Head Injury, Age 3 and Younger

Home Treatment

Any child who has hit his or her head should be watched carefully for several days after the injury. Home treatment can help relieve swelling and bruising of the skin or scalp and pain that occurs with a minor head injury.

• If your child had an accident, try to remain calm and speak to your child in a calm, relaxed voice. This will help reduce your child's fear and allow you to assess the situation.
• If your child has a cut that is bleeding, apply firm pressure directly over the cut with a clean cloth or bandage for 10 minutes. See how to stop bleeding. If the cut is deep and may have penetrated the skull, emergency treatment is needed.
• Check for injuries to other parts of the body, especially if the child has fallen. The alarm from seeing a head injury may cause you to overlook other injuries that need attention.
• Apply ice or cold packs to reduce the swelling. A "goose egg" lump may appear anyway, but ice will help ease the pain. Always keep a cloth between your child's skin and the ice pack. Do not apply ice for longer than 15 to 20 minutes at a time, and do not let your child fall asleep with the ice on his or her skin.

After your child is seen by a doctor, be sure to follow the instructions given to you by your child's doctor. You may need to watch your child closely for the next 24 hours or longer. Here are some general instructions:

• Check for the following signs of a severe head injury immediately afterwards and then every 2 hours for the next 24 hours:
  • A significant change in the child's level of consciousness
  • Confusion or not acting normal, such as extreme fussiness or crying that cannot be comforted
  • Abnormally deep sleep, difficulty waking up, or extreme sleepiness
  • Vomiting
  • Symptoms that affect one side of the body more than the other side, such as weakness or problems moving an arm or leg
  • Significant changes in the eyes, such as crossed eyes, droopy eyelid (usually just one eyelid), or problems using the eyes
• Continue to check on your child often during the night. If your child had a head injury right before going to bed or taking a nap and falls asleep soon afterward, check him or her for changes in colour or breathing, or twitching arms or legs. You do not need to try to wake your child unless you notice changes. Call911or go to an emergency room immediately if you notice changes and cannot wake your child (unconsciousness). Seek medical care if your child has any symptoms of a serious head injury.
• Do not give any medicine, including non-prescription acetaminophen, such as Tylenol or Panadol, to a child you are watching for signs of a more serious head injury unless your doctor tells you to.

Symptoms to Watch For During Home Treatment

Use the Check Your Symptoms section to evaluate your child's symptoms if any of the following occur during home treatment.

• Bleeding has not stopped after 10 minutes of direct pressure.
• Bruising or discoloration develops around the eyes, behind the ears, or on the scalp.
• Moderate to severe swelling develops on the face or scalp.
• Any of the following symptoms develop:
  • A significant change in your child's level of consciousness
  • Confusion or not acting normal, such as extreme fussiness or uncontrollable crying
  • Abnormally deep sleep, difficulty waking up, or extreme sleepiness
  • Vomiting
  • Symptoms that affect one side of the body more than the other side, such as weakness or difficulty moving an arm or leg
  • Changes in the eyes, such as crossed eyes, droopy eyelids (usually just one eyelid), or difficulty using the eyes
  • Fever
• Your child's symptoms become more severe or more frequent.

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Author:	Sydney Youngerman-Cole, RN, BSN, RNC	Last Updated: September 15, 2006
Medical Review:	William M. Green, MD - Emergency Medicine Michael J. Sexton, MD - Pediatrics Thomas Emmett Francoeur, MDCM, CSPQ, FRCPC - Pediatrics
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