What to do if a child hits his head: instructions for parents

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If a child hits his head, this is not always a reason for panic and parental worries. Nevertheless, parents must be able to distinguish what kind of “catastrophe” has happened - the child has a concussion or (which happens ten times more often!) just a slight bruise. Because each “scenario” has its own special action plan...

© Provided by: Woman.ru The child hit his head: what to do

According to statistics: of all people seeking medical help for a traumatic brain injury, 35% are children under 15 years of age.

Concussion in a child: the devil is not as terrible as...

One of the most terrible and dangerous head injuries in a child, according to most parents, is a concussion. But in reality, as it turns out, everything is exactly the opposite...

Let us explain in a nutshell what generally happens when a child has a concussion. The head (including a child’s head), to put it very simply, consists of bone (a hard and relatively strong skull), which protects the soft, vulnerable and “delicate” brain enclosed inside this very bone. With a strong external blow that falls on the skull, the brain from the inside, in turn, also hits the wall of the skull. In this case, the brain cells at the site of this impact are not damaged, but for some time they lose their relationship with each other. This leads to loss of consciousness, most often extremely short-term.

The most obvious and obligatory symptom of a concussion in a child is loss of consciousness. If the baby did not “pass out”, then there is no talk of any concussion.

At the same time, parents should know that from a medical point of view, a concussion is one of the mildest and most harmless head injuries. In the vast majority of cases, after a concussion and loss of consciousness, the child comes to his senses and adapts very quickly.

The maximum ailments that can occur in a child after a concussion are a short headache, loss of appetite and drowsiness. However, after 1-2 days, these symptoms disappear without a trace.

The situation is completely different if the child suffers a brain contusion due to the impact.

Prevention

Fall prevention is the best way to keep your child from getting a head injury. However, accidents do happen. After a fall, it is important to reevaluate the safety and security of children at home.

Never leave a child unattended on an adult bed, even if the pillows are in place, to prevent them from getting close to the edge. In addition to falls, adult beds pose a risk for other types of accidents, including entrapment and suffocation.

Also, do not place a car seat or booster seat on top of a raised surface, even after you have secured your child.

Always put your baby in a crib when leaving him alone in the room. There should be no soft bedding in the crib that could crush or suffocate the baby.

Brain contusion in a child

A brain contusion is a situation in which, during a blow to the inner wall of the skull, the brain is not only shaken, but also receives certain damage. As a rule, the following occur at the site of injury:

• Hemorrhages (hematomas)
• Edema

This scenario can already be extremely dangerous for the child’s health, since the damaged brain is located in a confined space of the skull - during bleeding, the blood simply has nowhere to go, as does the growing edema. Usually in these circumstances there is a risk of compression of the brain, which can lead to very disastrous consequences.

If a child hits his head, and doctors record all three symptoms - concussion, bruise and compression of the brain, only in this case do they have every reason to diagnose a “traumatic brain injury”.

Thus, neither a concussion in a child, nor a bloody abrasion on the head, nor a “bump”, nor a black eye give you the right to panic and believe that your child has “suffered” a traumatic brain injury. There are completely different reasons for this, and we will talk about them later...

Features of the structure of the child’s skull and brain

• In the first years of life, infants' head size rapidly increases. This expresses the disproportion of growth;
• any slight trauma to the skin can cause serious damage, because the child’s stratum corneum is poorly developed;
• A feature of the blood supply to the head is a richly developed venous network with many anastomoses. About 18 - 20% of the blood emitted by the heart goes directly to the baby's head. These two factors are a risk of massive bleeding in scalp wounds;
• Due to the fragile attachment of the thin aponeurosis to the periosteum, extensive cephalohematomas may appear. In children older than 6 months, the risk is lower;
• The brain part of the child’s skull is smaller than the facial part. Adolescents and adults, on the contrary, have a more extensive facial area;
• A special feature of babies is fontanelles.
  They increase the “reserve space” with increasing brain volume for various pathologies, especially if the child hits his temple. It contributes to a longer “clear interval” in case of hemorrhages in the baby. A sharp bulging and/or tension in the fontanel area is a serious sign! You need to go to the clinic urgently!;
• The bones that make up the baby's skull are thin, contain few mineral elements, but are rich in water. Due to this feature, linear or depressed fractures are observed, and not comminuted, as in adults;
• diploic veins, devoid of valves, can contribute to the rapid spread of infection from the wound to the cranial cavity;
• the brain grows rapidly until the age of six, then growth slows down;
• the baby’s brain is better supplied with arterial blood, but venous outflow is difficult due to underdevelopment of the veins after the fontanelles close;
• Nerve fibers are unevenly covered with myelin. First, motor (the child hones his skills in walking, coordination of movements, manipulation of hands with objects), only then sensitive. Therefore, the pain is not felt as much;
• The blood-brain barrier is an obstacle between the brain and infectious environmental agents. In children, it is more permeable, so there is a high probability of exposure to toxic and infectious agents on the nervous system;
• at an early age, in response to injury, swelling and edema of the brain often occurs, which can have serious consequences and need to be supervised by a doctor.

