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Head Injuries – Skull Fractures, Concussions & Compressions




Head injuries can cause concussion, compression or skull fractures, and may lead to disturbance of the brain.

If this happen the casualty may become drowsy or even unconscious, masking the symptoms of other injuries.

Therefore, head injuries must always be regarded as serious and requires immediate check-up, even if there is no obvious sign of a wound. Generally, head injuries commonly occur due to:

  • A road accident
  • A fall, particularly in a person who is elderly, unwell or drunk.
  • A sports accident
  • Dangerous occupations, such as mining or construction work.
  • Illegal fighting.

There are 3 types of commonly known and potentially dangerous head injuries:

1. Concussion / Blows

Concussion is unconsciousness, however brief, that results from a head injury such as:

  • A blow on the head.
  • A blow to the jaw.
  • A fall on to the feet from a height, which causes the brain to the shaken within the skull.

The loss of consciousness, may be so brief that even the casualty may not be aware of it.

When the casualty regains consciousness, he or she may feel nauseous and may not be able to remember what happend just before or just after the incident. If the casualty remains unconscious, you should suspect compression see below.

The Symptoms for Concussions include:

  • Blurred vision.
  • Dizziness.
  • Unsteadiness.
  • Difficulty in concentrating.
  • Nausea and vomiting.
  • Headaches.

First Aid Guide for Concussion

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  1. For a casualty who swiftly regains consciousness, watch for any deterioration in the level of response, even after apparent recovery. Check breathing and pulse.
  2. Ensure that the casualty remains in the care of a responsible person after the causative incident.
  3. Advice the casualty to see his or her doctor.
  4. Someone injured while playing sport should not be allowed to continue without medical approval.
  5. If the casualty remains unconscious after three minutes, place in the recovery position and ask for an ambulance. Monitor essential signs.

2. Skull Fracture

If a blow to the lead is violent enough to cause an obvious sclap wound or bruising, it may have caused a skull fracture. In areas where the skull is very thin, for example in children and some adults, a fracture may have occurred, even though there may be little evidence of external damage.

Common sites of a skull fracture are at the crown and the base of the skull. The signs of a fractured skull may include:

  • A sclap wound.
  • Loss of consciousness or a temporary, fluctuating consciousness.
  • Blood, or a clear, watery cerebro-spinal fluid coming from the nose or ear.
  • Bloodshot or black eye following a head injury.

First Aid Guide for a Skull Fracture

  1. If the casualty is unconscious, check breathing and pulse and place them in the recovery position.
  2. Help a conscoius casualty lie down, with head and shoulders raised and supported. If there is discharge from an ear , cover with a sterile dressing. If you suspect a spinal injury, treat appropriately.
  3. Control any bleeding from the scalp. Look for and treat other injuries.
  4. Dial the emergency number for an ambulance. Check breathing, pulse rate and level of response at intervals.

3. Compression

Compression is a very serious condition that usually requires surgery. It occurs when pressure is exerted on the brain by a buildup of blood within the skull, by swelling, or by a bony fragment if there is a skull fracture.

It can follow concussion or a skull fracture and may develop immediately or up to several days after the casualty appears to have recovered from the incident. It may also be due to a number of other causes, such as a stroke, infection or tumour.

The Symptoms of Compression include:

  • Noisy breathing.
  • A rinse in temperature.
  • A slow pulse.
  • Unequal dilation of the pupils of the eye.
  • Weakness or paralysis which occurs on one side of the body.
  • Intense headache.

First Aid Guide for Compression
If you suspect that a casualty may be suffering from compression, you should arrange for urgent medical attention. Depends on where you are, reach for a phone and dial your local emergency number and ask for an ambulance.

Check breathing and pulse, and be prepared to resuscicate. Examine for an injury or bleeding and treat as required. Place the injured person in the recovery position.


How can  we examine the skull?
Run your hands over the scalp to identify any swelling, bleeding, or area of soft indentation that may indicate a fracture. Always handle the head and neck carefully, recalling the consequences of spinal cord damage.

Do not attempt to drag or pull a  casualty by holding his body parts because the person could be hurt or injured in different parts of his body. Always get professional help or someone with First Aid knowledge when dealing with an injured person.


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