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What to do if a child hits the back of his head. The child hit his head

If a child hits his head, this is not always a reason for panic and parental worries. However, parents must be able to distinguish what kind of “catastrophe” has happened - the child has a concussion or (which happens tens of times more often!) just a slight bruise. Because each “scenario” has its own special action plan...

According to statistics: of all people seeking medical help for a traumatic brain injury, 35% are children under 15 years of age.

Concussion in a child: the devil is not as terrible as...

One of the most terrible and dangerous head injuries in a child, according to most parents, is a concussion. But in reality, as it turns out, everything is exactly the opposite...

Let us explain in a nutshell what generally happens when a child has a concussion. The head (including a child’s head), to put it very simply, consists of bone (a hard and relatively strong skull), which protects the soft, vulnerable and “delicate” brain enclosed inside this very bone. With a strong external blow that falls on the skull, the brain from the inside, in turn, also hits the wall of the skull. In this case, the brain cells at the site of this impact are not damaged, but for some time they lose their relationship with each other. This leads to loss of consciousness, most often extremely short-term.

The most obvious and obligatory symptom of a concussion in a child is loss of consciousness. If the baby did not “pass out”, then there is no talk of any concussion.

At the same time, parents should know that from a medical point of view, a concussion is one of the mildest and most harmless head injuries. In the vast majority of cases, after a concussion and loss of consciousness, the child comes to his senses and adapts very quickly.

The maximum ailments that can occur in a child after a concussion are a short headache, loss of appetite and drowsiness. However, after 1-2 days, these symptoms disappear without a trace.

The situation is completely different if the child suffers a brain contusion due to the impact.

Brain contusion in a child

A brain contusion is a situation in which, during a blow to the inner wall of the skull, the brain is not only shaken, but also receives certain damage. As a rule, the following occur at the site of injury:

Hemorrhages (hematomas)
Edema

This scenario can already be extremely dangerous for the child’s health, since the damaged brain is located in a confined space of the skull - during bleeding, the blood simply has nowhere to go, as does the growing edema. Usually in these circumstances there is a risk of compression of the brain, which can lead to very disastrous consequences.

If a child hits his head, and doctors record all three symptoms - concussion, bruise and compression of the brain, only in this case do they have every reason to diagnose a “traumatic brain injury”.

Thus, neither a concussion in a child, nor a bloody abrasion on the head, nor a “bump”, nor a black eye give you the right to panic and believe that your child has suffered a traumatic brain injury. There are completely different reasons for this, and we will talk about them later...

The child hit his head: damage and wounds

What to do if a child hits his head and a bleeding wound appears:

In this case, you should give him the same help as:

On a bleeding wound, you should first apply ice (crushed ice or a bag of frozen vegetables is best), and a little later, make a pressure bandage;
If the head wound is more than 7 mm wide and 2 cm long, the child must be taken to a medical facility - such wounds usually require stitches.

Let us repeat: if a child hits his head and a “bump” appears at the site of the injury, or even a small bleeding wound appears, but he does not lose consciousness, then no matter how “scary” it may look from the outside, it is a serious injury. there is no reason for the head. And if the baby does not show any dangerous symptoms (we will list them below), then you don’t even have to call a doctor or take your child to the hospital.

What to do if a child hits his head and damages his skull:

Naturally, with a strong blow, not only the child’s brain suffers - the skull itself can be damaged.

Depending on whether there are visible damage to the skull bones or not, head injuries are conventionally divided into open and closed. In both cases, they require immediate medical examination and qualified assistance.

However, the skull consists of more than just bones. On the inside of a child’s skull there is a special wall (in medical terms, the dura mater) that directly separates the brain from the bones of the skull. If upon impact this shell is damaged and ruptured, then in this case doctors pronounce a verdict of “penetrating head injury.” And this is also certainly the case when the child must be immediately taken to a medical facility.

So, your action in case of obvious (or suspected) damage to the skull bones is to take the child to the hospital. Most often, this picture is accompanied by corresponding symptoms, indicating that the child’s brain was also seriously damaged by the impact.

These are the symptoms:

But now - panic and run to the doctor!

So, if a child hits his head, and after that you notice the following signs, immediately take your child to the doctor:

Impaired consciousness;
Problems with speech (the tongue is slurred, the child cannot find the right words, etc.);
Inappropriate behavior;
Pronounced drowsiness;
Severe headache that does not improve within an hour after the impact;
Repeated attacks of vomiting (but if vomiting occurs after a single blow, this is not an alarming sign);
Convulsions;
Severe dizziness that lasts more than 1 hour after the impact;
Inability to move your arms or legs;
The child has different pupil sizes;
If there are bruises under both eyes or behind the ears;
Colorless or bloody discharge from the nose or ears (a rather specific, but very serious symptom: the fact is that with a strong blow, the circulation of cranial fluid can be disrupted, which begins to flow through the nose or ears).

All of the above signs are symptoms of either a bruise or compression of the child’s brain. They occur in the vast majority of cases in the first 24 hours after the child hits his head. And each of these symptoms threatens with serious consequences, therefore, if they appear, it is necessary to immediately take the child to the doctors, or vice versa.

Remember: if a child hits his head, your first and most important task is to closely monitor him in the first 24 hours after the hit.

If for some reason you do not trust your own judgment, or are simply afraid to miss a dangerous symptom and are worried about the possible consequences, do not be afraid to be branded as an alarmist and take your child to see a doctor for examination.

How many fingers, buddy?

If a child hits his head hard, he may experience problems with his senses and perception. It is not difficult to “catch” these violations.

Remember, in every movie about heroes and villains, there is such a scene: a character who has gotten into trouble and received a blow to the head is poked in the face by a friend with his hand and asked to count how many fingers are looming before his eyes. So this is the most primitive test for the adequacy of perception and feelings.

