Head Injuries — What to Do — First Aid for Life

Head Injuries – What to Do

Head injuries in sport continue to be a major concern.


This concern has led the Scottish Football Association to announced they are set to introduce a ban on children under the age of 12 heading the ball in training sessions.

The ban has resulted from research demonstrating a proven correlation between football 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.

The Scottish FAs are quick to emphasise that their ban on under-12s heading the ball in training should not lead people to assume it is therefore safe for older children. Repeated head injuries are not good for our brains! 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 and this can adversely affect their brains.

A similar ban was put in place in the US since 2015. But Scotland would become the first European country to impose a restriction on head contact.

Dr Angus Hunter suggested that a softer lighter ball could cause less potential damage. This would reduce rates of concussions, which is far greater in children, and improve memory recall.

Old style leather footballs were particularly damaging, especially when wet.

As of 24 February 2020, the FA has ruled that children aged 11 and under are to no longer to head footballs during training in England, Scotland and Northern Ireland.


Like with football, rugby and head injuries are cause for concern, especially for women.

Rugby is one of the fastest growing sports for women and one of the few sports where men and women play in exactly the same way.

But recent research suggests female players are at a greater risk of suffering concussion than men – and the effects are more severe.

Swansea University is carrying out a pioneering study to understand why. The work is also studying if changes to the way female rugby players train can cut the risk of concussive injuries.

Elizabeth Williams, a senior lecturer in biomedics at the university’s college of engineering, is behind the study. She said: “Head impacts in the men’s game are usually caused by player to player contact whereas with the women it’s often head to ground, or head to knee.” It is therefore important to treat a injury in line with how it was caused.

Head injuries – what to do?

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 cause damage to 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!

It is very important to look out for anything unusual following a head injury as a severe bang on the head could cause swelling and damage to the brain and it is vitally important that you recognise any early and worrying signs of increased pressure on the brain.

Not sure what the signs are? We’ll tell you now.

First steps in the event of a head injury

For a child, look out for:

Loss of consciousness

  • Intense crying
  • Trouble walking
  • Complains of head and neck pain

If you see these signs, call 999 or 112.

If the casualty is not an infant, has not lost consciousness, and is alert and behaving normally after the fall or blow:

  • Apply a wrapped ice pack or instant cold pack to the injured area for 10 minutes.
  • Observe them carefully for the next 48 hours. No one should go home to an empty house for the 48 hours following a severe head injury. If you notice any of the signs of brain injury (see below), phone an ambulance immediately.
  • If the casualty is unusually drowsy or can’t be woken, or they show any symptoms of a brain injury (see below) call an ambulance immediately. People can go to sleep following a head injury, but only if they appear to be completely alert and showing no signs of confusion, losing consciousness or any other symptoms. If worried seek medical attention immediately.

Suspected brain injury

The brain is cushioned by cerebrospinal fluid, however a severe blow to the head may knock the brain into the side of the skull or tear blood vessels.

It can be difficult to determine the level of injury, so it’s always wise to discuss a head injury with your doctor. A clear indicator of a more serious injury is when someone loses consciousness or has signs of confusion. These symptoms can come on at any time from immediately after the accident to a couple of days later. If it is a child that is injured it is sensible for them to sleep in the same room as you for a couple of nights following a head injury.

Signs of a serious head injury

Call an ambulance if someone shows any of these symptoms:

  • unconsciousness
  • 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
  • dizziness
  • neck pain or stiffness
  • fitting
  • vomiting more than two to three times – (it is not unusual for children to vomit immediately after an accident as a response to pain, so do not panic if an injured child is sick just once after a head injury).

What to do if someone is unconscious:

  • If they are breathing – roll them into the recovery position (on 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.

Most important advice following a head injury:

Initial symptoms of concussion – in football and rugby the most common symptoms that you may see on the pitch are the following:

  • headache
  • confusion
  • blurred vision
  • nausea
  • difficulty concentrating
  • fatigue
  • drowsiness
  • dizziness
  • memory impairment

Concussion can also affect someone’s mood, balance, sleep, thinking, concentration and senses. Most symptoms resolve in 7-10 days and many much sooner.

  • Don’t make things worse – important to take seriously and rest
  • Do not risk injury again
  • Rest your brain = lots of sleep, avoid reading, screens and sports for at least 24 hours / 48 hours

Children and adolescents may need one or 2 days off school and a gradual return to academic study. They can start light reading and small amounts of screen time but should monitor and stop if there are signs of any recurrence of symptoms.

At least 2 weeks with no training to give the brain a chance to fully recover.

