Emergency advice

Minor head injury:

  1. Hold ice pack against head.
  2. Assess level of response with AVPU scale.
  3. If unresponsive or worried call 999/112.

Severe head injury:

  1. Call 999/112.
  2. Monitor breathing, prepare to do CPR if necessary.
  3. Try not to move in case of a spinal injury. 

Minor head injuries

Signs and symptoms

Look for:

  • any loss of responsiveness
  • scalp wound
  • dizziness or feeling sick
  • loss of memory of events before or during the injury
  • headache
  • confusion.

What to do

  1. If they are responsive, sit the casualty 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 using the AVPU scale:

    • A - Are they alert? Are their eyes open?
    • V - Can they respond to you if you talk to them? Can they answer simple questions?
    • P – Does the casualty respond to pain? If you pinch their ear lobe, do they move or open their eyes?
    • U - Are they unresponsive to all the above? If they are unresponsive or you are worried, call 999 or 112 for emergency help.
  3. If they have any wounds, treat them by applying direct pressure to the wound. Secure with a dressing if needed.

  4. 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 999 or 112 for emergency help and explain the cause of the injury and give them details of the casualty’s response to the AVPU scale.
    • If they become unresponsive at any point, open their airway, check their breathing and prepare to treat someone who’s become unresponsive.
  5. 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 medical practitioner.

  6. 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.

Serious head injuries

Signs and symptoms

If someone has had a serious head injury, they may have:

  • experienced a severe blow to the head
  • increased drowsiness
  • persistent headache
  • dizziness and confusion
  • loss of balance or memory
  • difficulty speaking or walking
  • vomiting episodes
  • double vision
  • seizure
  • deteriorating level of response
  • unresponsive
  • blood or blood stained watery fluid coming from the ear or nose
  • unequal pupil size.

What to do

  1. If you think someone has a serious head injury, call 999 or 112 for emergency help and tell ambulance control that you suspect a serious head injury.

  2. While waiting for help to arrive, ensure their airway is open and clear, keep checking their breathing and prepare to start CPR if necessary.

  3. Try not to move the casualty from the position you found them in as they may have a spinal injury. Only move them if they are in danger.

  4. Continue to monitor the casualty, watching for any changes in level of response.

Did you find this information helpful?

Browse our first aid products:

 

First aid ice packs and heating pads

First aid ice packs and heating pads

Shop now


Our training courses:

First aid courses

First aid courses

View


Related first aid advice

Severe bleeding

When bleeding is severe, it can be dramatic and distressing. Find out what to do.

How to do CPR on an adult

If an adult is unresponsive and not breathing normally, you need to call 999 or 112 for emergency help and start CPR straight away. Learn what to do.

Spinal injury

There are a variety of possible causes for a spinal injury. The greatest risk is damage to the spinal cord. Find out what to do and what to look for.

St John Ambulance volunteers providing support