Head Trauma and Head Injuries
Every child hits his or her head at some point. Luckily the brain is protected by the bones of the skull, which is made to withstand some bumping. This page is to help you manage those inevitable bumps (head trauma) and to figure out when your child needs to be seen by his/her Pediatrician (for a head injury).
When a trauma to the head occurs there are a couple of things to keep in mind:
1. The head bleeds a lot (as do the nose and the mouth). If there is a large or gaping cut your child might need stitches (see cuts, scrapes and stitches page for guidelines). Lots of blood is scary, but to be expected with any cut to the head or face.
2. A bump on the head will be much larger, much more quickly, than a bump on the arm or the leg. It is not unusual to have an egg sized bump within a couple of minutes after an injury to the head. This is caused by veins in the scalp leaking fluid and may take a few days to go down. The size of the bump is no indication of the seriousness of the injury.
If your child falls or bumps his/her head:
1. Keep calm. Your child is watching your cues. If you look frantic, s/he will feel frantic too.
2. Check his/her head and body for bumps, bleeding or deformities. Make sure to check from head to toe. If your child has any deformities call his/her pediatrician.
3. If your child has a bump on his/her head but no signs of a head injury (listed below) then do your best to put pressure on the area, try to use ice or cold compresses (a bag of frozen corn or peas) for 20 minute intervals (20 minutes on, 10 minutes off, 20 minutes on, etc.), and give acetaminophen or ibuprofen (see medication dosing page) for his/her discomfort. If your child will not allow you to put pressure or ice on the area then don’t. The bump might be bigger and last a bit longer, but it will go away eventually with or without the ice and pressure.
4. If your child has a bleeding cut see the cuts, scrapes and stitches page for guidelines.
Head Injury- When to see a doctor immediately
If your child has fallen on or bumped his/her head and has the following signs or symptoms, you need to see a doctor immediately:
1. Loss of consciousness. If your child passes out at the time of the injury or afterward call 911.
2. Vomiting. If your child is crying a lot, and vomits once while upset but is otherwise acting well you can continue to observe. If your child is acting unusual or has vomited more than once s/he needs to be seen immediately.
4. If the area injured has a ridge when you run your hand over it this suggests a fracture and your child should be seen immediately.
5. Not acting normally. All children will be upset after having a fall, but if your child is just not acting right, not alert, not responding in a way that is normal for him/her this may be cause for concern.
6. Loss of balance. If you have a child who is old enough to walk well or to sit without any help and soon after a head injury s/he suddenly cannot keep his/her balance, s/he needs to be seen immediately.
7. Severe headache. The type that you cannot rest through.
8. Eye changes. If your child’s eyes are crossing, rolling, if they have unequal pupil sizes, or if your child complains of blurred or double vision, go to the ER.
9. Blood or clear fluid coming from an ear or from the nose.
10. Once s/he has gone to sleep if your child looks pale or has a very rapid shallow or irregular breathing take him/her to the ER.
11. If your child just does not seem OK to you. No one knows your child like you do, so trust your gut feeling. If you are worried, head to the ER.
Waking your child up regularly, or not allowing him/her to go to sleep for many hours, is no longer a recommendation. If your child has been acting normally and has none of the above signs or symptoms then allowing him/her to sleep is fine. You can check on your child every couple of hours to assess color and breathing (as described above) and if all seems well do not wake him/her. If your child does not awaken and act normally at the expected time after a nap or is not alert in the morning, see a doctor immediately.
-Monique Araya, MD, FAAP
The medical information on this Web site is provided for educational purposes only. The information provided in this site, or through linkages to other sites, is not a substitute for medical or professional care, and you should not use the information in place of a visit, call consultation or the advice of your physician or other healthcare provider.
If you believe you have a medical emergency you should call 911 or your physician immediately. If you have any questions regarding your health or a medical condition, you should promptly consult your physician.
- Accidental Poisoning
- Bites and Stings
- Burns (and sunburns)
- Childhood Asthma
- Colic and Crying Babies
- Constipation in Children
- Cough & Cold
- Diaper Rash
- Ear Pain
- Head Trauma and Head Injuries
- Kids and Allergies
- Medication Dosages
- Nosebleeds in Children
- Pink Eye and Styes
- Scrapes, Cuts and Stitches
- Sudden/Acute Abdominal Pain
- Treating a Common Cold Cough
- Vomiting and Nausea