If there are no symptoms players can then start the gradual return to play or GRTP

  • 24 hours per stage (48 hours for children and adolescents) – go back a stage if symptoms occur
  • Light aerobic exercise
  • Sport specific exercise
  • Non-contact training
  • Full contact practice

19 days is the earliest that an adult can return to play

23 days is the earliest that a child or adolescent can return to play

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 actually be unconscious, therefore the other 90% of people who have experienced concussion will remain conscious. Look out for the more obvious signs such as 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 any 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 (see above)

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 GRTP method.

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 and your brain is so important to every aspect of life, that it is vital we take head injuries seriously.

The RFU have a superb online training course specific to parents, players, teachers and coaches. http://www.englandrugby.com/my-rugby/players/player-health/concussion-headcase/

The Football Association have the following:

It is strongly advised that you attend a Practical First Aid course to understand what to do in a medical emergency. Please visit firstaidforlife.org.uk or call 0208 675 4036 for more information about our courses.

Onlinefirstaid.com have developed unique on-line first aid training to allow you to learn these vital skills at a time and place that suits you.

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.


Airplanes and ear pain: Why it happens and what you can do

Contributed by Lisa Packer
April 13, 2017 2017-04-13T00:00:00-05:00 2017-04-13T00:00:00-05:00

Learn about what happens to your ears during air travel and what you can do to prevent pain, discomfort and temporary hearing loss. 2017 956 Airplanes and ear pain: Why it happens and what you can do https://www.healthyhearing.com/report/52447-Airplanes-and-ear-pain-why-it-happens-and-what-you-can-do

Regardless of how much you paid for your seat, how much leg room you have or whether you are flying first class or coach, one thing many air travelers have in common is ear discomfort. Ear pressure, popping and even severe pain do not discriminate.

While most ear discomfort during air travel is nothing more than an annoyance, what happens when it becomes more serious? Unfortunately, the ear pain and pressure does, in rare cases, lead to severe pain and hearing loss, so it is best to take precautions, before, during and after your flight.

How ear pain happens

It all comes down to air pressure. Normally the air pressure inside the inner ear and the air pressure outside are essentially the same, or at least not different enough to cause any trouble. Even if you were to hike to the top of a tall mountain, the slow speed of your ascent would allow time for the pressure to equalize along the way. A problem only occurs when the change in altitude is so rapid, like it is in air travel, that the pressure inside the inner ear and the air pressure outside don’t have time to equalize.

When your flight takes off and the plane begins its ascent, the air pressure inside the inner ear quickly surpasses that of the pressure outside. The tympanic membrane or eardrum swells outward. Picture a loaf of bread rising while baking, and you get the idea.

Conversely, if air pressure inside the inner ear rapidly becomes less than the air pressure outside, the tympanic membrane will be sucked inward, almost like a vacuum effect. What has happened is that the Eustachian tube has flattened and needs a bit of help from you to continue to do its job of bringing air into the inner ear. Whether ascending or descending, the stretching of the eardrum can cause pain.

Whether ascending or descending, the stretching of the eardrum can cause pain.

During this time, the eardrum is not able to vibrate, so you also experience decreased hearing and muffled sounds.

How to prevent ear pain when flying

Everyone who has flown in an airplane has felt the effects of a change in altitude on ears; a feeling of fullness and popping is commonplace. You need to equalize the pressure by introducing as much air as possible via the Eustachian tube and there are several ways to do that.

  • Swallowing – When you swallow, that clicking or popping sound you may hear is a tiny bubble of air that has moved from the back of the nose into the middle ear, via the Eustachian tube. The Eustachian tube ensures that the air in the middle ear is constantly being replenished. That air is then absorbed into the membranes of the inner ear, and the cycle starts over again. This constant cycle of air ensures that the air pressure on both sides stays equal. When you fly, the trick is to ensure that the Eustachian tubes work overtime and open more frequently to accommodate the change in air pressure.
  • Chewing gum or sucking on hard candy — Chewing gum or sucking on hard candy will stimulate frequent swallowing which helps equalize air pressure. For infants, whose Eustachian tubes are much narrower than an adult’s, the change in air pressure can be even more excruciating, so a bottle or pacifier is recommended to increase swallowing, especially upon descent. Older children can suck on a lollipop, drink through a straw or blow bubbles through a straw to relieve ear pain. If you are planning on flying with an infant or child, talk to a pediatrician about the possibility of pain relieving eardrops for use in flight.
  • Valsalva maneuver — With a mouthful of air, close your mouth and pinch your nose shut. Gently force air out until ears your ears pop. If you are sick with a cold or allergies, the Valsalva maneuver is not recommended, as it could cause a severe ear infection. Instead, try a lesser known method called the Toynbee maneuver: Close your mouth and nose and swallow several times until pressure equalizes.

