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Skiing Accidents: First Aid for Head Injuries
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Skiing Accidents: First Aid for Head Injuries

The skiing season is just about to reach its peak and the beautiful forest parks of Northeast Iowa will be popular locations for this exciting winter activity. Whilst skiing is undoubtedly great fun, it is not without its dangers for even the most experienced, as the recent head injury sustained by former racing driver, Michael Schumacher all too clearly illustrates.

All head injuries are potentially very serious, even if the casualty is conscious and appears uninjured at the time. There’s also the possible complication of a spinal injury, particularly if the person crashed out at speed or fell awkwardly. Would you know what to do if a member of your party fell and suffered a head injury? Read on to learn more.


Concussion is caused when the brain is shaken within the skull following a blow to the head. This results in widespread, temporary disturbance of the brain’s normal activity but no long term damage is suffered. The casualty may briefly lose consciousness but will recover fully within a few minutes.


The casualty will suffer a brief period of impaired consciousness as a result of a blow to the head. On regaining consciousness they may feel dizzy or nauseous and be unable to remember what happened or the events immediately preceding the injury. They may also have a mild, generalized headache.

What to do

First of all, check the casualty’s response level using the AVPU code as follows:

· A – Is the casualty Alert and able to answer questions?

· V – Does the casualty respond to your Voice?

· P – Can the casualty feel Pain; e.g. respond to being pinched by moving or opening their eyes?

· U – Is the casualty completely Unresponsive?

Keep the casualty quiet and watch them carefully for any signs of deterioration while they recover. Don’t let them carry on skiing, even if they say they feel okay. It is advisable in the event that the casualty became unconscious as a result of the accident to make sure they attend hospital as soon as is practicably possible.

Cerebral Compression:

Cerebral compression is very serious and usually requires urgent surgery.

The condition occurs when pressure builds up on the brain. This may be caused by an accumulation of blood inside the skull or when the brain tissue swells due to injury. Although cerebral compression is generally caused by a head injury, it can also occur as a result of infection, stroke or a brain tumour.

This condition may not be immediately apparent following a head injury and may not manifest itself until a few hours or even days later.


The casualty’s levels of response will deteriorate and they may become unconscious. They may complain of a severe headache; their breathing may become slow and noisy, their pupils may appear unequal in size, their temperature may become elevated and they may experience paralysis or weakness down one side of their face or body. You may observe a change in their behaviour and personality or they may appear disorientated and drowsy.

What to do

You must arrange for urgent medical attention. If the casualty is conscious, support them in a comfortable, resting position. Reassure them whilst continually monitoring and noting vital signs; level of response, pulse and breathing until medical assistance arrives.

If the casualty is unconscious, your priority is to maintain an open airway so that they can breathe. If the accident has just happened and the casualty is still in situ, keep them warm and try to maintain the airway without moving them in case of spinal injury.

Skull fracture

Skull fractures are potentially extremely serious as there is a risk that the casualty may have sustained brain damage either directly from fractured bone or from bleeding inside the skull.

Classic signs of a skull fracture are clear fluid or watery blood leaking from the nose or ear.


The casualty may have impaired levels of consciousness. There may be a wound to the head or an area which feels soft or appears depressed. The symmetry of the head or face may appear distorted.

Often there will be bruising apparent behind one ear or around one or both eyes. There may be clear fluid or watery blood coming from one ear or from the nose; there may also be blood in the white of one eye. The casualty’s response levels may progressively deteriorate.

What to do

Summon emergency medical assistance immediately.

If the casualty is conscious, help them to lie down. Keep the head still in case of a neck injury and try to control any bleeding from the scalp by applying pressure around the wound. If there is any discharge from the ear, cover it lightly with a clean pad and secure it with a bandage.

Monitor and record the vital signs until medical assistance arrives.

If the casualty is unconscious, make sure that the airway is open so that they can breathe. Try to avoid moving the casualty in case they have also sustained a spinal injury. Obviously, you will have to move them if you are otherwise unable to maintain an open airway but ask an assistant to keep the casualty’s spine as straight as possible whilst placing them in the recovery position.

We all hope that we will never have to deal with a serious accident out on the slopes but it’s well worth attending a basic first aid course before you go, just in case.

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