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Guidelines for dealing with head injuries in children

Children are busy at all times. It is not surprising then that at some time or another your child may bump its head. Bumps and bruises are part and parcel of growing up and exploring the world but head injuries in children do occur and parents or caregivers need to be aware of the signs of a serious injury.

If your child does bump its head there are specific signs to look out for that necessitate medical attention. Please call your doctor or take your child to the nearest Emergency Room should any of the following symptoms appear. Some of these symptoms are age dependant.


Signs that your child requires medical attention:

head injury

  • Disorientation (eg child does not know own name, date or location)
  • Abnormal behaviour or abnormal movements.
  • Irregular breathing.
  • Increased sleepiness or drowsiness.
  • Inability to awake child from sleep.
  • Unequal size of pupils (black centre of the eye becomes unequal in size)
  • Blurred vision.
  • Peculiar movement of the eyes or difficulty in focusing.
  • Difficulty in hearing.
  • Clumsy movements or clumsy when walking or crawling.
  • Increased irritability, confusion, restlessness or inability to concentrate.
  • Persistent vomiting.
  • Blood or fluid draining from the nose or ear.
  • Swelling or blackening of the eye-lids.
  • Bruising behind the ears.
  • Child starts to fit.
  • Complaining of worsening headache.
  • A swelling on the head or face larger than 2cm

Head wound:

Should your child have a cut/ wound resulting from a head injury that is open and bleeding please seek medical attention immediately. Your child may need stitches and under certain circumstances may require a CT scan.

Cause of the injury:

Should your child have sustained the injury as a result of one of the following please get medical assistance:

  • A car accident or being hit by a vehicle as a pedestrian.
  • A fall from more than 2 m high.
  • Being hit with a moving object (like a cricket bat, tennis racket, stone etc) on the head or face.

Immediate treatment:

It is a good idea to put a cold compress on the bump to help with swelling or pain. This can be any cold item. Be sure to put cold items that come out of the freezer in a towel. You do not want to damage the skin with a very cold item. You could use ice blocks wrapped in a towel or a bag of frozen peas in a towel. The peas work really well as they take the shape of the face and don’t have sharp edges.

If your child is in a lot of pain then you can give something for pain. Pain relief may, however, make the child drowsy. If you suspect that your child may have concussion then hold off on the pain relief so you can assess excessive sleepiness.