If your child hits his head, loses consciousness for a while, and then comes to his senses, do the same with him: make sure that he sees and hears you, that he feels touch and is able to answer a simple question, that he does not experience numbness in limbs, does not feel a surge of abnormal heat or cold.

If disturbances related to the child’s sensory organs are visible on the face, immediately go with him to the nearest hospital.

What to do if you don’t need a doctor’s help

If a child hits his head, but you do not find any dangerous symptoms (and therefore there is no reason to contact medical workers), this does not mean that the baby can be allowed to jump and run around the yard again. Not at all!

You must do the following:

The baby must be reassured (so that he does not scream, cry, or be afraid);
The child should be put to bed and cold applied to the site of the blow;
The child must be constantly monitored for 24 hours from the moment he hits his head;
Typically, after a child hits his head and after he has calmed down, he will fall asleep for a while. Don't interfere - let him sleep. But every 3 hours you have to wake him up and ask him some simple question. If the child answers you coherently and adequately, let him continue sleeping; and if his consciousness begins to “fog up”, this is a reason to immediately go to the doctor.

There are no preventive measures for your children that would keep them from curiosity, active games and running around, and therefore from falls and injuries. Moreover, few families manage to raise a child who never falls off the couch or down the stairs. But you, parents, can (and should!) minimize the risk of traumatic brain injuries in your children.

This means:

Do not give your child a bicycle (roller skates, skateboard, etc.) without giving him a helmet;
Teach your child to stop instantly at your word if you are near the roadway, in a crowd of people or in other similar places;
If your child goes to the pool, make sure his flip-flops don't slip on wet floors (a fairly impressive percentage of children admitted to hospitals with traumatic brain injuries come from swimming pools, where children often slip on wet floors);
Do not leave a small child alone in a room or in the yard unattended.

Etc. - the list could go on for a long time, but to prudent parents the principle is probably already clear: you cannot protect your children from all the misfortunes that they may encounter when communicating with the outside world, but you can protect your children from injuries that occur due to stupidity or negligence adults - you simply must.

Often, the mobility and curiosity of children leads, due to parental oversight or accident, to falls and injuries. Such injuries are especially alarming under the age of three, while children cannot accurately describe their feelings and condition, and only external data and approximately the strength of the injury can be assessed if it occurred in front of their parents. The most worrisome are falls with head impacts, since the child’s brain is vulnerable to traumatic impacts, concussions, bruises and other damage. Almost no child grows and develops without falls and minor injuries; he learns about the world and his activity and freedom cannot be limited. But it is important to ensure maximum safety and know why head injuries are dangerous, how to help with them, and which symptoms for certain types of injuries, especially if the baby fell, hit the forehead or back of the head, are dangerous and which are not?

The structure of a child's head

Nature has taken care in advance to protect the child in certain ways in case of possible falls and injuries. At an early age, in order to avoid injury during childbirth, and then partially as they grow, the baby’s head has a special structure. The head at birth is large relative to the body, disproportionate to the rest of the body. And therefore, when babies fall from beds, sofas or changing tables, they fall forward with it. But there are also special positive, compensatory mechanisms.

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In case of possible falls, if it is not at an extreme height, the brain of babies is relatively reliably protected from injury. The bones of the head are relatively elastic, not completely ossified; at the joints they have sutures, as well as a fontanelle, which, due to its elasticity, can compensate for changes in pressure in the cranial cavity.

The brain itself is surrounded by hard, soft and arachnoid membranes, floating in a liquid that compensates for shocks to a certain extent. These environments absorb the impact force quite strongly, so either a large impact force or a high altitude is needed for a young child to receive dangerous brain damage.

Hazardous surfaces and falls

For a baby, falls from a height equal to or less than his own height can be considered relatively safe. That is, this distance is about 50-60 cm. In addition, it is important, how the child did it, whether acceleration was imparted to the body or whether it was a fall under the influence of its own weight. The surfaces on which the head lands during falls are also important.

As the baby grows and begins to walk, falls occur:

from your own height when walking and running,
when walking in a walker, jumping in jumpers,
when riding on gurneys, children's bicycles, sleds
from chairs, when climbing on them,
elements of furniture, when trying to climb higher,
various sports equipment, outdoor slides, swings and carousels.

There are many options for falls, but the higher the distance from the place of the fall to the surface on which the child lands, and the denser and harder this surface, the more dangerous the injury.

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If the fall occurred on a carpet or carpet, it will partially mitigate the injury, but if it is tile, linoleum or uneven surfaces, it is worse.

The likelihood of falls and injuries is directly proportional to the age of the young “pilot”. In early relapse (the first six months), falls are possible due to oversight or negligence of parents who left the baby unattended, or due to improper care, rough care and education, or domestic violence.

When learning to roll from side to side and gradually master crawling, pulling oneself up with one's hands, falls from sofas and beds are likely; for the most part, such falls are accompanied more by the fear of parents than by really dangerous injuries to children. Further, as you master walking. the risk of falls increases and vigilance needs to be increased. From the moment they master the space on their own two feet, when children are already walking, running and jumping, climbing everywhere, you need to increase your vigilance to the maximum.

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Remember, even in your own home, let alone on the street, a child can receive dangerous and even fatal injuries. Plastic windows with mosquito nets are especially dangerous in the warm season. They will not support the weight of a child who, having climbed onto the windowsill, can lean on them. This threatens the death of the baby who fell out of the window.

But this does not mean at all that the baby needs to be locked within four walls and not allowed to actively develop and explore the space. We must be alert and on the alert.

