Head trauma in children
Mar 14, 2018
There is no other sound that makes your back goosebumps like a crash with which your child's head hits hard floor. Hematomas and bleeding from the scalp top the list of calls to the doctor about injuries. It is important to distinguish the trauma of the skull from brain trauma. The skull serves as a protective helmet for a fragile brain, and on top of the skull there is a very rich skin of the scalp.
In the vast majority of cases, bruises lead only to damage to the scalp, from which, when injured, much blood flows or in which large tumors( hematomas) are formed due to rupture of blood vessels under the skin. Do not be afraid of how fast these huge cones grow. They also pass quickly if you apply ice and pressure. These cones and bleedings are usually limited only to the scalp and rarely indicate that the lower brain is affected.
The main concern after any head attack is a brain injury that can be expressed in two forms: bleeding and concussion. When small blood vessels break between the skull and the brain or inside the brain, bleeding occurs in this space, and the blood clotches the brain. Pressure on the brain due to bleeding or concussion accompanied by the appearance of a tumor, gives obvious symptoms of brain damage.
Treat seriously to stab wounds of the head. Outwardly, they may seem trivial, but, for example, a nail can pass through the scalp and skull and lead to dangerous inflammation of the brain. Immediately let the doctor know.
If the child is unconscious but breathes and his skin is pink( lips are not blue), put it on a flat surface and call an ambulance. If you have a reason to suspect a neck injury, do not move the baby from the place, providing transportation to experienced professionals. If the child does not breathe, perform cardiopulmonary resuscitation, or, if the child has convulsions, be careful not to block his airways.
Sometimes, if the child is very impressionable and often rolls up hysterics, anger after falling causes the child to hold his breath for a long time, which can be mistaken for convulsions. This naturally causes panic, and parents are rushing with the child to the hospital. Even if it turns out that there was no need, it's better to be safe. Remember the words: "When in doubt, take the child and sit at the door of the reception room."
If the child has a clear consciousness, he walks, says, plays and behaves quite the same as before the fall, give him a dose of parental sympathy, attach a packet of ice to the cut or bump for twenty minutes and, before calling the doctor,observe. The observation period is necessary because the doctor is more important to know how the child behaves after the injury, and not what happened. If the brain is damaged, the symptoms can appear instantaneously, or they can slowly build up over the next twenty-four hours. After a period of observation, depending on the condition of the child, you can call or do not call the doctor. In addition to any list of emergency situations, when you need to call a doctor urgently, there is still drowning out all and all the inner voice, so valued by mothers, which is called the mother's alarm signal. You need to trust this monitoring system no less than any clever electronics. If this inner voice tells you that everything is not okay, call the doctor and tell him about the condition of your child, ask for advice and, among other things, tell the doctor why you are so concerned. This is what should be paid attention in the next twenty-four hours.
For young children, it's normal to go to sleep after a trauma, which makes the usual instruction "see if the consciousness does not return to it" as a source of terrible parental alarm. If the head injury occurred closer to the night or at the usual time of daytime sleep and the child was already tired, even before the injury, you can unsuccessfully puzzle whether the drowsiness is caused by trauma or simply it's time for the child's natural immersion into sleep. And it may be completely impossible to follow the advice: "Just do not let the child fall asleep."Let the baby sleep, but you wake up every two hours and look at the baby.
If your child has any of the following symptoms after a head injury, call your doctor or take your child to a hospital.
• loss of orientation, problems with awakening;
• unusual breathing in a dream;
• strabismus, unequal pupils;
• indomitable vomiting;
• Increasing pallor;
• blood or watery liquid oozes from the ear canal;
• The child loses his balance when sitting, crawling or walking.
Pay attention to:
• change of skin color from pink to pale or, more dangerous, to blue;
• changes in breathing: periods of very shallow breathing, episodes of respiratory arrest lasting ten to twenty seconds, followed by uneven, irregular breathing, or periods when the baby begins to intermittently catch air( do not forget that the newborns breathing and normally uneven);
• twitching on one side of the body, covering the whole limb.
If the color of the baby's skin and his breathing are normal( no change compared to the usual characteristics) and your parental intuition tells you that everything is in order, there is no need to wake the child, unless you are advised to do so by a doctor. A deep sleep in which a child sinks after an injury is almost always accompanied by a superficial, irregular breathing, which you most likely have never seen before.
If you are in uncertainty or the appearance of the child is causing you anxiety, try to partially awaken it. Plant the child or put it, and then put it back. Normally the child after that will tinker a little and will be bedridden in order to be comfortable again and fall asleep. If the child behaves differently, try to fully awaken him, sitting him down or putting him on his feet, opening his eyes and calling him by name. If the child wakes up, looks at you, begins to cry or smile, and breaks out, so that you release it and do not disturb, you can calmly go back to sleep. If the child does not protest, can not wake up enough to cry, if he is pale, has irregular breathing and saliva flows abundantly, or there are any signs of brain damage, seek medical help immediately.
Happy signs of brain damage seen easier. Observe the play of the child. Does he do everything exactly like before falling: sitting straight, walking well, moving his arms and legs normally? Or is he losing his balance, staggering, dragging one leg or is he getting worse? If the child is not walking yet, do you notice any changes in how he sits or crawls, or in how he manipulates toys while holding them?
