First Aid – Head Trauma


If you’ve been skating for a while, the chances are you will have hit your head yourself or have seen someone hit their head. Helmets make a big difference, and if you’re going to skate fast we strongly recommend that you wear one, but they will not protect you from every impact. We hope you will never need to know this stuff, but the few minutes between incident and the arrival of an ambulance can be critical – a few simple actions, easily learnt, could save a skater’s life.

Your Aims:

– To maintain an open airway

– To assess and record the level of response

– To treat any major associated injuries (stem bleeding etc)

– To arrange urgent removal to hospital

Do not:

– Attempt to give an unconscious person anything by mouth

– Move the casualty unnecessarily because of the possibility of spinal injury

– Leave an unconscious casualty unattended at any time

– Remove a skater’s helmet unless you have to no choice but to give rescue breaths or CPR. If you absolutely have to, you will need a helper to support the casualty’s neck as you remove the helmet. You need to minimise movement to the casualty’s head and neck as you risk accentuating any spinal damage. Always look for alternatives to movement – perhaps you can lift the helmet’s visor?

1: Check Response

After making sure the scene is safe, establish whether the casualty is conscious or unconscious. Do this by gently shaking his shoulders. Ask “Are you OK?” and “Open your eyes.” Always speak loudly and clearly.

If there is a response then leave him in the position he’s in. Check for life threatening injuries and phone 999 if needed. Keep talking to him and keep him talking back to you – concussion can sometimes take a long time to make itself known. Even if the casualty appears ok, watch for any dizziness, nausea, double vision, slurred speech or other odd behavior. If you see any of these symptoms, get to hospital as soon as possible, and make sure he’s got someone to keep an eye on him overnight. If it was a heavy blow to the head it’s probably a good idea to go anyway, just to be safe.

If there is no response, leave the casualty in the position found and get a helper to phone 999 immediately. Do not leave the casualty unattended.

2: Open Air Way

Place one hand on his forehead. Gently tilt his head back. As you do this the casualty’s mouth will fall open slightly. Have a look inside, pick out any obvious obstructions and make sure the air way is clear. Place your fingertips under his chin and lift it gently. If you suspect a spinal injury, open the air way by gently lifting the jaw but not tilting the head.

3. Check breathing

Look for chest movement, listen for sounds of breathing, and feel for breath on your cheek. Do this for no more than 10 seconds.

If he is breathing, examine the casualty quickly but systematically to identify ant external bleeding or major fractures. Control any bleeding and protect any suspected fractures. Place him in the recovery position.

If the casualty is not breathing, give rescue breaths.

4. Pinch Nose and Open Mouth

Make sure the air way is still open. Make sure the casualty’s head remains tilted by keeping two fingers under the tip of his chin. Use the thumb and forefinger of your other hand to firmly pinch the soft part of the nose. Make sure his nostrils are closed to prevent air escaping. Open his mouth.

5: Give Rescue Breaths

Take a deep breath to fill your lungs with air. Place your lips around the casualty’s lips, making sure you form a good seal. Blow steadily into the mouth until teh chest rises. Maintaining head tilt and chin lift, take your mouth away and watch the chest fall. Give two effective breaths. Look, listen and feel for signs of circulation, such as breathing, coughing or movement.

If the casualty starts breathing but remains unconscious, place him in the recovery position.

If circulation is absent, perform CPR.

6: CPR Give Chest Compressions

Locate your casualty’s lowest rib at the point it meets the breast bone. Place your middle finger at this point and you index finger next to that. Place the heel of your other hand next to your index finger. This is the point you will apply pressure. Place the heel of your first hand on top of the other hand, and interlock your fingers. Press down vertically on the breastbone and depress the chest by 4-5cm. Allow the chest to come back up before giving the next compression. Repeat this compression process 30 times.

7: CPR Give Rescue Breaths

Move the casualty’s head and make sure that the air way is still open. Repeat steps 5 and 6. Continue the cycle of 30 compressions followed by 2 breaths until either the emergency sevices arrive and take over, or the casualty starts to breathe.

8: The Recovery Position

Once the casualty is breathing, put him in the recovery position. Kneel beside the casualty. Straighten his legs. Place the arm nearest you at right angles to the body with the elbow bent and the palm facing up. Bring the arm farthest from you across his chest and hold the back of his hand against the cheek nearest you.

9. Recovery position continued

Roll the casualty towards you onto his side. Adjust the upper leg so both the hip and knee are bent at right angles. Tilt the head back and ensure the air way remains open. Monitor and record vital signs – level of response, pulse and breathing – until the ambulance arrives.

Disclaimer: The intention of this post is to highlight the dangers of skateboarding and the importance or first aid training. All information here is presented as such and has been thoroughly researched and is in line with current medical practise at the time of posting. Lush Longboards Ltd accepts no liability for any outcomes resulting from readers acting on this information. The use of this content is at your sole risk. We encourage you to skate within your limits, wear a helmet and undergo basic first aid training from an accredited body.

We have assumed that the casualty is male throughout this article – this is not intended to offend any of you girls reading this, if we’d put “him/her” the article would have read very badly! Thanks for understanding…

Inspired by the Albion Magazine.