For children under three years of age, the arm's length rule must apply; in dangerous places, the baby must be within the reach of the parents so that, if necessary, they have time to secure him.

The child hit his head: what to do?

The first thing to do if a child falls and hits his head is not to panic and not to scare the child with your actions even more. Often, after a fall or injury, children cry more from fear and surprise than from pain. If there is only a small bump in the area of impact, the child is conscious and quickly calmed down, you need to create an atmosphere of peace around him, as if nothing had happened . You should not let him scream loudly, jump and run a lot, observing his behavior and general condition. The first 24 hours are important in assessing the injury if a dangerous fall is suspected. There are different types of injuries depending on their location, and this makes them different in tactics.

What to do if a child hits his forehead

Often, when struck in the frontal area, where the tissues are very pliable and richly supplied with blood, bumps appear. It's not dangerous, but it can be scary for parents. At the site of injury, small capillaries may burst, causing blood to leak into the tissue, forming bruising and swelling. There are many subcutaneous vessels in this area, as elsewhere on the face, which is why the swelling can be pronounced and severe, but the bone itself is strong enough, so most such injuries have no consequences . However, the age of the baby is important; if it is an infant in the first months of life, and he has a hematoma on his forehead, it is worth showing the baby to a doctor to assess the extent of the injury.

What to do if a child hits the back of his head

Falls on your back and blows to the back of the head are more dangerous than the previous ones, It is important to show the child to a doctor in case of such an injury, because usually such falls occur from a sufficient height.

note

With such impacts, vision, coordination of movement and other functions may be impaired; there are many important centers of the brain in the occipital zone of the cortex. Such a fall with the formation of a lump is especially dangerous if the child experiences weakness and lethargy, trembling in the legs, etc.

If this happens, you should immediately call an ambulance. Such injuries in the area of fairly soft and pliable bones of the occipital zone can lead to skull cracks and concussions, brain contusions.

Traumatic brain injury in children

If there is a head injury, it is important to closely monitor the child and identify dangerous symptoms that may indicate the presence of a head injury. In this case, the role of the parents is great; they know the characteristics of the child well and will immediately notice deviations in his behavior and condition. The gender and age of the child are relative, as opposed to the height from which the child falls. The size of the bruise or lump that forms does not always correlate with the severity of the injury, as well as the presence or absence of blood, abrasions, and skin damage.

Signs such as:

Clouding of consciousness or loss of consciousness, even if it was short, literally a few seconds.
Any inappropriate actions and behavior, abnormal crying and screaming
Disturbance in falling asleep, unusually long and deep sleep after a stroke
, if the baby is older, attempts to grab the head that do not go away for several hours.
Sudden or profuse regurgitation without fever or signs of infection
Uncertain gait, swaying to the sides, problems with coordination of movements
General convulsions or twitching of limbs
Severe weakness in an arm or leg, an arm or leg hanging with a whip, movement disorders on one side.
The appearance of bloody or bloody discharge from the ear or nose.
Decreased hearing or vision, different size icons, squinting of one or both eyes, impaired muscle tone in the face, sagging of part of the face
Coldness of the extremities, a sharp change in skin color (redness, pallor, marbling), especially on certain parts of the body.

All these symptoms indicate brain damage of varying severity.. The appearance of any, even one of them, is a reason to immediately call an ambulance and hospitalization in a hospital with a full examination. Based on the severity of the injury, head injuries can be divided into concussion, contusion and compression; their clinical symptoms vary, as well as severity and prognosis for subsequent health and life.

Signs of a concussion in children

It is believed that this is a relatively simple and mild injury (but this is for doctors and treatment in a hospital). What is typical for him is a short-term disturbance of consciousness, loss of consciousness for no more than 5 minutes. There may be seizures and vomiting and dizziness. There is no damage to the brain, it simply experiences a kind of shock, which causes “interference in the air,” that is, the work of certain brain centers or cells is temporarily disrupted. Usually all brain functions return to normal within a week. The basis of treatment for a concussion is observation and rest, taking vitamins.

Signs of brain contusion in children

Brain contusion is a more serious injury; it affects the membranes of the brain and its substance itself, deep subcortical structures, blood vessels with the possible formation of hematomas, the formation of pronounced edema-swelling of the brain. In many ways, the prognosis and further treatment tactics will be influenced by the fact how long the loss of consciousness was. Based on the severity of brain contusions, doctors sometimes divide them into three stages, based on the duration of the unconscious period. If it is a mild bruise, consciousness usually returns within five minutes; with moderate severity, the unconscious state lasts from 10 minutes to an hour (give or take); with a severe brain bruise, consciousness may not return for several hours, or even days, even weeks - coma occurs.

What is brain compression in children

Compression of the brain is usually formed against the background of damage to the bones of the skull, compression is formed inside its cavity, and the normal anatomical relationship of the brain, its membranes and bones is disrupted. With such a pathology, there may be cerebral vomiting due to increased intracranial pressure, periodic loss of consciousness with the appearance of “light” gaps. During this time, the child may behave quite normally, without showing signs that he has problems with the brain. They last up to two days, after which coma may occur.

Consequences of TBI can vary depending on which centers are damaged, how dangerous the injury was, how first aid was provided, and then treatment was carried out. In case of bruise and compression of the brain, death is possible without proper medical treatment. Therefore, it is important that parents know how to provide first aid, recognize dangerous symptoms and consult a doctor in a timely manner without attempting self-medication.

Alena Paretskaya, pediatrician, medical columnist

A child fell out of bed and hit his head: possible injuries

When small children fall, hitting their head is inevitable. What matters is not exactly where he hit when he fell (forehead or back of the head), but the severity of the brain damage.

