A strong blow to the head may cause swelling and bleeding inside the skull. This can cause pressure that injures the brain (concussion). If you have any doubts about a concussion, have a doctor check the person.

Call 911 right away if any of the following happens:

• The person loses consciousness or is lethargic.
• The person has convulsions or seizures.
• The person has unequal pupil size. (The pupil is the black part in the center of the eye.)
• The person shows any of these signs of concussion:
  • Confusion or inability to follow normal conversation
  • Abnormal behavior
  • Slurred speech
  • Dizziness or vision problems
  • Nausea or vomiting
  • Muscle weakness or loss of mobility
  • Memory loss
  • Sensitivity to noise
• There is a depressed or spongy area in the skull, or visible bone fragments.
• Clear fluid is draining out of the ears or nose.
• You see bruising behind the ears or around the eyes.

While you are waiting for medical help, you can:

• Reassure the person.
• Treat the person for shock by maintaining body temperature and keeping them calm.
• Do rescue breathing or CPR, if needed.

If the person has neck or back pain or is unconscious, they might have a spine fracture. Move the person only with great caution and only if absolutely needed.

• Apply direct pressure to control bleeding. Wear gloves or use other protection to prevent contact with the person's blood.
• Wash a minor surface injury with soap and water after the bleeding stops or is reduced.
• Cover the wound with a clean dressing and bandage.

• Place a cold pack or ice on the injury to reduce swelling and pain. Put a cloth between the skin and the ice pack to prevent tissue damage from severe cold.

• Watch for vomiting or changes in mood or alertness. If you notice changes, call for medical help. Signs of concussion may not appear for up to 48 hours.
• Tell the person's partner, parent, or roommate about the injury so they can continue to observe them.

If a cut is deep or continues to bleed, or the edges of skin don't stay together evenly, the wound may need to be closed with stitches, tape, staples, or medical glue. Any of these can help speed healing and reduce the risk for infection and reduce the size of the scar. These may be especially important concerns with large wounds and wounds on the head or other visible body parts.

If you think a wound may need medical care, see a doctor as soon as possible. If the person needs stitches, this must be done in the first few hours. A wound that is not correctly closed is at risk for serious infection.