First Aid: Head Injuries

A strong blow to the head may cause swelling and bleeding inside the skull. The resulting pressure can injure the brain (concussion). If you have any doubts about a concussion, have a healthcare provider check the victim.

When to call 911

Call 911 right away if any of the following is true:

  • The victim loses consciousness or is lethargic.

  • The victim has convulsions or seizures.

  • The victim has unequal pupil size. The pupil is the black part in the center of the eye.

  • The victim shows any of the following signs of concussion:

    • Confusion or inability to follow normal conversation

    • Slurred speech

    • Dizziness or vision problems

    • Nausea or vomiting

    • Muscle weakness or loss of mobility

    • Memory loss

    • Sensitivity to noise

  • A depressed or spongy area in the skull, or visible bone fragments

  • Clear fluid draining out of  the ears or nose

  • Bruising behind the ears or around the eyes

While you wait for help:

  • Reassure the person.

  • Treat for shock by maintaining body temperature and keeping the victim calm.

  • Do rescue breathing or CPR, if needed.

If the person has neck or back pain or is unconscious, he or she might have a spine fracture. Move the person only with great caution and only if absolutely needed.

Step 1. Control bleeding

  • Apply direct pressure to control bleeding. Wear gloves or use other protection to avoid contact with victim's blood.

  • Wash a minor surface injury with soap and water after the bleeding stops or is reduced.

  • Cover the wound with a clean dressing and bandage.

Step 2. Ice bumps and bruises

  • Place a cold pack or ice on the injury to reduce swelling and pain. Placing a cloth between the skin and the ice pack helps prevent tissue damage from severe cold.

Step 3. Observe the victim

  • Watch for vomiting or changes in mood or alertness. If you notice changes, call for medical help. Signs of concussion may not appear for up to 48 hours.

  • Tell the person's partner, parent, or roommate about the injury so he or she can continue to observe the victim.


If a cut is deep or continues to bleed, or the edges of skin don't stay together evenly, the wound may need to be closed with stitches, tape, staples, or medical glue. Any of these can help speed healing and reduce the risk for infection and the size of the scar. These may be especially important concerns with large wounds, and wounds on the head or other visible body parts.

If you think a wound may need medical care, see a healthcare provider as soon as possible. If you need stitches, they must be done in the first few hours. A wound that is not properly closed is at risk for serious infection.