My main character was slammed into a brick wall and hit his head. He lost consciousness briefly, was alert for a few minutes, and now has lost consciousness again. His partner rushes over to my MC. Assuming that his partner has a very good understanding of first aid, what should the partner do? Will my MC's pulse and breathing rate be slower or faster than normal? An ambulance has already been called. What other steps should the partner take?
The strike / loss of consciousness / brief period of lucidity / re-loss of consciousness is pathognomonic (read: One True Diagnosable Sign) for a traumatic subdural SUBARACHNOID hemorrhage, which is an arterial bleed inside the skull. That blood expands and puts pressure on the brain, which has nowhere to go… but it will go there anyway.
Your character’s breathing will likely ramp up and then decelerate, with periods of just… stopping. It’s called Cheyne-Stokes respirations, and it’s the body trying to manage cerebral bloodflow. His pupils will be uneven, with one bigger and the other constricted. His pulse will be normal and dip down to slow and then back up to normal; as he worsens, it will simply be slow.
Understand that what you’ve given your character is a catastrophic injury. A great many SAH patients don’t live, and he’s going to, he needs brain surgery basically yesterday.
As for first aid, keeping the character on his side isn’t a bad plan (but first they should feel the spine to make sure the neck hasn’t been broken). This will help when the injured character starts vomiting profusely.
If you want to make this a less lethal event, I would consider either a) simply extending the period in which the MC is unconscious the first time (and not putting them out a second), or b) have them lose consciousness and wake up a few minutes later but be very confused and lethargic. Trust me, a few minutes is still enough to indicate plenty of brain damage, and plenty of drama and fear, because the seconds stretch into minutes in those situations.
For further reading I suggest you take a look at the head injury tag and the TBI tag!
Thanks for your ask and I hope I could help!
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