A child’s body differs in many ways from an adult’s; the bones of the skull are not completely fused until they are one year old (they easily move), and the brain tissue is fragile and immature. All of these factors predispose to more severe brain damage.

All traumatic brain injuries are divided into:

open (damaged bones and soft tissues)

closed (when the integrity of the skull bones and soft tissues is not compromised)

Closed brain injuries are divided into:

brain concussion

brain contusion

compression of the brain

With a concussion, there are no changes in the structure of the brain matter, with a bruise, foci of destruction of the brain matter appear, and compression appears against the background of the bruise due to rupture of blood vessels or fragments of the skull.

If a child falls and hits his head (the back of the head or forehead), there may be a soft tissue bruise - the mildest injury when the brain does not suffer in any way. Then a lump or abrasion occurs at the site of the impact.

Symptoms indicating a brain injury

Brain concussion manifests itself as a short-term loss of consciousness. In children under one year old, this can be difficult to notice. This condition can be assumed if some time has passed from the moment of the fall to the appearance of crying (1-3 minutes). The child may vomit. Up to 3 months, vomiting may occur repeatedly. There may be pale skin, sweating, as well as drowsiness and refusal to eat. Children under one year of age on the first night after injury.

With a brain injury loss of consciousness may be longer (more than an hour), and signs of respiratory and cardiac problems may appear.

If a child falls out of bed and falls in such a way that skull fracture, his condition may be serious. There may be leakage of cerebrospinal fluid (a light liquid) or blood from the nose or ear. Bruises appear around the eyes (a symptom of glasses). However, symptoms may appear several hours after the injury.

How to assess the severity of an injury if a child falls and hits his head?

If a child falls from a bed (sofa, changing table or other surface), it is necessary to closely monitor his condition. In the case when everything ends with 10-15 minutes of crying, and the child’s condition has not changed, you don’t need to see a doctor.

If the mother has any doubts that the injury is not dangerous, it is better to call a doctor, since it is more reliable to make sure of the child’s health than to treat serious consequences later.

Children under 1.5 years old can have neurosonography. This procedure is painless, inexpensive and performed using an ultrasound machine. It is used to determine increased intracranial pressure and the presence of life-threatening hemorrhages. At a later age, such a study will not be possible if a large fontanel is overgrown.

A child fell out of bed - first aid

If it appears at the site of the impact, you can apply ice in a napkin or something cold. Magnesia has a resolving effect; lotions with this solution should be done 2 times a day.

If there is bleeding, a cloth in the form of a tampon is applied to the wound. If the bleeding does not stop for more than 15 minutes, you must call an ambulance.

If a child falls and hits his forehead or the back of his head, he should not sleep for an hour (this applies to children over one year old), because by the adequacy of his answers and reactions to your questions, you can understand whether the brain has been damaged. You can (and should) wake up and check your coordination at night.

The child must be monitored very closely and cared for for 7 days if the doctor has allowed him to stay at home. The child needs peace and lack of visual stress (this is especially true for children over 1.5-2 years old).

Should I call an ambulance if my child falls and hits his head?

In case of loss of consciousness and severe bleeding from the wound, it is necessary to urgently call an ambulance. Before her arrival, it is better to lay the baby on his side, especially if there is vomiting (in this position he will not choke).

If a child falls from a great height on his head or back, the spine may be damaged. Then the baby’s position should be changed very carefully to avoid spinal cord injury.

An ambulance should be called if any of the alarming symptoms appear:

deterioration in health

the child “falls asleep on the go”, experiences dizziness (this applies to older children)

spasms or twitching of body muscles

wide pupils do not narrow in bright light or pupils of different sizes

severe pallor

blood in urine, stool, or vomit

paresis or muscle paralysis

For severe brain injuries, appropriate treatment is prescribed only after a thorough examination of the child.

Prevention of head injuries in children due to falls

The situation when a child falls from a bed or changing table occurs most often with children under one year old. Therefore, there is no need to leave the baby alone, especially if he has already learned to roll over. It is better to leave the child on the floor (not naked, of course).

A changing table is a very dangerous thing, as it has a small area. Therefore, the presence of adults alone is not enough; you need to hold the child with your hand. It is better to swaddle your baby on a bed or sofa.

You can lay down something soft or put pillows on the floor, in case the child does fall out of bed.

Children also “love” to fall out of strollers. Therefore, it is better to purchase lower models and strollers with high sides, and do not neglect to fasten the child.

Little fidgets get out of strollers, fall out of high chairs, and knock when they reach their favorite toy on a high shelf. Bruises, crying, bruises and bumps accompany the childhood of any active toddler. What to do if a child falls and hits his head and when you need to urgently see a doctor, we will tell you in our article.

From this article you will learn

Are head impacts dangerous?

Bumps, abrasions, scratches and hematomas on the head after a blow or fall only at first glance seem harmless. Serious consequences include the following:

visual impairment;
skull injuries;
loss of consciousness;
hematomas;
epilepsy;
traumatic meningitis;
encephalitis;
increased intracranial pressure.

Whether they appear or not depends on the physical condition of the child and the force of the blow. In any case, parents need to carefully monitor the behavior and well-being of the baby for several days after receiving even a mild injury. Visit a doctor to be on the safe side and rule out bruises to the brain or spinal cord.

Important! A therapist or traumatologist will tell you how long to monitor a child without serious external manifestations of a head impact.

