Head injuries range from a bump that needs only a cold pack to bleeding around the brain that threatens life. After a blow to the head a person may injure the scalp, skull, brain, eyes, ears or spine, and the damage inside is not always visible. First aid for head injuries has three goals: protect the airway, protect the neck and watch carefully for changes that signal the brain is in trouble.
Warning Signs After Head Injuries
- Headache that gets worse or giddiness
- Nausea or repeated vomiting
- Drowsiness, irritability or confusion
- Slurred speech, blurred vision or memory loss
- Bruising around the eyes or behind the ears, or bleeding into the corners of the eyes
- Blood or clear fluid from the ears, nose or mouth
- Weakness, loss of coordination or paralysis on one side
- Any loss of consciousness, however brief, or a seizure
Head Injuries First Aid for a Conscious Person
- Check DRABC using the primary survey. A clear airway always comes first.
- Keep the head and neck still. Any significant head injury should be treated as a possible spinal injury until proven otherwise. Support the head in the position found and do not let the person twist or lift it.
- Control bleeding with firm, gentle pressure over the wound. Do not press hard on a depressed or obviously fractured area of the skull.
- If fluid is draining from an ear or nose, let it drain freely and lightly cover with a clean dressing. Do not plug it.
- Reassure and monitor. Expect repeated questions if memory is affected. Check alertness, speech, pupils, pulse and breathing every five to ten minutes.
- Give nothing to eat or drink and have a bowl and towel ready in case of vomiting.
- Get medical help. Seek urgent advice for any warning sign above.
If the Person Is Unconscious
Open and clear the airway, check breathing and start CPR if needed. If breathing normally, support the head and neck and roll them into the recovery position with as little movement as possible, since vomiting is likely. Control bleeding, cover wounds, call an ambulance and record breathing, pulse and alertness regularly.
Medicines and Head Injuries
Do not give aspirin, which may increase bleeding, and do not give alcohol. Where the person lost consciousness in the previous week, avoid giving pain relief unless a doctor has assessed them, because drowsiness caused by the medicine can hide a worsening injury.
Delayed Danger After a Head Injury
A person can appear to recover and then deteriorate hours later as swelling or bleeding builds. Anyone with a significant blow to the head should not be left alone for the first 24 hours and should return for urgent assessment if they become increasingly drowsy, vomit repeatedly, have a severe headache, a seizure or develop unequal pupils. See our guides to concussion and cerebral compression.
Frequently Asked Questions
Should I wake someone with a head injury during the night?
If advised by a doctor, check that they are rousable and responding normally. Otherwise seek medical advice about monitoring.
Do all head injuries need hospital care?
No, but anyone who lost consciousness, has the warning signs listed above, or is a child, older adult or on blood thinners should be assessed.
References and Further Reading
- NHS, Head injury and concussion
- American Heart Association and American Red Cross, Guidelines for First Aid
Last updated: October 2026
Prepared by: EHS Guidelines Editorial Team
This article is general educational information and is not a substitute for accredited first aid training or professional medical care. In an emergency, call your local emergency number immediately. Emergency numbers, medicines and protocols differ between countries, so follow local guidance.
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