Very few children reach kindergarten without some sort of head injury. Fortunately, most are minor and required minimal attention. The most minor type of head injury is a blow that causes no swelling or a small raised bump or bruise, no blood or bleeding and no change in the child’s behavior after the initial tears and crying. Treatment consists of TLC (tender, loving care) and a “kiss where it hurts”.

A little more concerning is the head injury that results in a brief period of confusion (a dazed look lasting no more than five minutes) and a desire to sleep, occasionally preceded by vomiting. These children need to be observed carefully. If the dazed period is brief and the child seems all right in all other respects, let them go to sleep for 30 to 45 minutes. If they awaken and are feeling fine or have no more than a headache and two or three episodes of vomiting, continue to observe at home. Within one or two hours they should be normal. If not, call the office. If they are difficult to awaken after 30 to 45 minutes, call the office.

If a child is unconscious for even a short period of time, has persistent vomiting, or has a difficult time controlling arms and legs, call us promptly or call 911.

Occasionally head injuries associated with a laceration or cut require attention. Generally if the cut is gaping (the edges pull away from one another) sutures or staples will be required for best results.

Signs to watch for:

• Persistent vomiting – more than three or four times, or more than 6 hours after the initial injury
• Prolonged sleeping – most children want a brief nap after a head injury, and it is all right to let them sleep – provided you wake them after 30 to 60 minutes. And continue to wake them every 2 – 3 hours during the night to assure that they are easily aroused and aware of their surroundings
• A change in behavior or personality – other than that expected from any minor injury with crying
• Difficulty with control of arms, legs or speech
• Bleeding from the ears or clear nasal discharge that occurs without crying
• Large lacerations (cuts) that require sutures
• Convulsions or seizures
• Severe or progressive headaches
• Pupils unequal in size
• Mental confusion or amnesia
• Stiff neck

Call the office and take your child to the Emergency Room if one or more of these problems arise.