Minor Head Injury
The first point is to check the level of consciousness and ANY loss of consciousness requires a visit to a physician. In very young children, the absence of crying can indicate loss of consciousness. In older children, failure to move or respond to voice or touch may indicate loss of consciousness. Children who pop right back up, even if crying, generally do well.
Evaluate the force of the injury. A child who falls from a height must be watched more closely than one who falls while running. Look for cuts that may need to be sutured and for obvious extremity breaks. Expect swelling and bruising at the area of impact. In general, the areas below the eyes or behind or directly above the ears require more careful attention than the simple forehead bump.
If you decide that a call or visit is unnecessary, it is still advisable to watch the child carefully for several hours. If normal activity is resumed within 15-20 minutes, the child is usually fine. You may apply ice to any head bump, although it may make a younger child more agitated, and doesn’t change anything going on inside the skull, only perhaps the size of the bruise.
After a head injury, feed the child very lightly for the first hour or two, because it is not unusual for a child to vomit once or twice. For persistent vomiting or severe headache, call us to discuss whether further evaluation is warranted.
A young child may want to nap shortly after an injury. You may allow this, but check to see if the child is normally arousable and responsive within the first few hours of sleep.
For a simple headache, you may give acetaminophen.