Head injuries account for around 5000 deaths per year in the UK along with 162,000 hospital admissions. A cautious approach is needed due to the potential for brain injury as a consequence of the original injury to the head.


Concussion is a shaking up of the brain. Common causes of concussion include impacts to the head during sports such as rugby and boxing, road traffic incidents and falls.

Anybody who has lost consciousness, however briefly, through a head injury should be considered to be concussed. Not all concussions result in loss of consciousness though. Other signs of concussion include confusion, headaches, dizziness, sickness, fatigue, difficulty sleeping and memory problems.

Symptoms of concussion usually resolve within a few weeks of the incident but can be very unpleasant during that time. An extended period of rest is needed however as the effects may last longer than this. A second impact to the head before a full recovery has been made can increase the risk of long term effects on the brain including mood disorders and memory problems.

A series of small impacts to the head can have an equivalent effect to one large impact. This can be a particular concern in some sports.

Anybody who is believed to be concussed should attend A+E for assessment.

Cerebral Compression

Some head injuries can lead to bleeding into the skull. This injury may put pressure on the brain itself, known as compression and leading to a serious and worsening impact on the casualty. This is a life-threatening condition and needs urgent medical help. Signs may be similar to a concussion but a deteriorating level of consciousness may also be seen. The casualty may appear flushed in the face and both breathing rate and pulse may slow noticeably.

Compression injuryThe casualty’s eyes may not work as they should, with pupils not reacting to light or not reacting together.

If the casualty is conscious, keeping them in a position where their head is up may help to slow the effects of compression but this is a medical emergency and warrants a 999 call.


Skull Fractures

A skull fracture may occur if a significant enough impact takes place. Signs of skull fracture include bruising around the eye sockets and behind the ears as blood pools in the soft tissues, fluid or blood coming from the ears, nose and possibly eyes, severe headache and any ‘boggy’ sensation found when gently feeling the skull.

Any suspected skull fracture needs assessing in A+E even if the casualty feels well.

Caution Advised

Head injuries are amongst the more concerning incidents a first aider might have to deal with. The brain is such a complex and delicate organ that only a cautious approach is appropriate. Any concerns regarding head or brain injury must be referred to A+E.

Further info

For more information on brain injury and the support available, take a look at Headway’s website. If you’d like to join one of our first aid courses for individuals and businesses, take a look at our courses page.