Head Injury Assessment

Authored by Dr Gurvinder Rull, 09 Jul 2017

Patient is a certified member of
The Information Standard

Reviewed by:
Dr Adrian Bonsall, 09 Jul 2017

What to look for after a head injury

Make sure there is no risk of further injury to yourself and the patient. Look for the following six features which will help give an idea of the severity of the head injury:

  1. Did they blackout?
  2. Is there a wound on the head?
  3. Are they nauseous or dizzy?
  4. Can they remember what happened before and during the injury?
  5. Do they have a headache?
  6. Are they confused?

In a severe head injury you may also find:

  • They are less responsive. A simple way of checking this is using the AVPU scale. This stands for:
    • A - Alert: Are they alert? Are their eyes open? Do they respond to questions?
    • V - Voice: Do they respond to voice? Can they answer simple questions? Can they respond to instructions?
    • P - Pain: If they are not awake or are not responding to you try pinching them - do they move or open their eyes in response to the pain?
    • U - Unresponsive: they are not responding to questions or a gentle shake or pain.
    • If they can do all of the above then the head injury is likely to be mild but someone should still stay with them until they recover.
  • There is blood or water-like discharge from ear or nose.
  • The pupils are of different sizes.

What you need to do next

  1. Press a cold compress or a packet of frozen peas wrapped in a towel at the site of the head injury.
  2. If there is a cut on the head use simple pressure to stop the bleeding.
  3. Use the AVPU scale as above.
  4. Call help if needed.

Call 999/112/911 for an ambulance if:

  • They are not improving.
  • They have any of the serious features.
  • You are concerned about how alert they are or they are not responding normally.

Medical help may also be needed in:

  • Those over 65 years of age.
  • An injured person who has been drinking alcohol.
  • An injured person who has been using recreational drugs.

Whilst you are waiting for the ambulance, do not leave the injured person alone and do keep checking on them.

Further reading and references

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