Head Trauma

Injury Definition
Injuries to the head: These types of injuries include:

  • Scalp trauma (cut, scrape, bruise or swelling)
  • Skull Trauma: bruises, fracture
  • Concussion: brief period of confusion or amnesia (loss of memory). Does not require a loss of consciousness
  • Brain trauma: recognized by the presence of Acute Neurological Symptoms: (1) Difficult to awaken OR (2) confused thinking and talking OR (3) slurred speech OR (4) weakness of arms OR (5) unsteady walking.

Call 911 Now (your child may need an ambulance) If

  • Acute Neuro Symptom (as defined above) and present now
  • A seizure (convulsion) occurred
  • Knocked unconscious > 1 minute
  • Not moving neck normally (Caution: protect the neck from any movement)
  • Major bleeding that can’t be stopped

Call Your Doctor Now (night or day) If

  • You think your child has a serious injury
  • Age < 1 year old
  • Neck pain
  • Bleeding that won’t stop after 10 minutes of direct pressure
  • Knocked unconscious < 1 minute
  • Acute Neuro Symptom (as defined above) and now fine
  • Blurred vision persists > 5 minutes
  • Skin is split open or gaping and may need stitches
  • Large swelling
  • Large dent in skull
  • Severe force or speed involved (e.g. auto accident, fall from great height, blows from hard ball or club)
  • Vomited 3 or more times since injury
  • Watery fluid dripping from the nose or ear while child not crying
  • Severe headache or crying
  • Can’t remember what happened (amnesia)

Call Your Doctor Within 24 Hours (between 9 and 4) If

  • You think your child needs to be seen
  • Headache persists > 3 days

Call Your Doctor During Weekday Office Hours If

  • You have other questions or concerns

Parent Care at Home If

  • Mild head injury and you don’t think your child needs to be seen

Home Care Advice for Scalp Injuries

  1. Wound Care: If there is a scrape or cut, wash it off with soap and water. Then apply pressure with a sterile gauze for 10 minutes to stop any bleeding.
  2. Local Cold: Apply ice for 20 minutes to any swelling. (Big lumps are common)
  3. Observation: Observe your child closely during the first 2 hours following the injury.
    • Encourage your child to lie down and rest until all symptoms have cleared. (Note: mild headache, mild dizziness and nausea are common)
    • Allow your child to sleep if he wants to, but keep him nearby.
    • Awaken after 2 hours of sleeping to check the ability to walk and talk.
  4. Diet: Offer only clear fluids to drink, in case he vomits. Regular diet OK after 2 hours.
  5. Avoid Pain Medicines. If the headache is that bad, he needs to be examined.
  6. Special Precautions at Night: Awaken child at your bedtime and again 4 hours later for 2 nights. Check the ability to walk and talk. Sleep in same room as your child for 2 nights. After 48 hours, return to a normal routine.
  7. Expected Course: Most head trauma only causes a scalp injury. The swelling may take a week to resolve. The local headache usually clears in 2 to 3 days.
  8. Call Your Doctor If
    • Pain becomes severe
    • Neurological symptoms occur during the next 3 days
    • Your child becomes worse or develops any of the “Call Your Doctor” symptoms