Awareness and First Aid
A head injury can change a life in minutes.
Whether caused by a fall, a sports injury, or a road accident, knowing how to respond in the first hour can make the difference between a full recovery and serious long-term damage.
Christna van Wijk, an Emergency Care Practitioner at ER24 East Metro, says spotting a head injury early and responding correctly can make a critical difference. “Head injuries are unpredictable,” she says. “What looks mild at first can escalate quickly if warning signs are missed.”
What to watch for in the first hour after a head injury
After a head injury, the person should be closely monitored for signs of either a mild concussion or a more serious traumatic brain injury (TBI).
Concussion vs traumatic brain injury: what’s the difference?
A concussion is considered a mild traumatic brain injury. Symptoms are often temporary and may include headache, dizziness, nausea, and confusion. These usually resolve within minutes to weeks, although recovery can sometimes take longer.
More serious traumatic brain injuries (TBIs) can cause ongoing or life-threatening complications, including loss of consciousness, seizures and long-term cognitive, emotional or physical impairment.
“The key differences are the severity and duration of symptoms, as well as changes in consciousness,” Van Wijk explains. “Symptoms may appear immediately or develop over time. That’s why close monitoring in the first hour is so important.”
Do head injury symptoms differ in children?
Yes. Children may show different or more subtle warning signs, including:
- Changes in eating or nursing
- Persistent crying or unusual irritability
- Seizures
- Loss of previously learned skills, such as toilet training.
“Children can’t always explain what they’re feeling,” Van Wijk says. “If you feel something isn’t right, you should trust your instinct and seek medical advice.”
When to go straight to an Emergency Centre
Look out for these warning signs, which may indicate a serious head injury and need immediate assessment at an Emergency Centre:
- Seizures
- Loss of consciousness, unresponsiveness or increasing drowsiness
- Difficulty staying awake
- Repeated vomiting
- Severe or worsening headache
- Increasing confusion, agitation or irritability
- Severe neck pain
- Vision or hearing problems
- Weakness, numbness, tingling or burning in the arms or legs
- Clear fluid draining from the nose or ears
- A history of brain surgery, blood-clotting disorders or blood-thinner use.
“When in doubt, go to the Emergency Centre,” Van Wijk says. “It’s always safer to err on the side of caution with head injuries.”
The 3 things not to do if you suspect a head injury
1. Never leave the person unattended
A person with a head injury should never be left alone, especially in the first few hours.
“Symptoms can get worse very quickly,” Van Wijk explains. “If no one is watching for changes in behaviour, alertness or breathing, life-saving treatment can be delayed.”
2. Never move the person if there’s a risk of neck or spinal injury
If the person collapsed after a fall, tackle or accident and complains of neck pain or can’t get up, do not move them unless their life is in imminent danger. “Moving someone with a possible spinal injury can cause permanent damage,” warns Van Wijk. “The safest option is to keep their head still and wait for trained professionals to immobilise them properly.”
3. Never put something in their mouth during a seizure
If a person has a seizure after a head injury, place them on their side if possible.
“There’s a common myth that you should put something in their mouth to prevent swallowing the tongue. This is dangerous and can lead to choking, aspiration (inhaling a foreign object), or serious mouth injuries.”
Medication after a head injury
Avoid medicines like blood thinners and anti-inflammatories unless advised by a healthcare professional, as they can increase the risk of bleeding. Alcohol should also be avoided. “For pain relief, paracetamol is generally safe for healthy individuals,” Van Wijk says, “but medical advice should always come first”.
Sleep isn’t automatically dangerous after a head injury, but close monitoring is essential. The person should be checked regularly to ensure they’re alert and behaving normally. If they become increasingly drowsy, confused or difficult to wake, they need urgent medical attention.
Returning to normal activities
Recovery depends on the severity of the injury. After a concussion, ER24 experts recommend at least 24-48 hours of rest for both the body and brain before slowly returning to normal activities. More serious head injuries take longer to recover from and must be managed by a medical professional.
What bystanders should do first
“The single most important thing is to call emergency services if any red flags are present,” Van Wijk advises.