Other expert tips:

  • Avoid sleeping during ascent or descent.
  • Drink lots of fluids in-flight to stay hydrated.
  • Yawn.
  • Try EarPlanes, specially designed ear plugs that have a filter to equalize pressure.
  • Use nasal spray 1 hour prior to landing and only as-needed. Overuse of nasal sprays can cause more congestion.
  • Take a decongestant 1 hour before landing and also post-flight until ears normalize.

If you are very sick with a cold, the flu, allergies or congestion, you could consider changing your travel plans if possible. Your fellow travelers will appreciate one less sick person spreading germs around the plane’s cabin, and your illness can cause a blockage in the Eustachian tube, preventing the necessary equalization of pressure. A ruptured eardrum or severe infection can occur which can cause hearing loss or permanent ear damage.

See a hearing healthcare professional if your hearing doesn’t return to normal within several days post-flight. If you don’t have a regular hearing healthcare professional, check out our directory to find hearing clinics near you.

More: Wear hearing aids? Check out our air travel tips for people with hearing loss.

Lisa Packer

Lisa Packer holds a bachelor’s degree from Ohio University. She is a freelance writer and blogger with extensive experience in healthcare, law, organic practices and yoga.


What to Do If an Insect Flies Into Your Ear

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Few things are more annoying than that buzzing sound when an insect is flying near your ear. And the annoyance can turn to something more serious if that insect decides to fly into the ear. Once the insect flies in the ear canal, it can be slightly uncomfortable or very painful and it puts you at risk for an infection. There are a few things you can try to remove the insect, but it is best if you seek medical attention immediately.

How to Know?

Most cases of insects flying into the ear occur when camping. You could either be sleeping on the ground or just spending more time outdoors when a fly decides to head straight into the ear. The buzzing should wake you up if you are sleeping and most likely you will be able to identify that it is indeed an insect in your ear. Children have a much more difficult time verbalizing their pain and discomfort. It will be more difficult for them to distinguish the sensation from something else, so it is best not to try any removal techniques on children. Seek medical attention for them right away.

Lie Down

Do not put your fingers into your ear. Shoving a finger into the ear could cause the insect to bite or sting, which will only make you more uncomfortable. First try lying down on your side with the ear facing up. Wait calmly for a couple of minutes and ask a friend to monitor if the insect flies out by itself.

If the insect fails to come out, you can try using oil. Mineral oil, olive oil or baby oil are all safe to use. Do not use anything else and be sure that the object in the ear is an insect. The oil could cause other objects to react differently causing more problems. Ask a friend to pour the oil (room temperature) into the ear. Pull the lobe of the ear backward and upward. The oil should kill the insect. It will drown in the oil and float to the top. Extract the insect and seek medical attention just to ensure that there is no chance of an infection. If the insect doesn’t come out, go to the emergency room.

What the Doctor Will Do?

The doctor will examine your ear canal with an otoscope. This device will help the doctor examine the internal structure of the ear and identify the object that is causing pain. The doctor will then use either mineral oil or lidocaine to kill the insect and then flush out the ear with a warm water irrigation. After the insect is removed, the doctor will give you antibiotic drops to decrease the chance of infection.


What to Do When Your Ears Won’t Pop on a Plane

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The pilot announces it’s time to strap in for landing, the plane begins to descend and, sure enough, the pressure starts building in your ears. And if you’re traveling with a baby or toddler, here comes the wail of pain.

Then you land, start down the aisle and your ears pop — or not. Sometimes they don’t pop for hours or even days. What’s going on?

Photo courtesy of Radist/Getty Images

How Air Travel Affects Our Ears

It’s all about the Eustachian tube, a cocktail-straw-sized passage that connects the middle ear, which contains the eardrum, to the nose and back of the throat, according to Dr. Ana Kim, an otolaryngologist and neuro-otologist at Columbia Doctors Midtown and associate professor of otolaryngology/head and neck surgery at Columbia University Medical Center in New York. The tube has a significant role in equalizing pressure on both sides of the eardrum.

“When you’re flying, especially during landing and takeoff, there’s a rapid change in the barometric pressure, which causes a collapse of the Eustachian tubes and interferes with the normal air flow from the nose to the ear,” says Dr. Kim. “When the Eustachian tube collapses, it interferes with airflow and there’s not sufficient space around the eardrum.”

That popping sensation you feel is the Eustachian tube opening up again. But as we all know, that doesn’t always happen immediately.

What to Do When Your Ears Won’t Pop

Your goal is to move the muscles of your mouth to open the airway. Swallowing and yawning (even fake yawning, with your mouth open wide) are the first things to try, and you can also chew gum or suck on candy. “When you move the muscles of your mouth and throat, it moves the eardrum, which is made of a cellophane-like material,” says Dr. Kim. “And when you move the eardrum, you’re making more air space.”

But the most effective maneuver is to take a deep breath and go through the motion of expelling the air while you hold your nostrils tight and keep your mouth closed, a technique called the Valsalva maneuver.

