Head injuries are common injuries that frequently happen in schools. It is incredibly important that pupils experiencing head injuries are properly assessed and cared for. Particularly if injuries occur whilst playing sports such as football, hockey, cricket and rugby.
In the news
Concerns around the long term impact of repeated head injuries led the Scottish Football Association to announce that they are set to ban children, under the age of 12, heading the ball in training sessions. They are keen to stress this should not imply that heading the ball is safe in older children, as repeated head injuries are not good for brains.
Research has demonstrated a strong association between football players and dementia. A report has shown that former professional footballers are 3.5 times more likely to die with dementia and other serious neurological diseases.
Dr Angus Hunter from Stirling University stated that when young people head the ball it causes electrical disturbances in the brain, disruption to muscles and a reduction in memory recall. When children head the ball in training, they are repeating the event multiple times. This can adversely affect their brains.
How to tell if it’s serious?
When people bang their heads, it can be difficult to tell whether they have done any serious damage. Most head injuries are not serious and simply result on a bump or bruise. However severe, or repeated, head injuries can damage the brain.
Fortunately, the majority of falls or blows to the head result in injury to the scalp only and this is more frightening than life threatening. As the head and face are served by numerous blood vessels, these injuries bleed profusely and can be very scary!
If someone sustains a more serious blow to the head, it is important to assess them properly and ensure they receive prompt and appropriate first aid treatment. It is vital to remember that a severe blow to the head can also result in spinal injury.
Suspected brain injury
The brain is cushioned by cerebrospinal fluid and surrounded by the skull. When an injury occurs, the brain oscillates within the skull and this shaking can tear blood vessels around the brain and cause bleeding. In addition, swelling resulting from injured brain tissue, adds further pressure around the brain and can further squeeze and damage the brain as the swelling increases.
It can be difficult to determine the level of injury. A clear indicator of a more serious injury is when someone loses consciousness or has signs of confusion. Other head injury symptoms can occur at any time; from immediately after the accident, to a couple of days later.
What to look out for:
• abnormal breathing
• obvious serious wound or suspected skull fracture
• bleeding or clear fluid from the nose, ear, or mouth
• disturbance of speech or vision
• pupils of unequal size
• weakness or paralysis
• neck pain or stiffness
• vomiting more than two to three times
Support their head and neck and call an ambulance if someone shows any of these symptoms.These signs of a serious head injury can occur at any point over the following 48 hours.
What to do if someone is unconscious
• If they are breathing – roll them into the recovery position (onto their side so that their tongue falls forward in their mouth and any vomit can drain away), trying not to twist their neck or spine at all. Any head injury could have caused spinal damage as the head recoils from the blow.
• If they are not breathing start CPR.
• Call for an ambulance.
Common symptoms after a head injury
It is common to experience headaches, fatigue, confusion, blurred vision, and drowsiness after the event. Concussion can also affect someone’s mood, balance, sleep, thinking, concentration and senses. It can have an impact upon long term memory recall.
Most important advice following a head injury
If the casualty is showing any adverse signs or symptoms within 48 hours of the head injury, seek urgent medical advice, as it could be a sign of compression. This needs immediate hospital treatment.
Coaches and first aiders should be confident to:
Remove – any player who has experienced a head injury and shows any of the above symptoms should be removed from play immediately.
Recognise – learn the signs of concussion. Only about 10% of people experiencing concussion will lose consciousness. Look out for a dazed or blank expression or tonic arm extension following the blow to the head; along with the symptoms listed above.
Applying a wrapped ice pack will reduce superficial bruising and swelling – but has no effect on brain recovery.
If a severe head injury has been sustained and you are concerned about the casualty’s spine, they should only be removed from the field by someone appropriately trained to do so. If worried and no one appropriate to help; reassure the casualty, support their head in a neutral position, stop the game – or move to another pitch and await removal of the casualty by paramedics.
Rest – for at least 24 hours for an adult and 48 for a child or adolescent
Recover – Ensure the player remains completely symptom free before contemplating any form of return to play.
Return – return to play using the Gradual Return to Play GTRP.
It is recommended to have at least 2 weeks with no training to give the brain a chance to fully recover. Recovery time is vital
It may take 4-6 weeks before a player is fully fit and back to competitive play. This may seem a long time away from the game. However, it is comparable to the recovery time following a soft tissue injury. Brains are important to every aspect of life, it is vital we take head injuries seriously.
The RFU have a superb online training course specific to parents, players, teachers and coaches. www.englandrugby.com/my-rugby/players/player-health/concussion-headcase/
The Football Association also offer useful advice: www.thefa.com/get-involved/coach/concussion
First Aid for Life cover head injuries on all our first aid courses. We have a full range of practical and online first aid courses designed for staff and pupils in schools. Please visit firstaidforlife.org.uk or call 0208 675 4036 for more information.
First Aid for life provides this information for guidance and it is not in any way a substitute for medical advice. First Aid for Life is not responsible or liable for any diagnosis made, or actions taken based on this information.