake
• Confusion, strange behaviour, or slurred speech
• A seizure (fit)
• Repeated vomiting
• A headache that keeps getting worse
• Weakness, numbness or difficulty walking, seeing or talking
• Clear fluid or blood coming from the ears or nose
• Bruising behind the ears or around both eyes
• Pupils of different sizes
• A dent or soft area in the skull

Take extra care with babies and young children, people over 65, anyone on blood-thinning medicine, anyone who has been drinking, and anyone injured in a high fall, a crash or by a heavy blow.

Neck injury

If the injury came from a fall, crash or dive, assume the neck may be hurt as well. Keep the head and neck still and in line with the body. Only move them to keep the airway open or to get them out of danger.

What to do

1. If they are unresponsive, check their breathing. If they are breathing normally, put them in the recovery position, keeping the head and neck in line. If not, start CPR.
2. If they are responsive, help them sit or lie down somewhere comfortable.
3. For scalp bleeding, press with a clean pad. Scalp wounds bleed a lot. If you feel a dent or something moving, press gently around the edges instead.
4. Hold a cold pack wrapped in cloth on a bump for up to 20 minutes.
5. Write down what happened, when, and whether they were knocked out.

The next 48 hours

Someone should stay with the person for at least the first 24 hours to watch for the warning signs above. They can sleep, but check that they can be woken normally and answer simply in the first few hours.

• Rest, with no sport or hard work for a few days.
• Avoid alcohol and sleeping tablets.
• Paracetamol can ease a headache.
• Don't drive or operate machinery until fully recovered.

Headache, tiredness, dizziness and poor concentration can last for some days or weeks after a minor head injury. If these aren't improving after two weeks, get them checked.

This guide does not replace a first-aid course. A few hours of hands-on practice will make you far more confident when it matters.

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