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Head injuries

head; injuries; bump; concussion; bruise; shake; skull; fall; first; aid; injury; cut; bleed; ;

Children's heads are often hurt when they fall over or bump into something hard. Sometimes bangs on the head can cause very severe harm, but often small knocks just cause bruising and pain for a short while.

Contents

If you have any concerns about your child after a bump to the head, always get the child seen by a doctor. This topic contains some information about managing bruises and minor cuts on the head. It does not give any information about how to assess whether the bang has caused any harm to the child.

Alert!

If the bang on the head has been hard (perhaps in a car accident or a fall from a height), or the child appears dazed, loses consciousness (even for a moment), seems unwell or vomits after the bang, get medical help quickly. If your child is unconscious call an ambulance. Do not leave the child alone.

Important Note: Children can also have bad brain damage from being shaken.

Never shake a baby.

Bruises

  • Even small bangs on the head can cause large bruises and large soft swellings because the scalp has a very good blood supply and the bone of the skull is just under the skin (no 'padding' to absorb the knock).
  • Sometimes the bruise can be kept small if ice (or a packet of frozen vegetables such as frozen peas) is applied to the banged area quickly (wrap ice in a damp cloth; do not put something very cold directly onto the skin).
  • Some pressure on the banged area can also help if the child will allow it.
  • These bruises usually go down quite quickly too (within a day or two), leaving just the colour of the bruise and a sore spot. If the swelling stays, the child should be seen by a doctor.

When to see a doctor

Get medical help quickly if:

  • the bang on the head has been hard (perhaps in a car accident or a fall from a height)
  • the child appears dazed or loses consciousness (even for a moment)
  • the child seems unwell or vomits after the bang.

If your child is unconscious call an ambulance. Do not leave the child alone.

You should also have your child seen by a doctor if you feel uneasy.

  •  After a fall or bump young children are often sleepy, especially if they have cried a lot or it is getting near to a sleep time. If the child seemed well after the bang on the head, it is OK to let him go to sleep. But if he seems unusually sleepy (you cannot wake him up after about an hour or he seems dazed when he wakes), he should be seen by a doctor straight away.

If your child seems well, but complains of a sore head, it would be OK to give some paracetamol or ibuprofen.

Cuts

  • Cuts on the scalp can bleed a lot, because of the good blood supply in the scalp.
  • Put a clean dressing over the cut and press on the cut for about 5 to 10 minutes.
  • If the bleeding has stopped, gently examine the cut and if it is more than about 1 centimetre long it may heal better with treatment from a doctor.
  • If the bleeding has not stopped in 10 minutes, get the child seen by a doctor.
  • Smaller cuts may heal without extra treatment so long as they are clean, but always check with a doctor if you are unsure. If there is any chance of dirt, glass or anything else in the cut, always get this checked by a doctor.
  • Again, if the child seems dazed, loses consciousness, vomits or seems unwell after the bang, get help from a doctor.

NB: if the child is not fully immunised against tetanus, this should be checked with a doctor. An extra tetanus injection may be needed. 

What is concussion?

Concussion is a brain injury that may result in a bad headache or unconsciousness.

  • Concussion can happen when the head hits an object, or a moving object strikes the head, hard. It can be caused by a fall, sports activities, and car accidents. The brain is able to move a short distance inside the skull and can hit first one side of the skull, then the other. This can sometimes damage blood vessels causing bleeding into the brain, or around the brain, even if the person does not become unconscious.
  • The jarring can cause unconsciousness. How long a person remains unconscious may indicate how serious the concussion is.
  • Often people who are concussed have no memory of events just before the injury, or immediately after even when they do not become unconscious. More severe head injuries can cause longer periods of memory loss (amnesia).
  • Because bleeding into or around the brain can occur with any blow to the head, someone who has received a blow to the head should be watched closely for signs of possible brain damage.
    • Things to watch for include repeated vomiting, unequal pupils, confused mental state or varying levels of consciousness, seizure-like activity, weakness on one side of the body or the inability to wake up (coma). If any of these signs are present, immediately call your doctor.
  • If the person is unconscious for a few minutes or more, that person usually needs care in a hospital. There may be other problems such as a skull fracture as well as concussion.

Ongoing effects

  • Mild concussion usually does not cause any lasting problems, but for a while after the injury (hours to days), the person can have a bad headache. She may not cope well with school work or other tasks which require good concentration for a few days.
  • More severe concussion can cause dizziness, confusion, difficulty with remembering things and restlessness that can last weeks or more. There can also be a long lasting headache. If any of these happen, it is important to check with a doctor. Extra help may be needed, including time off work or school.

Resources

Australia

Red Cross Australia
http://www.redcross.org.au/first-aid.aspx

  • A free First Aid Smartphone App can be downloaded from Google Play or the App Store.

Better Health Channel

Reference

MedlinePlus 'Head injuries'
http://www.nlm.nih.gov/medlineplus/ency/article/000028.htm

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The information on this site should not be used as an alternative to professional care. If you have a particular problem, see a doctor, or ring the Parent Helpline on 1300 364 100 (local call cost from anywhere in South Australia).

This topic may use 'he' and 'she' in turn - please change to suit your child's sex.

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