Every child sooner or later strikes his head. Falls are especially common when your child is learning to walk. Most bruises occur on the forehead. Sometimes black eyes appear 3 days later because the bruising spreads downward due to gravity. Head trauma can be due to a blow to the head, or scalp trauma, such as scrapes, bruises, or swelling. Most head trauma simply results in a scalp injury. Big lumps can occur with minor injuries because the blood supply to the scalp is so plentiful. For the same reason, small cuts can bleed profusely. Only 1% to 2% of injured children get a skull fracture. Usually there are no associated symptoms except for a headache at the site of impact. Your child has not had a concussion unless there is temporary unconsciousness, confusion, and amnesia.
Home Care – observe carefully for 48 hours
Wound Care. If there is a scrape, wash it off with soap and water. Then apply pressure with a clean cloth or sterile gauze for 10 minutes to stop any bleeding. For swelling, apply ice for 20 minutes.
Rest. Encourage your child to lie down and rest until all symptoms are gone. Your child can be allowed to sleep; you don’t have to try to keep him awake. Just have him sleep nearby so you can check on him. Don’t give any pain medicine. If the headache is bad enough to need acetaminophen, a physician should check your child.
Diet. Only give your child clear fluids until he has gone 2 hours without vomiting, which is common after head injuries. Any child who vomits 2 or more times, need to be seen by a physician.
Awakening. Awaken your child twice during the night – at your bedtime, and 4 hours later. Arouse him until he is walking and talking normally. Do this for two nights, and sleep near him for those two nights. If his breathing becomes abnormal, awaken him to be sure a coma is not developing. After two nights, return to a normal routine.
Call our office IMMEDIATELY if . . .
- The headache becomes severe.
- Vomiting occurs three or more times.
- Vision becomes blurred or double.
- Your child becomes difficult to awaken or confused.
- Walking or talking becomes difficult.
- Your child’s condition worsens in any other way.