Head injuries are fairly common, especially in children, but they can happen to anyone from trips and falls, traffic collisions and sporting injuries. It may be obvious from the injury that someone needs professional medical attention, but sometimes signs take a while to manifest.
Let’s talk you through when to seek help immediately, and what to look out for in the hours and days afterwards. It's important to stress that most head injuries are minor and do not result in serious or lasting injury, but it's important to be aware when an injury could be significant.
If it’s a yes to any of this checklist, make sure the person you’re looking after gets to hospital:
Have been knocked unconscious, even if they have since recovered
Are finding it difficult to stay awake
Clear fluid running from their ears or nose
Bleeding from one or both ears
Bruising behind one or both ears
Any signs of damage to the skull or skin on the head, like a deep cut, bleeding or a dent
They are intoxicated with drugs or alcohol
A seizure or fit
In relation to the mode of injury:
It was caused by a forceful blow to the head or a knock at speed – this might be in an assault with a fist or weapon, a collision between car and pedestrian, bike or another car passenger
They have fallen from a height of more than 1 metre or 5 stairs
If you know about the person’s background, they should go to hospital urgently if:
They've previously had brain surgery
They have problems with bleeding or clotting, either from a condition (like haemophilia) or medication (warfarin, apixaban or rivaroxaban)
You suspect a non-accidental injury or this is a vulnerable person
Symptoms usually start within 24 hours, but can take up to 3 weeks to show, and may indicate concussion (a mild brain injury), a skull fracture or a bleed in the brain.
You should get the injured person to the emergency department with urgency if any of the following manifests in the hours or days after the accident:
Problems with walking or balance
Weakness, numbness or loss of sensation in any part of the body
Changes to your eyesight
A headache that doesn’t go away with painkillers
Problems with speaking or understanding, and problems with reading or writing
Problems with remembering of events before or after the injury
Behaviour changes such as being more irritable or short-tempereda, finding concentration difficult, or feeling no interest in things or people around them
Young children and babies can be difficult to assess, and their heads are more vulnerable as it takes time to develop the hard shell of skull we have as adults. All of the above applies, but particularly take notice of changes to behaviour – lacking interest in anything, crying more than usual.
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