Head Injuries

Head Injuries – Part I

Any head injury is potentially serious. If not properly treated, injuries that seem minor could become life threatening.

Head injuries include scalp wounds, skull fractures and brain injuries.

Other injuries include nose bleed, eye injuries as well as spinal injuries.

We want to concentrate on scalp wounds, skull fractures and brain injuries. We will cover the remaining head injuries in our June edition.

Scalp wounds

hWounds to the scalp appear very often much more dangerous than they really are.

The reason for this is the fact that there are many vessels in our scalp. So any cut can cause heavy bleeding.

Myth buster – A bleeding scalp wound does not affect the blood supply to the brain!

First Aid:
  1. Apply a sterile or clean dressing and direct pressure to control bleeding
  2. Keep the casualty’s head and shoulders slightly elevated to help control bleeding if no spinal inury is suspected.
  3. Seek medical attention.
  • DO NOT remove an embedded object; instead stabilise it in place with bulky dressings.
  • DO NOT clean or irrigate a scalp wound if you suspect a skull fracture. The fluid can carry debris and bacteria into the brain.

Skull fracture

If a casualty has a head wound, be alert for a possible skull fracture. A skull fracture is serious because there is a risk that the brain may be damaged either directly by fractured bone from the skull or by bleeding inside the skull.

How do you recognise a fractured skull?

Watch out for the following symptoms:

  • wound or bruise on the head
  • soft area or depression on the scalp
  • deformity of the skull
  • drainage of clear or bloody fluid from the ears or nose
  • bruising under the eyse or behind an ear hours after the injury
  • changes in pupils (unequal, not reactive to light)
  • penetrating wound
  • progressive deterioration in the level of response
First Aid
  1. Monitor breathing. It is your aim to maintain an open airway.
  2. If casualty is conscious, help her to lie down.
  3. Control any bleeding by applying a sterile or clean dressing and applying pressure around the edges, not directly on it
  4. Stabilise head and neck to prevent any movement
  5. Call an ambulance
  6. If casualty is unconscious open the airway and check for breathing. Be prepared to deliver CPR.
  7. If necessary put casualty in the recovery position. If you have helpers use the “log-roll” techniques (to be covered in the June edition)

Brain injuries

We only want to concentrate on traumatic brain injuries which include compression and concussion.

Here a quick summary of the different symptoms:

Concussion is characterised by a brief period of impaired consciousness following a blow to the head or indirect force from falling.


Compression occurs when there is a build-up of pressure on the brain and is usually caused by a head injury. However it can also be caused by stroke, infection or a brain tumour.
Concussion Symptoms
Compression Symptoms
Pale Face
Cold clammy skin
Dry / hot
Rapid breathing
Noisy slow breathing
Rapid pulse
Slow, full and bounding pulse
Sudden onset
Gradual onset
Confused-drowsy, dizziness,headaches
Diminished level of response, goinginto unconsciousness
Pupils equal, nausea, may vomit
Possible paralysis / weakness on oneside
Memory loss
Possible fits, unequal or dilated pupils, intense headache

First Aid :

Treat casualty as for impaired consciousness
Call an ambulance – if conscious keep him supported in comfortable resting position
Monitor and record vital signs, level of response. Even if initially fully recovered watch for subsequent deterioration in level of response.
Regularly monitor and record the casualty’s vital signs – level of response, pulse, breathing – until medical help arrives.
If injured during sport don’t allow to “play on” without first obtaining medical advice.
Do not allow casualty to eat, drink or smoke because a general anaesthetic may be given in hospital!

If you would like to like to read about our range of First Aid Courses in Dublin please click here.