Valsalva maneuver (Photo by U.S. Air Force Airman 1st Class Kate Thornton / Wikimedia Commons)

Of course, these instructions aren’t going to work for a baby or toddler, but you can encourage them to swallow by nursing or offering a bottle or pacifier. With older toddlers and preschoolers, you can try encouraging them to yawn, doing so yourself in exaggerated fashion so they can copy you.

When your ears feel blocked, it’s easy to think that removing excessive earwax can help. Be careful. When you use a cotton swab or other method to remove earwax, you risk actually pushing it farther in and packing it harder.

My Ears Still Won’t Pop — Now What?

In most cases, there’s nothing serious to worry about and you can safely wait to see if the problem clears up on its own. “In general I would wait a couple of days, depending on the level of discomfort. But if you’re in pain or the problem is affecting your hearing, I would go [to the doctor] right away,” says Dr. Kim. “Your doctor can provide medications such as steroids, which are powerful anti-inflammatories, and can make sure that your hearing is OK.” This is important, she says, because inflammation can cause long-term hearing loss.

Sometimes the problem involves fluid buildup, but that’s likely the result of having a cold or infection, not just from the airplane trip itself. If you’re experiencing fluid that’s unable to drain on its own, your doctor can do an in-office procedure that involves making a small incision and vacuuming fluid from the middle ear. In some cases, tubes are then left in to drain. “The cut closes in a day, but if we want continuous airflow to dry up the fluid, we put in temporary tubes to keep the air moving,” she says.

How to Prevent Future Problems

To remind yourself to swallow during takeoff and landing, travel with gum or candy and pop them in as soon as you feel the pressure begin to change. When flying with a baby or toddler, give them a bottle or pacifier. Nursing babies and toddlers works well too. If you don’t want to give small children gum or candy, try a snack like a fruit leather that involves prolonged sucking and swallowing.

It can also help to use a long-acting decongestant like Afrin or Sudafed. Start using it a half-hour before takeoff or landing.

Beware of conditions that can predispose you to have problems with ear-popping. “Someone who gets frequent sinus infections can be more at risk for this because if the lining of the nose is inflamed and swollen, it can interfere with air flow,” Dr. Kim says.

Likewise, having a cold or being stuffed up because of allergies can leave you susceptible as well: “The ear is actually a very sensitive gauge of what’s happening in the nose,” she says. In these cases, you definitely want to take a decongestant before you fly.

It’s a different situation, though, in the case of ear infection which, as moms know, babies and toddlers are particularly susceptible to. “If you or your child or baby has an ear infection, we advise you not to fly,” says Dr. Kim.

Bottom Line

In most cases, an ear that fails to pop is just a routine travel annoyance that can be handled with patience. Have you or your children encountered this problem after flying? What helped? Let us know in the comments.

Featured image by Lisa5201/Getty Images


A Brief History of Drones

Unmanned aerial vehicles (UAVs) are aircraft with no on-board crew or passengers. They can be automated ‘drones’ or remotely piloted vehicles (RPVs). UAV’s can fly for long periods of time at a controlled level of speed and height and have a role in many aspects of aviation.

The first pilotless vehicles were built during the First World War. These early models were launched by catapult or flown using radio control. In January 1918, the US Army started production of aerial torpedoes. The model that was developed, the Kettering Bug, was flown successfully in some tests, but the war ended before it could be further developed.

During the inter-war period the development and testing of unmanned aircraft continued. In 1935 the British produced a number of radio-controlled aircraft to be used as targets for training purposes. It’s thought the term ‘drone’ started to be used at this time, inspired by the name of one of these models, the DH.82B Queen Bee. Radio-controlled drones were also manufactured in the United States and used for target practice and training.

Reconnaissance UAVs were first deployed on a large scale in the Vietnam War. Drones also began to be used in a range of new roles, such as acting as decoys in combat, launching missiles against fixed targets and dropping leaflets for psychological operations.

Following the Vietnam War other countries outside of Britain and the United States began to explore unmanned aerial technology. New models became more sophisticated, with improved endurance and the ability to maintain greater height. In recent years models have been developed that use technology such as solar power to tackle the problem of fuelling longer flights.

Drones now have many functions, ranging from monitoring climate change to carrying out search operations after natural disasters, photography, filming, and delivering goods. But their most well-known and controversial use is by the military for reconnaissance, surveillance and targeted attacks. Since the 9/11 terrorist attacks, the United States in particular has significantly increased its use of drones. They are mostly used for surveillance in areas and terrains where troops are unable to safely go. But they are also used as weapons and have been credited with killing suspected militants. Their use in current conflicts and over some countries has raised questions about the ethics of this kind of weaponry, especially when it results in civilian deaths, either due to inaccurate data or because of their proximity to a ‘target’.


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