Head Injury and Concussion

Overview

All head injuries are potentially serious and should be assessed promptly.

A head injury may cause damage to the brain tissue, a skull fracture or an injury to the spine or neck.

You must get medical help if you or your child have any symptoms after a head injury. You might have concussion (temporary brain injury) that can last a few weeks.

Immediate First Aid Steps

1. If the casualty is responsive, sit them down and hold something cold against the injury to help reduce the swelling, like an ice pack or a frozen bag of vegetables wrapped in a tea towel.
2. While you do this, try and assess the casualty’s level of response:
   • ​Are they alert? Are their eyes open?
   • Can they respond to you if you talk to them? Can they answer simple questions?
   • Does the casualty respond to pain? 
     If you apply pressure on the eyelid just below the eyebrow next to the bridge of the nose with your thumb for 10 seconds, do they move or open their eyes? 
   • Are they unresponsive to all the above? If they are unresponsive or you are worried, call an ambulance immediately for emergency help.
3. Keep monitoring their level of response.

• ​​If they are alert and responsive and have always been so, their head injury is probably mild. You or another responsible adult should wait with them until they recover.
• If they’re not alert or responsive or they appear to be confused, their head injury could be more serious. Call an ambulance for emergency help and explain the cause of the injury.
• If they become unresponsive at any point, open their airway, check their breathing and prepare to treat someone who’s become unresponsive.

If their injury has been caused by a sporting incident, make sure they do not return to the sport until they have been fully assessed by a healthcare professional.

Advise the casualty to seek medical help if the head injury appears to get worse or if any of the following apply:

• they are over the age of 65
• they had previous brain surgery
• they are taking anti-clotting medication
• they have been taking drugs or drinking alcohol
• there is no one responsible to look after them.

When To Seek Medical Help

Call an ambulance if someone has hit their head and has:

• been knocked out and has not woken up
• difficulty staying awake or keeping their eyes open
• a fit (seizure)
• fallen from a height more than 1 metre or 5 stairs
• problems with their vision or hearing
• a black eye without direct injury to the eye
• clear fluid coming from their ears or nose
• bleeding from their ears or bruising behind their ears
• numbness or weakness in part of their body
• problems with walking, balance, understanding, speaking or writing
• hit their head at speed, such as in a car crash, being hit by a car or bike or a diving accident
• a head wound with something inside it or a dent to the head

Seek immediate medical help (e.g. Emergency Department) if you or your child have had a head injury and have:

• been knocked out but have now woken up
• vomited (been sick) since the injury
• a headache that does not go away with painkillers
• a change in behaviour, like being more irritable or losing interest in things around you (especially in children under 5)
• been crying more than usual (especially in babies and young children)
• problems with memory
• been drinking alcohol or taking drugs just before the injury
• a blood clotting disorder (like haemophilia) or you take medicine to thin your blood
• had brain surgery in the past

You or your child could have concussion. Symptoms usually start within 24 hours, but sometimes may not appear for up to 3 weeks.

You should also go to Emergency Department if you think someone has been injured intentionally. 

Recovery

How to care for a minor head injury

If you have been sent home from hospital with a minor head injury, or you do not need to go to hospital, you can usually look after yourself or your child at home.

You might have symptoms of concussion, such as a slight headache or feeling sick or dazed, for up to 2 weeks.

Do:

• hold an ice pack (or a bag of frozen peas in a tea towel) to the area regularly for short periods in the first few days to bring down any swelling
• rest and avoid stress – you or your child do not need to stay awake if you're tired
• take painkillers such as paracetamol for headaches
• make sure an adult stays with you or your child for at least the first 24 hours

Don’t:

• do not go drive, back to work or school until you're feeling better
• do not play contact sports for at least 3 weeks – children should avoid rough play for a few days
• do not take drugs or drink alcohol until you're feeling better
• do not take sleeping pills while you're recovering unless a doctor advises you to

See a GP if:

• your or your child's symptoms last more than 2 weeks
• you're not sure if it's safe for you to drive or return to work, school or sports