Head Injuries

It is incredibly common for children to bang their heads: they rush around at the wrong height for everything; they are totally unaware of risk and are head heavy! Fortunately, the majority of 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 these 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 the child is slightly older (not an infant) and is alert and behaving normally after the fall or blow:
o Apply a wrapped ice pack or instant cold pack to the injured area for 10 minutes to reduce superficial bruising – if the child doesn’t want this then don’t persist.
o 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.
o 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 colour 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), try to rouse your child gently, they should object to this and attempt to resettle. If they don’t appear to be rousable try to wake them fully. If they can’t be woken, or show any symptoms of a brain injury (see below) call an ambulance.

Suspected brain injury
The brain is pretty well protected within in the skull and cushioned by the cerebrospinal fluid, but a severe blow to the head can knock the brain into the side of the skull or tear blood vessels. The brain may then bleed and start to swell causing secondary brain injury – this can happen immediately or continue over the next 48 hours. This secondary damage is often far more serious than the original injury and is serious and possibly life threatening.
It can be really difficult to determine the severity of an 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, repeated vomiting, a weakness down one side… 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 has, or starts showing any of the following:
• 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 once – (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 – but you may want to contact your doctor).

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 as a head injury can cause 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 as they could have a spinal injury.
• If there is 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.

It is strongly advised that you attend a Practical First Aid course to understand what to do in a medical emergency. Please visit www.firstaidforlife.org.uk emma@firstaidforlife.org.uk or tel 0208 675 4036 for more information about our courses. 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.

Emma Hammett, First Aid for Life Tel: 0208 675 4036   www. firstaidforlife.org.uk

First Aid for Life is an award winning First Aid training business that is HSE and Ofqual Approved through Qualsafe Awards. Our trainers are medical and emergency services professionals and our training is tailored to your needs.