The child hit his head: damage and wounds

What to do if a child hits his head and a bleeding wound appears:

In this case, you should give him the same help as for a bruise in any other place:

• On a bleeding wound, you should first apply ice (crushed ice or a bag of frozen vegetables is best), and a little later, make a pressure bandage;
• If the head wound is more than 7 mm wide and 2 cm long, the child must be taken to a medical facility - such wounds usually require stitches.

Let us repeat: if a child hits his head and a “bump” appears at the site of the injury, or even a small bleeding wound appears, but he does not lose consciousness, then no matter how “scary” it may look from the outside, it is a serious injury. there is no reason for the head. And if the baby does not show any dangerous symptoms (we will list them below), then you don’t even have to call a doctor or take your child to the hospital.

What to do if a child hits his head and damages his skull:

Naturally, with a strong blow, not only the child’s brain suffers - the skull itself can be damaged.

Depending on whether there are visible damage to the skull bones or not, head injuries are conventionally divided into open and closed. In both cases, they require immediate medical examination and qualified assistance.

However, the skull consists of more than just bones. On the inside of the child’s skull there is a special wall (in medical terms, the dura mater) that directly separates the brain from the bones of the skull. If upon impact this shell is damaged and ruptured, then in this case doctors pronounce a verdict of “penetrating head injury.” And this is also certainly the case when the child must be immediately taken to a medical facility.

So, your action in the event of obvious (or suspected) damage to the skull bones is to take the child to the hospital. Most often, this picture is accompanied by corresponding symptoms, indicating that the child’s brain was also seriously damaged by the impact.

How to help if your child hits his nose?

1. If the blow starts bleeding from the nose, do not tilt the child’s head back. Why? Because it is necessary to know how much blood the baby lost if the bleeding did not stop for a long time in order to provide adequate medical care and avoid adverse consequences.
2. Place on a flat surface.
   To prevent your baby from being frightened by the sight of blood, you can insert a sterile gauze pad shallowly into the external nasal passage. There is no need to try to insert the gauze swab as deeply as possible in order to remove it later without additional trauma to the mucous membrane. It is advisable not to use cotton wool or cotton pads, since you will have to “tear off” the cotton pad soaked in blood from the wall of the nose, and the cotton fibers can impair the regeneration (restoration) of the mucous membrane. If a child has blood clotting diseases, it is necessary to contact a medical facility. There, medications will help stop the bleeding.
3. After the blood has stopped flowing and the child is ready for new feats, do not let the baby overexert himself, monitor his body temperature. There is no need to blow out blood clots or rinse your nose; give the blood vessels time to recover. In the first two to three days after the child hits, thermal procedures - bath, sauna, bathhouse - are undesirable.

But now - panic and run to the doctor!

So, if a child hits his head, and after that you notice the following signs, immediately take your child to the doctor:

• Impaired consciousness;
• Problems with speech (the tongue is slurred, the child cannot find the right words, etc.);
• Inappropriate behavior;
• Pronounced drowsiness;
• Severe headache that does not improve within an hour after the impact;
• Repeated attacks of vomiting (but if vomiting occurs after a single blow, this is not an alarming sign);
• Convulsions;
• Severe dizziness that lasts more than 1 hour after the impact;
• Inability to move your arms or legs;
• The child has different pupil sizes;
• If there are bruises under both eyes or behind the ears;
• Colorless or bloody discharge from the nose or ears (a rather specific, but very serious symptom: the fact is that with a strong blow, the circulation of cranial fluid can be disrupted, which begins to flow through the nose or ears).