Types and symptoms of head injuries

Head injuries due to falls or collisions with a hard surface can be divided into several groups:

Light damage. They are not particularly dangerous and go away in a couple of days. These are bruises, bumps or small hematomas. In this case, only the epidermal tissue is damaged, small vessels burst. The child usually quickly forgets about the injury and does not experience severe pain.
Moderate bruises. Open wounds, deep scratches, abrasions, bleeding. The brain and skull bones are not damaged in such bruises. The baby cries for a long time, complains of a headache, short-term clouding of consciousness, and dizziness. After 1–2 hours, the alarming symptoms disappear, skin wounds heal within 1–2 weeks.
Severe damage. These are concussions, open and closed craniocerebral injuries. The child loses consciousness after a fall, blood flows from the wound, and in serious cases the skull bones are crushed. Such injuries take a long time to heal and are accompanied by unpleasant consequences for children’s health. A concussion does not fully manifest itself immediately, after 1–4 hours or 1–2 days. The baby's coordination of movements is impaired, the skin of the eyelids darkens, and vomiting is observed.

Important! If the baby falls down the stairs or tubing, does not get up, does not cry, call a doctor immediately. There is no need to raise him unconscious. Wait for an ambulance. The cervical spine may be damaged.

What to do if your child hits his head

In case of strong blows, visible damage to the skull bones, or heavy bleeding, parents should not take any action. Call for help and urgently take the child by car to the emergency room.

If the blow is light, the baby gets up on his own, complains, cries, if he falls from his height, first aid is as follows:

Raise a crying child.
Place on a hard surface such as a bed or changing table.
Examine the forehead, back of the head, and crown. Lightly touch the bump, head, back of the head, check the child’s reaction. You will have to determine the degree of danger of the wound yourself in the first minutes.
Ask him how he feels. Pay attention to the expression of the eyes. If the child’s gaze is distracted, the child really wants to sleep, or faints, don’t delay calling an ambulance.
Examine the limbs for dislocations and fractures. When infants fall, they often break their collarbone and dislocate their joints. In this case, you need to help him get up carefully, and it is better to wait for the ambulance to arrive.
Treat the hematoma. If the lump is tall and hard, it means the damage is external; there is no need to panic. Apply a cold spoon, ice, or compress to the swelling. Cool the huge bruise on the forehead and the back of the head.
Shallow scratches and abrasions should be anointed with hydrogen peroxide. If your baby falls on the asphalt while walking, wash the wounds. Iodine and green tea can be smeared on the wounds a little later or the next day.
If there are deep wounds, stop the bleeding and call for medical help.
When vomiting begins, place the baby on its side. Nausea will not go away soon if the baby has suffered a concussion.
Provide your child with peace. But don’t let him sleep for several hours if he feels nauseous or has a severe headache. Let him just lie there.
Give an antipyretic if there are no serious injuries. Nurofen and Ibuprofen will relieve pain.
Monitor his condition more closely for several days. If your baby complains of a headache, vertigo (dizziness), nausea, or loses consciousness, go to see a doctor for additional examination.

How to check if you have a concussion

The first day after injury

On the day of the fall and another day after, observe the behavior and well-being of the victim. Pay attention to:

Clarity of consciousness. The baby should respond to voice, touch, cry if wet, etc. For older children, ask simple questions, ask them to bring an object, or tell them about their day.
Coordination of movements. Traumatologists advise waking up the baby in the middle of the night and putting him on his feet. If the baby stands well and can stretch his arms straight out, you don’t have to worry about his health.
Appetite. Refusal to eat and nausea are negative symptoms. The child has vomited several times, he complains of a severe headache, and cannot walk on his own - call a doctor.
Speech. Talk to the child, listen to the babbling. Slowness of speaking rate and stuttering are reasons to seek medical help.
Behavior. Decreased activity, apathy, and constant crying should alert parents.
Injuries. Watch for bruises and bumps. If they do not heal and become redder and wider, make an appointment with a doctor.
The child's appearance. Paleness, blue lips, differences in pupil sizes are signs of serious consequences of a bruise.

Alarming symptoms

It’s great if the baby feels good after falling from the sofa or getting hit and quickly forgets about what happened. Parents can relax.

The following signs become a reason to panic and call a doctor (Important! The table can be scrolled left and right):

Physical condition, appearance of the injured area	External warning signs	From the side of the central nervous system	From the gastrointestinal tract	Behavior
There is a dent on the skull that was not noticed immediately after the impact. The bruised area hurts and bleeds.	The skin became pale, cyanosis appeared around the eyes, lips, and nose.	The baby cries for a long time and is capricious.	During feeding, an infant often burps, and a one-year-old baby vomits repeatedly.	Disadaptation.
The lump on the forehead has increased to a huge size, and swelling is observed.	The eyes are crossed.	Speech is inhibited, babbling is absent.	Food and drink are disgusting.	Psychoses. Wants to cry for any reason, even minor ones.
The baby does not turn his head and moves his neck with difficulty.	The pupils have enlarged.	The baby cannot fall asleep, he has begun to sleep poorly.	Increased nervousness.
I feel dizzy and have a headache.	There is blood coming from the nose and ears, and there is discharge of a different kind.	After one year, the child complains of double vision.		Inadequacy.
My back hurts. The spinal cord may be damaged.	The temperature has risen.	Limbs go numb.
After hitting my temple on the corner, a bruise formed on the side.		Short-term loss of consciousness, maladjustment in space.
It hurts to move your arms and legs. Check the bones for fractures, take an x-ray.		There is drowsiness.
Limping.		Lethargy.
When walking, the one-year-old toddler constantly falls.

Important! The cause of falls for newborns is often the inexperience and negligence of young parents. For a baby, ordinary household objects pose a danger: a changing table, a sofa, a wooden cabinet, a cast-iron radiator, a tiled floor, even a low step. You need to monitor a child starting to take independent steps and a helpless baby 24 hours a day.

This is what Dr. Komarovsky thinks about head injuries. Watch the video:

Negative consequences

Hitting any part of the head is dangerous. The consequences of a fall and bruise depend on the location of the injury, the force of the impact, and the age of the child.

