My Child Fell and Hit Their Head; Now What?
If you have a child, and they have a head – chances are good that at some point before they reach adulthood, they will fall and bump it. Although this is a relatively common and arguably unavoidable occurrence, children hitting their heads can be quite scary for parents. In such moments, it’s important to know how to assess the severity of head trauma, recognize concerning signs of head injury that could indicate a potential concussion, and navigate the critical steps of aftercare. Let’s talk about some practical guidelines for confidently assessing and managing minor head injuries.
Is it a concussion?
The big, bad ‘C’ likely defines the first worry that a parent has when their child hits their head. The 25-cent word at play here is mild TBI (traumatic brain injury), and it’s true that repeated concussions can result in cognitive impairments and long-term brain damage. While it would make things easier if there was an easy diagnostic test for concussion, they aren’t detectable on CT scans, x-rays, or MRIs. So, we must rely on clinical expertise, which includes the history of the event or injury and the examination findings. Here are some of the standout symptoms to look for:
- Headache
- Dizziness
- Nausea/vomiting
- Sensitivity to light or noise
- Confusion
- Memory problems, especially about the injury/event
- Difficulty concentrating
- Changes in mood or behavior
Of course, some of these signs could be naturally present in small children even without serious head injury, so it’s still difficult to assess the situation accurately. For this reason, the PECARN algorithm was created; it is a nifty tool that all parents and caregivers should reference when a child hits their head.
PECARN
The PECARN (Pediatric Emergency Care Applied Research Network) head injury tool is recommended to assess the risk of significant head injuries in children who have experienced head trauma. It’s been validated extensively in academic medicine and beyond.
The algorithm takes the caregiver or healthcare provider through a series of questions to help decide if a child needs further testing, like a CT scan, after hitting their head. The tool helps determine the likelihood of serious brain injuries by considering factors such as the child’s age, how the injury occurred, and specific symptoms they might be experiencing.
Concussion Treatment
If your child is diagnosed with a concussion, the management that your doctor recommends will likely look very different from what it was when you were a child. In the past, concussion management relied on a ‘rest-is-best’ approach, advocating for passive recovery despite limited evidence.
However, recent research has shifted towards an ‘exercise-is-medicine’ philosophy, opposing the traditional resting approach. Studies exploring aerobic exercise have shown promise in managing concussion symptoms across physical, cognitive, emotional, and sleep-related domains. For this reason, it is likely that your doctor will recommend a gentle return to normal activity relatively soon after the incident.
Head Injury Response Steps
From determining when to seek medical attention to understanding the warning signs that necessitate immediate action, having a clear understanding of how to respond can make all the difference in safeguarding our child’s health and ensuring their recovery. So, if your child falls and hits their head, here are some simple guidelines to get you through that troubling moment:
- Stay calm: reassure your child and help them feel safe. Take deep breaths.
- Assess: use the PECARN tool and look for any signs of distress or unconsciousness.
- Monitor: watch for any changes in behavior, loss of consciousness, vomiting, confusion, difficulty walking, or unequal pupil size.
- First aid: clean any cuts or bruises with mild soap and water and apply a cold compress to reduce swelling. Avoid putting direct pressure on the injury.
Remember, it’s always better to seek medical advice if you’re unsure about the extent of your child’s injury. Prompt and appropriate care can help ensure the best possible outcome for your child’s recovery.
From strep throat to stitches, we’re here for your family – wherever you are! Click here to find a PM Pediatric Urgent Care near you, or learn about our telemedicine options!
About the Expert
Dr. Christina Johns is a nationally recognized pediatric emergency physician and Senior Medical Advisor at PM Pediatric Care. An official spokesperson for the American Academy of Pediatrics, she is board certified in both pediatrics and pediatric emergency medicine. With extensive media experience, the proud mom of two teenagers shares over 20 years of pediatric expertise with patients and families everywhere. Follow Dr. Johns for more insights on children’s health!