All of the above signs are symptoms of either a bruise or compression of the child’s brain. They occur in the vast majority of cases in the first 24 hours after the child hits his head. And each of these symptoms threatens with serious consequences, therefore, if they appear, it is necessary to immediately take the child to the doctors, or vice versa.

Remember: if a child hits his head, your first and most important task is to closely monitor him in the first 24 hours after the hit.

© Provided by: Woman.ru Concussion in a child: symptoms

Head injury - how to help your child

Could you explain the difference between head injuries in children and adults?

If we talk about children in the first year of life, then their level of fluid inside the skull is much higher than that of older children and adults. Also, since babies have fontanels, as well as movable sutures between the bones of the skull, the brain is not tightly closed in the cranium. The result is depreciation, which to some extent reduces the risk of impacts to the head and head.

What are the possible consequences of head injuries?

The vast majority of traumatic brain injuries are not serious and do not have adverse outcomes. But absolutely every blow to the head and head requires serious attention from the parent. Anything is possible: unsafe damage to the brain matter and bleeding in the brain cavity. A common consequence of head injury is a concussion. What is the nature of a concussion?

Science still cannot give an exact answer to the question of what happens to the brain in this case. The most likely option is shaking of the brain matter with an impact of the brain on the skull from the inside. As a result, connections between brain cells and its parts are disrupted. The main symptoms in this case are disorders of consciousness. The main difference is that during a concussion, the integrity of the brain tissue is not compromised.

What other injuries are possible with a blow to the head?

The options can be very different: from compression to brain contusion. If we talk about the latter, then we are talking about damage to the brain matter with subsequent swelling and hemorrhage.

Another option is intracranial hematomas with severe swelling of the brain tissue, which is otherwise called compression of the brain.

The concept of traumatic brain injury includes all three of these possible outcomes: compression, bruise and concussion. Due to an impact, the injury can be either open or closed, depending on the violation of the integrity of the bones of the skull. If these abnormalities are present, then the injury is open.

Between the inside of the skull and the brain matter is the hard part of the brain membrane. Damage to the dura mater due to an open head injury is called penetrating.

The opposite situation with a head contusion is damage to the soft tissues, which in this case are the skin and subcutaneous tissue above the bones of the skull, without disorder. All of the above are medical diagnoses that a doctor can and should make. At the same time, there are obvious symptoms indicating the potential danger of a possible head injury in a child, which requires mandatory consultation with a doctor.

The main task of parents in such cases is to immediately provide emergency assistance, knowing these symptoms.

Tell us more about the symptoms that indicate medical attention is needed.

I want to make a reservation right away that any head injury is dangerous. “Screaming” symptoms may not appear immediately, which is why round-the-clock monitoring of the child is so important in this situation, even if the injury does not seem serious. Moreover, seeking medical help is mandatory if the head injury was sustained under the influence of alcohol and drugs.

The main signs of a serious traumatic brain injury are:

• speech disorder;
• unnatural drowsiness;
• disturbance of consciousness of any kind;
• inappropriate behavior;
• severe headache that persists for more than an hour after injury;
• difficulty moving your arms and legs, including weakness in an arm or leg;
• loss of balance and/or dizziness that persists for more than an hour after injury;
• convulsions;
• different pupil sizes;
• more than one episode of vomiting;
• bleeding from the nose/ears;
• dark/dark blue spots under the eyes and behind the ears;
• any, even seemingly insignificant, changes in the sensory organ (auditory hallucinations, fog, double vision, strange taste in the mouth, goosebumps, decreased skin sensitivity);
• discharge of fluid from the nose or ears, both colorless (runny nose) and bloody.

If the child falls asleep after an injury, it is necessary to wake him up every 2-3 hours by asking simple questions: “How old are you?”, “What is your name?” and others.

It is important to know all these symptoms, but I repeat once again - if in any doubt, you should consult a doctor immediately.

What about emergency care for a child? What steps can parents take?

It all depends on the symptoms. If there are no dangerous signs of a head injury, then it is enough to calm the child, limit his physical activity as much as possible and apply cold to the bruised area.

