Active children can fall and have many bangs to the head, but it can often be hard to know whether they are serious or not.
Many head injuries are not serious and simply result in a bump, bruise or small cut. More serious head injuries can cause brain damage and need to be carefully treated.
Seek urgent medical help immediately if:
There has been a hard bang to the head, such as falling off something high or at high speed, like a car accident
Altered consciousness, dizziness, confusion
Nausea or vomiting after the incident
Deep wounds or profuse bleeding
Clear fluid leaking from the eyes or nose, black eyes
Bruises behind the ears and vision changes
Obvious swelling or disfigurement
Difficulty breathing, walking, talking or balancing
Signs and symptoms
The symptoms of head injuries are used to determine how serious it is. Head injuries can be classified into minor, moderate or serious.
A minor head injury is when a person:
Has not lost consciousness
Is alert or interacts with you
May have minimal bruising or cuts on their head
Has normal reactions and behaviour
Feels mild to moderate pain from the injury
Most children with minor head injury make a full recovery. Most small knocks just cause bruising and pain for a short while.
Treatment of a minor head injury:
Apply ice or a cool wash to the area injured to help reduce the swelling
If a child has a minor cut or abrasion, apply a clean dressing and press on it for about 5 minutes to stop bleeding
Moderate head injuries
Loss of consciousness for less than 30 seconds
Not alert and responsive to voice
Vomiting twice or more
Seizures that may have happened straight after the injury
Large bruise, lump or cut on the head
A cut that does not stop bleeding after applying pressure for 5 minutes
Cuts to the head will often bleed a lot but only need medical attention if they don’t stop bleeding, are deep, or in a location that may cause a scarring concern – on the face, for example.
It is recommended to take someone with a moderate head injury to the hospital to be monitored.
After a head injury: the first day or two
Monitor if the child has a headache. They may just need paracetamol (with parents’ permission) or it may be the sign of something more serious.
Vomiting: the child may have vomited once but if vomiting continues, go see a doctor.
Drowsiness. It is likely the child will be more drowsy and want to sleep after a head injury. It is not necessary to keep them awake if you are confident there is no serious injury sustained. However, be sure wake them every half to one hour until they are no longer drowsy, making sure they have a normal reaction to familiar things. Ask them the name of their favourite toy, what they ate for breakfast, etc. to see that they have regular brain function.
After a head injury: the next couple of weeks
Head injury symptoms are not always immediate. In fact, in many cases, the effects can be present from internal bleeding for up to a couple of weeks after the head injury is sustained.
Make sure you watch for the following signs and seek urgent medical treatment if any of the following signs are present.
Any difficulty waking
Differences in behaviour
Irritability and mood swings
Lack of concentration
Severe head injuries
Loss of consciousness for more than 30 seconds
Is disorientated and does not respond to your voice
Multiple fits or convulsions at the time of the injury
Has other significant head injury signs, such as unequal pupils, arm and leg weakness
Something stuck or protruding from their head
Bleeding or discharge from the nose or ear
Unusual or confused behaviour
Difficulty talking, walking or balancing
A persistent headache that is not relieved by paracetamol
Constant crying in the case of a young child a baby
You should always call an ambulance by dialling 000 immediately if a child in your care has a severe head injury.
Treatment of a moderate or severe head injury
Follow DRSABCD action plan
Make sure you:
Control bleeding of the head, but do not apply pressure if you suspect a skull fracture
If you see blood or clear fluid coming from the ear, cover with a sterile dressing and turn patient on their side to drain the ear
If the patient is conscious:
rest in a comfortable position with elevated head and shoulders
If the patient is unconscious:
Place in the recovery position, lying on their side
Support head and neck during movement to the recovery position
Monitor airway and breathing
If the face is injured or swollen, ensure the breathing airway is open by slightly lifting the chin
Watch this video for more info on managing head injuries
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