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First aid for head injuries

Head injuries caused by a blow or jolt to the head area can damage the brain. Experts call them traumatic brain injuries if the brain is damaged and its functions are restricted.

If you witness a head injury during or sports event or in traffic, you can help at the scene of the accident and prevent worse consequences by acting fast.

Head injuries often cause drowsiness, headache, dizziness and nausea. The injured person might also seem confused or disoriented. Some people can't remember what happened or might even be unconscious. If you witnessed the accident, you will be able to give the paramedics important information.

When is it important to call an ambulance?

It is not always easy to tell how severe a head injury is. If you're not sure, it's always better to call the emergency services immediately (112 in Germany and many other countries, 911 in the U.S.).

You should do so without delay in the following cases:

  • Unconsciousness
  • Impaired memory
  • Constant headaches that get worse
  • Repeated vomiting
  • Severe or drowsiness
  • Unclear speech or vision
  • Unusual behavior
  • Different sized pupils
  • Seizures
  • Bleeding or loss of fluid from the ear or nose
  • Severely bleeding wounds to the head

How can I help the injured person at the scene of the accident?

It is important to first talk to the injured person and check whether they are conscious.

What do I do if the person is unconscious?

If the person is unconscious and no longer breathing, it's critical to immediately start with reanimation until the paramedics arrive.

If the person is unconscious but still breathing, it's best to put them in the recovery position. Make sure you regularly check that they are breathing until the paramedics arrive.

Image: Supine position with elevated head

What do I do if the person is conscious?

If the injured person is awake and responsive, it's best to do the following:

  • Keep them calm: Make sure people around remain calm and calm the injured person.
  • Lie them down: If possible, carefully lie the person down on their back and slightly elevate their upper body and head, using a jacket or coat perhaps. That can reduce pressure in the brain which may be increased by a head injury. It is important to remember that the spine might have been injured in the accident. That is why it is very important to move the injured person as little as possible.
  • Observe: When taking care of the person, observe whether their condition changes – like if they lose consciousness or stop breathing.
  • Keep them warm: Use blankets or clothing to keep the person warm.
  • Treat wounds: Cover bleeding head wounds as hygienically as possible with compression bandages.
  • Stay with them: Stay with the person – they may need a little while to regain their orientation. Do not leave them alone.

Encourage the injured person to seek medical attention – even if the head injury seems harmless at first. Medical attention is especially important if symptoms like headache, drowsiness, or dizziness do not go away after a short while or even get worse. If in doubt, call the emergency services.

Deutsche Gesellschaft für Neurochirurgie (DGNC). Schädel-Hirn-Trauma im Erwachsenenalter (S2e-Leitlinie, in Überarbeitung). AWMF-Registernr.: 008-001. 2015.

Deutscher Feuerwehrverband (DFV). Erste Hilfe kompakt: Notfallstichwort: Kopfverletzung. Empfehlungen des Bundesfeuerwehrarztes – Folge XIII. 2012.

Deutsches Rotes Kreuz (DRK). Gewalteinwirkung auf den Kopf. Symptome bei Störungen des Bewusstseins. 2021.

Gänsslen A, Schmehl I. Leichtes Schädel-Hirn-Trauma im Sport. Handlungsempfehlungen. Bundesinstitut für Sportwissenschaft (BISp). 2015.

Gesellschaft für Neonatologie und pädiatrische Intensivmedizin (GNPI). Schädel-Hirn-Trauma im Kindes- und Jugendalter (S2k-Leitlinie), AWMF-Registernr.: 024-018. 2022.

Olasveengen TM, Semeraro F, Ristagno G et al. Basismaßnahmen zur Wiederbelebung Erwachsener (Basic Life Support). Leitlinien des European Resuscitation Council 2021. Notf Rett Med 2021 [Epub ahead of print]; 24(4): 386-405.

Pschyrembel Online. 2021.

Zideman DA, Singletary EM, Borra V et al. European Resuscitation Council Guidelines 2021: First aid. Resuscitation 2021; 161: 270-290.

IQWiG health information is written with the aim of helping people understand the advantages and disadvantages of the main treatment options and health care services.

Because IQWiG is a German institute, some of the information provided here is specific to the German health care system. The suitability of any of the described options in an individual case can be determined by talking to a doctor. informedhealth.org can provide support for talks with doctors and other medical professionals, but cannot replace them. We do not offer individual consultations.

Our information is based on the results of good-quality studies. It is written by a team of health care professionals, scientists and editors, and reviewed by external experts. You can find a detailed description of how our health information is produced and updated in our methods.

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First aid for head injuries

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Created on November 17, 2022

Next planned update: 2025

Publisher:

Institute for Quality and Efficiency in Health Care (IQWiG, Germany)

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