Consequences of a forehead strike

Children fall forward when running and trip over a pipe or step, fall out of their walkers, or crash their bicycle or scooter into obstacles. The frontal part of the head is affected first. This area is hard, the bones are strong, but serious injuries are life-threatening to the unborn child.

Injuries are divided into two types:

Closed injuries

The bones of the skull remain intact, but the skin, internal parts of the head, and brain structures are damaged. The consequences of closed injuries appear after several hours or days. Recognizing them at home is quite difficult. There are several types of such invisible and visible damage:

Concussion

Characterized by a short-term loss of consciousness. After a couple of hours, the child will feel ill, vomiting, nausea, and dizziness will appear. The face may turn pale and lips turn blue. Treatment of a concussion is carried out in a hospital; later at home, bed rest and restriction of activity will be required.

If symptoms are not observed during the day, pay attention to the child's sleep. If he has trouble falling asleep, insomnia or anxiety appears, consult a doctor.

Brain contusion

A serious complication for young children. A fallen child does not regain consciousness for 5–10 minutes. Dark circles form around the eyelids, and blood leaks from the nose and ears. Brain contusions occur from strong impacts on a hard surface: concrete, furniture, tiles on the floor, wall. The height of the fall should be more than a meter.

Soft tissue bruises

The most unpleasant, but less dangerous head injury. In children, large bruises, large pea-sized bumps, bruises, and shallow cuts appear on the forehead. The child cries after the blow, but quickly calms down.

It is almost impossible to detect internal damage to brain structures without X-rays, ultrasound, MRI and laboratory tests. If you notice symptoms of serious complications from a fall, do not hesitate to contact your doctor.

Open injuries

There is bleeding, deep wounds, and broken bones. The skin and face should turn white. Medical attention is required, in severe cases surgery. The consequences of complex open head injuries are difficult to predict.

Consequences of a blow to the back of the head

Falling backwards onto the back of the head is painful and dangerous even from a small height. The consequences of the impact may be as follows:

Deterioration of vision. At the back are the nerve endings that are responsible for vision. Their damage leads to a decrease in this function or complete blindness.
Decreased level of concentration.
Disorientation in space. If one side of the occipital lobe is damaged.
Speech disorders. Delayed articulation, OHP, DRR, stuttering.
Migraine. Your head will hurt for several days or weeks after the injury. Chronic migraines are observed in school and adolescence due to overwork.
Insomnia. It is difficult for the baby to sleep due to central nervous system dysfunction.

Important! Newborn babies are more likely to get bumps due to the fault of adults. The fontanelle saves them from the serious consequences of hitting the floor or hard surface. It plays the role of a shock absorber. A five-month-old baby and older children do not have such protection. Normally, the fontanel closes at 6 months.

How to avoid future injuries

Fall prevention is important for children of all ages, but especially for those who have already suffered serious head injuries. First, let's figure out which places and activities are dangerous for babies under one year of age and older. It is forbidden:

Riding a wheelchair without seat belts.
Being left alone in infancy on high sofas, beds, tables.
Running on the wet bathroom floor after bathing.
Close doors in front of other children during active games.
Swing hard on a swing.
Running around the apartment without looking around.
Pick up long sticks and play catch at the same time.
Ride a bicycle or scooter without a helmet.
Climb high horizontal bars, Swedish walls, slides in wet shoes, in the rain.
Lean out of the windows of a house or car to look down and forward.
Stand on chairs and tables.
Jump into deep holes and rivers with a running start.

Knowing the most common dangers, parents are obliged to talk about them to their children, supervise walks and secure their children when performing active maneuvers. And also follow a few more tips for creating a safe area at home:

Buy a crib and playpens with high sides. Even with this type of furniture, it is impossible to leave young children alone at heights. A six-month-old baby or a newborn can easily fall through the side.
Cover the door frame and sharp corners of wooden furniture with soft pads. A small child may hit a corner with the top of their head or temple.
Cover radiators with rugs and blankets.
Put on special indoor socks for your walking baby, with a pimply surface; they will not slip on the linoleum. Or lay down a carpet.
Remove glass furniture and floor vases from the house until the baby grows up. Breaking your head on the corners of fragile tables and chairs is even more dangerous.
Take care of your child's safety on the street. Hold your baby tightly by the hand for up to a year, and provide support on stairs during the first steps.
Fasten seat belts in strollers and cars.
Put the brakes on the children's transport if you stop for a drink or chat with a friend.
Do not let older children push a stroller with babies. A car may unexpectedly jump out onto the road or a hole may occur. The stroller will turn over and the baby will fall.

Not every person manages to fall without consequences at least once in their life. Blows, bruises, scratches, and head injuries rightfully frighten parents. To reduce troubles and health problems, it is worth telling children from infancy how to behave at home, on the street, and to be attentive yourself.

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Unfortunately, the baby often ends up on the floor. What should parents do in this case?

Dangerous heights or where a child could fall

A small child is surrounded by care and attention from birth. His loved ones are doing everything possible to ensure that the baby’s health is not in danger. But even the most attentive mother can make a mistake. Sometimes you just need to turn away for a second and the baby is already on the floor.

The fact is that not everyone correctly imagines the capabilities of the baby. Even a newborn child, making chaotic movements with his arms and legs, may well move to the edge and fall, although the likelihood of this is small.

Particularly dangerous places from which a fall can occur for babies under 6 months are the changing table, sofa, and parents' bed. After six months, the baby begins to actively master new movements, learns to sit, crawl, stand on his feet against a support, and then walk.

At this age, he can fall from his crib, from a highchair, from a stroller, etc.?

