Head injuries
Head injuries are extremely common in young children and usually result from accidents. While frightening for the carer, they are rarely serious or have any long-lasting effect.
Head injuries are classified as external or internal injuries. With serious internal head injuries, the main risk is bleeding or swelling inside the skull, which could cause a blood clot and result in brain damage. It is, therefore, vital to take immediate action if you suspect that a child in your care has an internal injury.
Symptoms
External head injury
Mild external head injuries are usually not serious and most do not need medical treatment. The symptoms include:
* Slight headache
* Nausea
* Swelling or bump to the head
* Bleeding around the affected area.
Internal head injury An internal head injury can have very serious implications if, despite the protective covering of the skull, the brain has been damaged. The signs include:
* Persistent headache
* Abnormal sleepiness/drowsiness for some time afterwards
* Difficulties in waking up
* Concussion/brief unconsciousness
* Dizziness/feeling weak
* Blurred vision/abnormal pupil size
* Confusion/incoherent speech
* Lapsed memory
* Nausea and vomiting
* Irregular breathing.
Treatment
External head injury
Encourage the child to sit down and apply a cold compress to the bump for at least 10 minutes. Cover the ice with a cloth to prevent frostbite. If she does not recover within five minutes call your local doctor for advice.
External cuts to the head may require stitches. If in doubt go to A&E.
Monitor her closely for the next 24-48 hours for any sign of an internal injury, such as drowsiness, vomiting or irregular breathing. In this case, call a doctor immediately or dial 999.
Internal head injury
Call an ambulance immediately if you think the child has a serious or internal head injury. If she is conscious while you wait:
* Keep her calm and still as there may be an injury to her neck or back.
* Place your hands on either side of her head and keep her in the position you found her. If the skull appears to be fractured, apply light pressure to the wound.
* If there is swelling, apply a cold compress to the injured area.
* Do not attempt to clean the wound as this could exacerbate any bleeding.
* If she vomits, roll her over to one side, keeping her head and neck in alignment.
* If the child is not conscious do not attempt to move her as this could injure her further. Apply basic life support if the child does not appear to have a pulse.
When to call an ambulance?
* If the child cannot be woken.
* If she has a convulsion or fit.
* If, hours later, she displays symptoms of confusion, headache, abnormal drowsiness or irregular breathing.
* If she appears confused or drowsy, has problems speaking or is vomiting.
* If she has fluid or watery blood leaking from her nose or ears.
Medical treatment
If the child has only a cut to her head, the doctor might need to stitch it or apply a type of glue. However, if a fracture is suspected her skull may need to be X-rayed or scanned. If the scan shows any signs of internal bleeding she may need an emergency operation. If she has severe concussion she may need to be kept under observation in hospital for a couple of days.
Home care
A child recovering from a minor head injury will probably need to rest for two to three days. Keep an eye on her for the first 24 hours to see if she develops any symptoms, such as abnormal drowsiness, slurred speech, vomiting or confusion.
If she has been treated in hospital for a serious head injury she will probably need to rest for several weeks afterwards. Remember, if in doubt go to A&E. NW
Researched and written by Marcella McEvoy
