Head wounds are concerning because the scalp contains an extensive network of blood vessels, leading to profuse bleeding. The close proximity of the injury site to the brain also means that any trauma carries the risk of a more severe underlying injury. The immediate goal when encountering a scalp wound is to apply temporary first aid and control bleeding until professional medical assessment can be secured.
Assessing Severity and When to Seek Emergency Care
A head injury’s seriousness is not determined by the amount of blood, so recognizing red flags for internal damage is your first action. Immediate emergency medical services must be contacted if the injured person loses consciousness, even briefly, or has a seizure. Look for signs that suggest a skull fracture or bleeding within the skull, which are life-threatening conditions. These include clear or blood-stained fluid leaking from the ears or nose, bruising around the eyes or behind the ears, or any obvious deformity in the skull.
Observe the person for any changes in their neurological state. Critical signs include slurred speech, difficulty walking or balancing, and pupils that are unequal in size. Persistent or repeated vomiting, worsening confusion, or an inability to stay awake are also urgent indicators. If the trauma resulted from a high-impact incident, such as a motor vehicle accident or a fall from a significant height, assume a neck or spinal injury is present and do not move the person before professional help arrives.
Controlling Bleeding and Preparing the Wound Site
Once emergency services are contacted, if necessary, your immediate focus shifts to managing the bleeding using clean materials. Head wounds often bleed significantly, and firm, sustained pressure is necessary to encourage clotting. Use sterile gauze or the cleanest cloth available, placing it directly over the wound. Apply firm and steady pressure with your hand for a full 15 minutes, resisting the urge to check the wound prematurely.
If the initial material becomes soaked with blood, do not remove it, as this may disrupt the early stages of clot formation. Instead, place another layer of sterile gauze or cloth directly on top of the saturated material and maintain the pressure. An exception to this procedure is if you suspect a skull fracture, indicated by a visible depression or deformity; in this case, cover the wound gently without applying direct, firm pressure. If time permits and debris is visible, gently clean the area around the cut with mild soap and clean water to reduce infection risk. Avoid scrubbing the wound itself or probing deeply into the injury.
Step-by-Step Dressing Application and Post-Care
After the bleeding is controlled through sustained pressure, a sterile dressing must be applied to cover the wound and maintain cleanliness. Place a sterile pad or gauze over the site, ensuring the entire wound is covered, and then secure it using adhesive tape or a roller bandage. Due to the curved shape of the head, a roller bandage is often the most effective method for maintaining even pressure and coverage. When securing the dressing, ensure the bandage does not cover the eyes or wrap under the chin, as this could impede breathing or vision.
Wrap the roller bandage around the head, ensuring each layer overlaps the previous one to hold the pad firmly in place. The tension of the bandage should be snug enough to keep the dressing from slipping but not so tight that it causes discomfort or restricts circulation. After the dressing is secured, the priority shifts to monitoring the injured person for any deterioration in their condition.
Continue to watch for signs like increasing drowsiness, persistent headache, or any difficulty with speech or movement, as these changes can signal internal complications. Post-care involves monitoring for signs of infection, which include increased redness, warmth, swelling, or drainage from beneath the dressing. Always seek professional medical evaluation for any head wound, regardless of how well the bleeding is controlled, to rule out underlying injury.