Most often, when falling, babies hit their heads: up to 1 year of age, the head is the most vulnerable place due to its rather large size and weight in relation to the body. But damage to other parts of the body is also possible. Most often these are bruises, in rare cases - bone fractures or traumatic brain injury (TBI).

If a child hits his head...

Head impacts in babies under 1 year of age are quite common, and they do not necessarily have to fall, because the baby can accidentally hit surrounding objects or furniture while making active movements. In this case, basically everything goes away without consequences: it is not a traumatic brain injury that occurs, but only a bruise. However, when falling from a height, the likelihood of suffering a traumatic brain injury (CHI) increases many times over.

What is TBI?

Traumatic brain injury is mechanical damage to the bones of the skull and soft tissues of the head (brain, its vessels, cranial nerves, meninges).

Traumatic brain injuries include:
concussion (mild form of TBI - there are no obvious changes in the structure of the brain, but functional activity may be impaired);
brain contusion of varying severity (accompanied by destruction of the brain matter in a certain area, causing severe functional disorders);
compression of the brain (severe pathology that occurs against the background of a brain contusion or rupture of a large blood vessel, which leads to the formation of an intracranial hematoma).

In children with typical falls, compression of the brain is extremely rare. To suffer such an injury, a child must fall from a height of at least 2? m or hit a very hard or sharp object.

We assess the situation. Symptoms of traumatic brain injury in a child are not the same as in an adult, which is due to the structural features of the skull and internal structures of the infant’s brain. In some cases, a long asymptomatic course of TBI or, conversely, a violent manifestation of symptoms with minimal trauma is possible. This is due to the flexibility of the skull bones, their mobility relative to each other in the suture area, as well as age-related anatomical and physiological characteristics of the brain. Brain cells in an infant are not yet fully differentiated, i.e. There is no strict division into zones of brain function, which is why the symptoms are most often vague.

When hitting the head, the baby feels pain and redness appears at the site of the impact. In the future, a slight swelling may develop. If nothing else alarms you, there is no need to worry: this is not a traumatic brain injury, but a bruise of the tissues of the head. In this case, you need to give the child a cold compress and calm him down. Cold constricts blood vessels, stopping subcutaneous bleeding, and has an anti-inflammatory and some analgesic effect.

For a compress, a heating pad with ice, a small plastic bottle with cold water, or any cold, non-traumatic object are suitable. It should be wrapped in a diaper or towel, applied to the site of the bruise and held for 10–15 minutes. It is important that the impact of cold is directed strictly at the bruised area - the surrounding tissues should not be affected. If the child does not allow you to hold the compress - he is capricious, dodges - you can moisten a gauze pad, bandage or piece of cloth in cold water and tie it to the damaged area. The bandage should be changed as it warms up within half an hour.

One of the symptoms of a brain injury may be loss of consciousness. But for children this phenomenon is quite rare, and often it does not accompany even severe damage. This is due to the underdevelopment in infants of the cerebellum and the vestibular apparatus as a whole, which are responsible for the coordination of movements. You also have no way of knowing if your baby is experiencing a headache. Thus, the most characteristic signs of traumatic brain injury in an infant are:

loud screaming as a reaction to pain;
increased physical activity, general anxiety or, conversely, lethargy and increased drowsiness;
vomiting, refusal to eat;
pale skin.

These signs are characteristic of a concussion. For a brain contusion of varying severity (damage to the brain substance itself), the following symptoms are characteristic, in addition to the above (or without them):

rolling of the eyes, temporary squint or difference in pupil diameter;
loss of consciousness (this can be assumed if after the fall the baby did not scream immediately, but after one or several minutes).

A child’s consciousness after a fall can be assessed using three signs:

Opening of the eyes (whether the baby opens his eyes on his own, or to a loud sound, or to a painful stimulus, or does not open at all).
Motor reaction (here it is important to evaluate the baby’s movements: is there any motor activity at all, does he move his limbs in the same way, is the tone of individual muscles increased).
Verbal contact (whether the child is walking, smiling, crying, moaning, or no voice).

This assessment can be made a few minutes after the fall, when the baby has already come to his senses. Normally, he should move normally, coo (or say syllables) and open his eyes just like he always did.

A dangerous symptom is a temporary external improvement when, after sleep, the child’s external signs of injury that were previously present disappear. But after this, the baby’s condition may deteriorate sharply.

There are also open craniocerebral injuries, when the integrity of the bones of the skull, and possibly the dura mater, is disrupted. In this case, there is a risk of infection of the brain tissue.

Thus, there are many signs of brain injury. Therefore, parents should be wary of any deviation from the baby’s usual behavior. You should consult a doctor in any case if your child falls and hits his head. If everything is limited to a bruise of the soft tissues of the head without other pathological signs, you need to show the baby to a pediatrician and neurologist at the clinic. If symptoms of a brain contusion appear (especially loss of consciousness and lack of reactions to external stimuli - light, sounds), as well as an open head injury, you should immediately call an ambulance.

If the head blow was not accompanied by the appearance of dangerous symptoms (for example, loss of consciousness), the child should be shown to the pediatrician on the same day or, in extreme cases, the day after the injury (you can call a doctor at home or bring the baby to the clinic). If necessary, the pediatrician will refer the baby for consultation to other doctors (neurologist, traumatologist).

Delayed seeking medical help can lead to a worsening of the child’s condition.

Before the doctor arrives

All that the mother can do before the doctor arrives is to calm the baby, put a cold compress on the bruise and provide peace to the baby. If a child has an open head injury, you need to cover the damaged area with a sterile gauze bandage and urgently call an ambulance. If there is an open head injury, cold should not be applied.

When the doctor arrives, he will examine the child and, if necessary, take you and the baby to the hospital for additional tests and treatment.