If dangerous symptoms appear, it is extremely important to exercise maximum vigilance. It is necessary to check the child’s breathing and circulatory conditions. If they are in critical condition, cardiopulmonary resuscitation is needed. If both breathing and blood circulation are normal, but the child is unconscious: place him on his back on a hard and flat surface, support his head with his hands and carefully monitor his breathing. It can be difficult due to excess saliva and vomit - then you need to put the child in a stable position on his side, avoiding rotation, excessive throwing back and lateral tilt of the head.

While waiting for help, it is recommended to immobilize the cervical spine - also known as splinting.

If you suspect damage to the skull bones, avoid direct pressure on the wound as much as possible.
To do this, cover the wound with a dressing. Do not remove foreign bodies from the wound. If the child is conscious, wait for medical attention with the child lying on his back without a pillow. You should not give food or drink at this time, as well as move him unless absolutely necessary.

How many fingers, buddy?

If a child hits his head hard, he may experience problems with his senses and perception. It is not difficult to “catch” these violations.

Remember, in every movie about heroes and villains, there is such a scene: a character who has gotten into trouble and received a blow to the head is poked in the face by a friend with his finger and asked to count how many fingers are looming before his eyes. So this is the most primitive test for the adequacy of perception and feelings.

If your child hits his head, loses consciousness for a while, and then comes to his senses, do the same with him: make sure that he sees and hears you, that he feels touch and is able to answer a simple question, that he does not experience numbness in limbs, does not feel a surge of abnormal heat or cold.

If disturbances related to the child’s sensory organs are visible on the face, immediately go with him to the nearest hospital.

What should parents do if your child hits his temple?

1. After the baby has hit his temple, it is necessary to assess whether he hears normally. Pay attention to whether he reacts to sharp sounds, whether he hears rattles or whispered speech.
2. If you notice strange behavior in a child after a blow, expressed in a sharp emotional response to any irritation (for example, with a sharp sound or bright light, the baby begins to cry, run to another room or hide; a previously sociable child does not understand well the speech addressed to him, requests or performs actions only after a visual image) it is necessary to consult an ENT doctor and take an audiogram.
3. If a child hits his head in the temple area on a corner and loses consciousness, seek medical help immediately. You will probably need a neurosonoscopy if your baby is still an infant. Or MRI of the brain if the child is of primary preschool age. It is necessary to exclude fractures of the temporal bone and hemorrhages in the temporal region.

The temporal lobe is involved in processing information coming from the organs of hearing and vision, and is also responsible for understanding speech and emotional reactions.

What happens if brain dysfunction after trauma is not treated?

1. Developmental delay in the child.
2. Speech difficulties.
3. Frequent headaches.
4. Dizziness.
5. Sleep disturbance.
6. Epileptic seizures.
7. Hyperactive behavior at school.
8. Difficulty in remembering new information.

What if it's barotrauma?

The condition when bleeding comes from a child’s ear causes panic in any parent. Such a symptom is a clear reason to go to an ENT specialist, because there is a high probability of a ruptured or torn eardrum.

Barotrauma occurs due to a strong blow to the ear, for example from water, or after a fall. It can also be triggered by a sharp foreign object in the ear. Internal pressure changes rapidly. The eardrum vibrates violently and becomes damaged. The child experiences noise or crackling in the ears and complains of a deterioration in his general condition.

If a complete rupture of the eardrum occurs, sudden hearing loss, severe bleeding and other symptoms are possible, including loss of consciousness. Minor tears can be asymptomatic for a long time, but the damaged area becomes an open gate for infections and otitis media. Therefore, it is dangerous to ignore mechanical ear injuries even with minor bleeding.

Bleeding from the auricle is the first sign of barotrauma

The ear is swollen: what to do?

In the heat of play, during sporting events, at home or in the yard, a child can always accidentally hit the ear. In response, it will begin to swell. It is impossible to leave this condition for later, in the hope that everything will go away on its own. The cartilage may be deformed. If the anterior wall of the external auditory canal is not repositioned in time, the child’s hearing will deteriorate over time. Then, to restore the lumen, a series of plastic surgeries will be needed.

Use a sterile bandage or gauze to remove dirt from the surface and rinse your ear with warm boiled water. If there are wounds, treat their edges with an alcohol solution of iodine, and apply a bandage over it. Go to the emergency room to rule out serious pathologies.

A seemingly harmless earbud earphone poses a great danger. If a blow to the auricle occurs while listening to music, the child will receive not only swelling, but also barotrauma.

Children often receive mechanical ear injuries in wrestling sections.