Just like some children after a head injury fall into a dream, other children get vomited, mostly from a disorder caused by falling and pain. Do not worry. But indomitable vomiting for six or twenty-four hours is an alarming sign. Call your doctor right away. Caution for the sake of not letting the child recover after the injury, nothing but empty water, for three to four hours. Breastfeeding has a therapeutic effect.
Eyes reflect what is happening inside, especially inside the brain. The back of the eyes is so closely connected to the brain that when looking at the child after a head injury, the doctor looks at the back of the eyes in search of signs of brain edema. The eyes of a child are more difficult to assess than other changes, but when you need to call a doctor: if the child has a strabismus or eyes roll, if one pupil is bigger than the other, if the child stumbles and falls or encounters objects, indicating visual disturbances. If the child is older, add to the list of alarming symptoms of a complaint that there is a single solid spot in the eyes or in front of the eyes.
What about X-ray of the skull?
With the exception of severe head injuries or obvious fractures, rarely occurs in the x-ray of the skull;there is also no need to take to the hospital on the roentgenogram of a fun-loving child. First, observe;then call your doctor;and only then will follow advice on whether it is worth doing an X-ray to a child. Axial computed tomography, which is a series of radiographs of transverse sections of the brain, almost completely replaced the usual X-ray. In most cases, if a child needs an X-ray, it is better to do an axial tomography. This technological breakthrough gives much more information about damage, such as the presence of bleeding or swelling in the brain.
Children with bruises refer to cold objects attached to a sore spot, not too friendly. Cold relieves pain, reduces bleeding and bruises. But only not bare ice on bare skin, please. This can lead to frostbite. You can buy instant ice packets that do not flow, and keep them in the locker with medications, or you can make your own: put ice cubes in a sock or in a handkerchief. If you use a plastic bag, wrap it in a thin cloth or a wet cloth. From the pounded ice in the toe, you get a package that can easily be shaped into any shape. You can keep ice cubes in reserve in a terry cloth toy. In our freezer, we always keep the "rabbit Bo-bo", which became a reliable friend of cones and bruises, as well as the best soul healer, in cases where only fragile sensitive child nature is injured. From the packages with frozen cut vegetables, wonderful cold compresses are also obtained, and a cold lollipop or a piece of frozen juice helps to swollen lips. If the child suffers the attached ice, begin to gradually increase the pressure;can hold up to twenty minutes. If you give your two-year-old baby a hand holding a packet of ice, he will treat the procedure more favorably.
A little note. In the life of the child, given the multiple impacts of small heads on the hard floor, brain trauma is a rare phenomenon.
Convulsions, or convulsions, also called seizures, are caused by abnormal electrical discharges in the brain, and they are shaken not only by children, but also by their parents. The degree of their severity ranges from twitching one muscle to shaking the entire body, which is called a large fit and can also be accompanied by a fall on the floor and rolling on the floor, rolling the eyes, the appearance of foam at the mouth, biting the tongue and temporary loss of consciousness.
Your primary task for convulsions is to prevent the occlusion of the airways by tongue or secretions, which will deprive the brain of oxygen. Most convulsions in infancy are associated with high body temperature. The seizures of these convulsions are short-lived, cease on their own and rarely cause the child damage, but their parents after them may be twitching for a long time.
If you witness a seizure, do the following:
• For safety, place the baby on the floor, face down, or on the side, so that the tongue falls forward and the fluid flows out of the throat due to gravity.
• Do not put any food or drinks into your mouth during or immediately after seizures;Also, the child's jerking should not be prevented.
• If the child's lips do not turn blue and he breathes normally, there is no cause for concern.
• Although this is unlikely, if the child's lips turn blue and he does not breathe, give artificial mouth-to-mouth breathing by first clearing the airway.
• In order for the rushing child not to hit the furniture, clear the place around.
After cramping, children usually fall into a deep sleep. In addition, in a small child, usually after the first convulsions a few minutes later, a second attack occurs, especially if the convulsions are caused by high fever. To prevent this, if after a convulsion the child burns, give him a suppository with acetaminophen( if you give the medicine through the mouth, it can cause vomiting).Remove the clothes from the baby and cool the child's body by rubbing with a sponge.
In general, it makes sense immediately after the cramps to call a doctor or take the child to the emergency room. Or, depending on the circumstances, you can begin the observation, as described above, in an article on head injuries. The observation period can make sense if the child felt fine until the seizures, and then the temperature rose sharply, after which a short spasm of seizures occurred, and now the child feels well. Keep the temperature under control, and you can safely wait a few hours, instead of calling your doctor or going to the hospital at three in the morning. But any cramps that are not associated with fever or have a child with a sick appearance deserve urgent medical attention. It makes sense to use all the means to lower the temperature( give an antipyretic and cool the body) before going to the hospital, because the entire rising temperature can cause a few more attacks along the way.
Leave a nine-month-old baby running with lightning speed around the mug with hot coffee, and you have everything for a severe burn. The severity of the burn determines how painful it is and how much it deforms the tissue. A first degree burn( eg, sunburn) causes reddening of the skin, not too severe pain and requires only cold water, soothing ointment and time. Burns of the second degree cause blistering, swelling and rejection of the upper layer of the skin and is accompanied by severe pain. With a third degree burn, deeper layers of the skin are damaged and the most conspicuous traces remain.