Stephen J. Schueler, M.D.

Head Injury Home Care

Home care for a head injury includes:

  • Avoid alcohol.
  • Avoid narcotic pain medications.
  • Avoid medications that make you sleepy.
  • Avoid driving until symptoms resolve.
  • Apply cold compresses to the scalp:
    • Wrap ice in a moist hand towel. Do not apply ice directly to the skin.
    • Apply for 20-30 minutes, every 1-2 hours, for the first few days.
  • Clean wounds thoroughly:
    • Use mild soap and water.
    • Gently dab the wound with hydrogen peroxide to remove clotted blood.
    • Do not scrub the wound.
    • Remove dirt or foreign material from the wound.
    • Dry the skin.
    • Apply an antibiotic ointment.
  • Eat a clear liquid diet for 24 hours.
  • Rest for 1-2 days. There is no need to try and keep the victim awake.
  • Perform neurological checks:
    • Every 1-2 hours for 24 hours
    • Make sure the person can be awakened
    • Make sure the person can walk
    • Make sure the person can speak normally
    • Make sure the person can move extremities normally
  • Acetaminophen for pain
  • Avoid aspirin.

Head Injury Neuro Checks

Neuro checks should be performed once an hour, for the first 24 hours in someone with head injury:

  • Make sure the person can be awakened
  • Make sure the person can walk
  • Make sure the person can speak normally
  • Make sure the person can move extremities normally

Seek medical care immediately for:

Head Injury Return to Sports

The American Academy of Pediatrics has published guidelines regarding when athletes can return to sports following a head injury.

American Academy of Pediatrics Return to Sports Recommendations

Grade 1 concussion:


Grade 2 concussion:

Grade 3 concussion:

Head Injury Skin Wound

Most minor cuts, abrasions and puncture wounds to the head can be safely treated at home. Initial care includes:

  • Control bleeding with direct pressure.
    • Use a gauze or clean cloth directly on the wound.
    • Maintain the pressure for at least 10 minutes.
    • Do not keep looking at the wound.
  • Clean the wound with mild soap and water. Running water can help remove dirt.
  • You may gently dab the wound with hydrogen peroxide to remove clotted blood or debris. Do not scrub or re-injure the wound.
  • Be sure there is no dirt or other foreign material left in the wound.
  • A butterfly bandage can be used to close very small, clean cuts.
  • Apply an antibiotic ointment and a dry dressing.
  • Minor scalp wounds may be left uncovered.
  • Keep the wound clean and dry.

Ongoing care for minor scalp wounds includes:
  • Abrasions may be cleaned 2-3 times a day with a mild soap such as dilute baby shampoo or dilute hydrogen peroxide - try not to cause bleeding. Do not disturb dry scabs.
  • Dry the wound gently, and completely, with a clean towel or gauze.
  • Apply an antibiotic ointment after each cleaning.

Tetanus Considerations
Tetanus shots (boosters) can be given up to three days after an injury, as long as you have had all your tetanus shots in the past. A tetanus booster seldom needs to be given right at the time of the wound. This is not an emergency and can be done in the doctor's office or clinic.

A tetanus shot is necessary right away if you have not had three tetanus shots at any time in your life.

You need a tetanus shot within three days for:
  • A dirty wound and you have not had a tetanus shot in the last five years
  • A clean, minor wound and you have not had a tetanus shot in the last ten years

Head Injury Vomiting

Home care for vomiting in someone with a head injury:

  • Drink clear liquids only, such as water, sports drinks, fruit juice and dilute tea. Sports drinks are best. The absence of food allows the intestines to rest.
  • Drink small quantities of fluids frequently. In general, two tablespoons of fluid every 5 minutes is an effective strategy.
  • Avoid milk and dairy products for 3 days.
  • Avoid liquids that irritate the stomach, such as citrus juice, alcohol and coffee.
  • If nausea or vomiting continues despite the above, consider one of the nonprescription medicines listed below.
  • Once vomiting and nausea resolves, start bland foods first. If you tolerate bland food, then you can resume a normal diet.

Nonprescription medications for vomiting include:

Head Injury Warning Signs

Notify your doctor if you have a head injury and any of the following:

Continue to Head Injury Underlying Cause

Last Updated: Dec 14, 2010 References
Authors: Stephen J. Schueler, MD; John H. Beckett, MD; D. Scott Gettings, MD
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PubMed Head Injury References
  1. Edwards P, Arango M, Balica L, et al. CRASH trial collaborators. Final results of MRC CRASH, a randomised placebo-controlled trial of intravenous corticosteroid in adults with head injury-outcomes at 6 months. Lancet. 2005 Jun 4-10;365(9475):1957-9. [15936423]
  2. Grappling with traumatic brain injury. Lancet. 2007 Dec 8;370(9603):1879. [18068492]
  3. Lee AC, Ou Y, Fong D. Depressed skull fractures: a pattern of abusive head injury in three older children. Child Abuse Negl. 2003 Nov;27(11):1323-9. [14637305]
  4. McKinley J. New challenges in assessing and managing concussion in sports. Am Fam Physician. 2007 Oct 1;76(7):948-9. [17956064]
  5. Ropper AH, Gorson KC. N Engl J Med. 2007 Jan 11;356(2):166-72. Review. No abstract available. Erratum in: N Engl J Med. 2007 Apr 26;356(17):1794. [17215534]
  6. Smits M, Dippel DW, de Haan GG, Dekker HM, Vos PE, Kool DR, Nederkoorn PJ, Hofman PA, Twijnstra A, Tanghe HL, Hunink MG. External validation of the Canadian CT Head Rule and the New Orleans Criteria for CT scanning in patients with minor head injury. JAMA. 2005 Sep 28;294(12):1519-25. [16189365]
  7. Tender GC, Awasthi D. Risk stratification in mild head injury patients: the head injury predictive index. J La State Med Soc. 2003 Nov-Dec;155(6):338-42. [14750754]
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