Children hit their heads all the time. An exaggeration I know, but they do, and frequently. I often say that you haven’t been inducted into parenthood until your child hits their head.
It is also said that an ounce of prevention is worth a pound of cure. Always look for safety hazards in your home and other environments you are in regularly. Could your child open the window? Could your child fall out of the window? Could your child fall down the stairs? Off the table? Off a bookshelf? Does your child climb furniture? Can the furniture fall on them if they try to climb it? Are they secured in their highchair every time they eat? Is their booster seat secured properly to the chair? Are they secured appropriately in their carseat and stroller? Is the trampoline zipped shut every time they are on it? Do they know how to play safe at playgrounds? On monkey bars? Do they wear a helmet when riding bikes or scooters? Do your part to prevent falls and head injuries.
How do I know if I need to take my child into the ER after a fall or head injury?
The consequences of a head injury can range from very minor to severe. If your child can do appropriately after the fall everything that they could do before the fall, then they are likely not in need of medical attention. Talking, eating, walking, and being able to see like normal are all good signs that no serious damage has been done.
If there is loss of consciousness at the time of the accident, take your child to the ER, even if it is just for a moment and they resume consciousness after. Loss of consciousness could be indicative of a concussion (jarring or shaking of the brain inside the skull), which is the most common type of traumatic brain injury. A more serious brain injury can cause a subdural hematoma (swelling caused by blood collecting outside of the brain), which can be life-threatening.
If your child is vomiting, has any seizure activity, any loss of vision, confusion, or is unable to talk (any one of these symptoms), take them to the ER.
A child with a contusion (a bruise, typically called a goose egg) may or may not need medical attention. Consult your pediatrician with any questions you may have.
If my child is sleepy after a fall, should I let them sleep?
Being sleepy after a fall is not a positive or negative sign in and of itself. Inconveniently, many children fall just before nap time because they are more clumsy, so it is normal for them to fall asleep after. Children also become sleepy after a hard cry. In the absence of any other signs (like those mentioned above), let your child sleep. Sleep is healing for the body and calming for the emotions.
If my child seems ok, is there anything I should do?
For bumps and bruises, use arnica oil on the area topically (as long as the skin is intact). Any cuts or lacerations should be bandaged and monitored for signs of infection, including excessive redness, pain, pus, or a fever. Watch for any serious symptoms or signs of injury (like those mentioned above). Frequently re-evaluate your child, especially for the first day. The possibility of a brain bleed significantly decreases 24 hours after a head injury.
For any additional concerns, contact your pediatrician. Also, trust your gut feeling. If you feel like you should take your child into the ER to be evaluated, do it. Pack some snacks, a few favorite toys or an iPad, and settle in for a little wait.
And welcome to parenthood.
Jaimeé Arroyo Novak, FNP