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Health Heed

Head injury

How to deal with head injuries
By: Emma Hammet

Emma Hammet Emma Hammett, founder of First Aid for Life has many years' experience in healthcare, teaching and first aid training. She provides practical and informative first aid training to ensure the skills and confidence to know what to do in an emergency.

Children have many bangs to the head and it can be difficult to tell whether they are serious or not. Many head injuries are not serious and simply result in a bump or bruise. However severe, or repeated head injuries can result in damage to the brain.

Fortunately, most childhood falls or blows to the head result in injury to the scalp only, which is usually more frightening than life threatening – the head and face are very vascular and consequently injuries bleed profusely and can be very scary! An internal head injury may have more serious implications because it could cause damage to the brain.

What to look for and what to do:

Call 999 or 112 if your child is an infant; has lost consciousness, even momentarily; or if a child of any age has any of these symptoms:

• won't stop crying

• complains of head and neck pain

• becomes difficult to console

•isn't walking normally
                             
If your child is not an infant, has not lost consciousness, and is alert and behaving normally after the fall or blow:

• Apply a wrapped ice pack or instant cold pack to the injured area for 10 minutes.

• Observe your child carefully for the next 24 hours. If you notice any of the signs of brain injury (see below), phone an ambulance immediately.

• If the incident has occurred close to bedtime or naptime and your child falls asleep soon afterward, check in every few hours to look for twitching limbs or disturbances in color or breathing. It is perfectly ok for your child to go to sleep – there is no need to keep a child awake after a head injury.

• If you aren't comfortable with your child's appearance (trust your instincts), arouse your child partially by sitting him or her up. Your child should object to this and attempt to resettle. If he or she doesn't protest, try to wake them fully. If your child can't be woken, or shows any symptoms of a brain injury (see below) call an ambulance.

Suspected brain injury

The brain is cushioned by cerebrospinal fluid, but a severe blow to the head may knock the brain into the side of the skull or tear blood vessels. Any internal head injury — fractured skull, torn blood vessels, or damage to the brain itself — can be serious and possibly life threatening.

Different levels of injury require different levels of concern. It can be difficult to determine the level of injury, so it's always wise to discuss a head injury with your doctor. A clear indicator of a more serious injury is when a child loses consciousness or has signs of confusion. These symptoms can come on at any time from immediately after the accident to a couple of days later. It is sensible to have your child sleep in the same room as you for a couple of nights following a head injury.

What to Look for and What to Do

Call an ambulance if your child shows any of these symptoms:

• unconsciousness

• abnormal breathing

• obvious serious wound or suspected skull fracture

• bleeding or clear fluid from the nose, ear, or mouth

• disturbance of speech or vision

• pupils of unequal size

• weakness or paralysis

• dizziness

• neck pain or stiffness

• fitting

• vomiting more than two to three times  - (it is not unusual for children to vomit immediately after an accident as a response to pain, so do not panic if your child is sick just once after a head injury).

•loss of bladder or bowel control
    
If your child is unconscious:

• If they are breathing - roll them into the recovery position (on their side so that their tongue falls forward in their mouth and any vomit can drain away), trying not to twist their neck or spine at all. Any head injury may well have caused spinal damage as the head recoils from the blow.

• If they are not breathing start CPR.

• Call for an ambulance.
    
If your child is conscious and it is a serious head injury:

• Phone for an ambulance

• Do your best to keep your child calm and still – making sure that they do not twist.

• If there's bleeding, grab a clean cloth and apply pressure.

• Do not attempt to clean the wound as it could make things worse.

• Do not apply forceful direct pressure to the wound if you suspect the skull is fractured.

• Do not remove any object that's stuck in the wound.

First Aid for life provides this information for guidance and it is not in any way a substitute for medical advice. First Aid for Life is not responsible or liable for any diagnosis made, or actions taken based on this information. It is strongly advised that you attend a practical First Aid course to understand what to do in a medical emergency.