Diagnosis of TBI

The first step in diagnosis is an examination by a doctor. The doctor evaluates the child’s general condition, his consciousness, the state of reflexes, motor activity, and the integrity of the skull bones. The purpose of further research depends on the preliminary diagnosis after examining the baby and on the capabilities of a particular medical institution. Sometimes just one study is enough to make a diagnosis, and sometimes, if doctors have doubts, they have to do several at once.

If the large fontanel on the top of the baby’s head is not yet overgrown, it is possible to conduct neurosonography in a hospital or clinic - an ultrasound examination of the brain through the large fontanel. X-ray computed tomography (CT) is widely used in the diagnosis of brain pathologies. Currently, CT is the most reliable method for studying the brain.

Magnetic resonance imaging (MRI) does not involve x-rays, but is based on the absorption abilities of magnetic fields. MRI provides higher contrast images of brain tissue than CT. However, CT and MRI are rarely prescribed for infants, since one of the conditions for their implementation is complete immobility of the patient, which is almost impossible to ensure with a small child. These studies for children are possible only under anesthesia if absolutely necessary.

To assess the integrity of the skull bones, craniography (x-ray of the skull) is performed. Ophthalmoscopy - examination of the fundus of the eye - is an additional research method. It allows you to identify signs of increased intracranial pressure, which is important for diagnosing intracranial hemorrhage or cerebral edema.

Lumbar puncture is a more reliable diagnostic method for suspected intracranial hemorrhage. The cerebrospinal fluid is taken with a needle inserted between the spinous processes of the 3rd and 4th lumbar vertebrae. But during the puncture, the child must be motionless, as there is a risk of damage to brain tissue.

How is TBI treated?

Treatment is prescribed based on examination data and clinical studies. For concussions and bruises of the brain, treatment is usually medication. For a concussion, a child is usually treated at home, and for brain contusions, in a hospital. As a rule, the child is prescribed drugs that have anticonvulsant, antispasmodic, and hypnotic effects. The baby will also be advised to rest for 4-5 days. The word “peace” for a baby should mean the absence of new impressions, limiting the number of people around to mom and dad, maintaining silence in the room where the baby is.

Consequences of TBI

After a concussion, the brain usually recovers within 1-3 months without any long-term consequences. For more serious injuries—brain contusions—the consequences depend on the severity of the injury. They can be different - from dizziness and loss of coordination of movements to increased intracranial pressure and epileptic seizures (convulsions with loss of consciousness).

The result of severe trauma can be psycho-emotional disorders (even dementia) or movement disorders (for example, the inability to make any movements). With open head injuries, there is a risk of infection of the brain tissue (encephalitis) and the development of meningitis - inflammation of the membranes of the brain.

If the baby didn't hit his head...

The first step is to quickly assess the child’s condition and examine the site of the injury. If you saw the moment of the fall, then finding the place of possible damage will not be difficult. If you were not around, you should, if possible, calm down and carefully examine the baby.

We assess the situation. The site of the injury can be seen by the characteristic redness that appears in the first seconds after the fall. Over the next few minutes, the redness of the skin may increase, as well as the development of swelling, followed by the formation of a hematoma. A hematoma occurs when a large number of subcutaneous blood vessels rupture from an impact, resulting in the accumulation of liquid blood that has a red-burgundy color in the tissues. A small hemorrhage cannot be called a hematoma - it is just a bruise (bruising due to damage to a small number of subcutaneous blood vessels).

When the site of the bruise is discovered, you need to immediately give the baby a cold compress, as described above in the section on TBI.

In a normal course, the hematoma decreases every day, and its color changes. A fresh hematoma is dark red in color, gradually it becomes blue, and then yellow. To speed up the resorption of the hematoma, you can use heparin-containing ointments, which prevent blood clotting and, therefore, have a resolving effect, or make an iodine mesh, which has a similar effect.

Parents should be alert to the sudden appearance during the healing period (in the first 2-3 days after the injury) of redness of the skin over the hematoma, general malaise of the baby, rise in body temperature, increasing pain at the site of the injury (the child in this case will begin to show anxiety, and when touching the place hematoma will react with a sharp loud cry). All this may indicate suppuration. In this case, the baby should be urgently taken to the surgeon. He will open the hematoma so that the purulent contents can flow out and apply a bandage.

If after a fall the hematoma continues to increase in size, you should also urgently consult a surgeon, as this may indicate ongoing bleeding. If the baby remains restless despite a visible bruise, it is better to consult a doctor, since the baby may have a bone fracture. This phenomenon occurs in young children more often than a fracture. You can suspect a crack if swelling appears at the site of the impact, and also if the baby starts crying when you try to move his injured limb.

When examining the site of the impact, it is important to determine whether there is a fracture. Its signs:
severe pain at the fracture site; if a limb is broken, it will be very painful for the baby to move it;
severe swelling and bruising at the fracture site;
change in the shape or length of a broken limb (shortening or lengthening);
limited mobility of a limb or, conversely, excessive mobility;
crunching sound when moving the injured limb.

If one or more of these signs appears, you should call an ambulance. In this case, the injured area should be immobilized if possible, for example, with a stick or plank tied with any piece of fabric to the broken limb. If the child cannot calm down due to pain, you can give him a painkiller based on PARACETAMOL or IBUPROFEN in accordance with the age of the baby and the dosage indicated in the instructions for the drug.
If there is an abrasion at the site of the injury (this is possible when falling on an uneven floor), you need to do the following:

wash the wound with soap and running cool water;
treat the damage with hydrogen peroxide;
treat the edges of the wound with an antiseptic solution (iodine or brilliant green);
dry the wound with a gauze pad;
apply a sterile bandage: cover the injury site with a sterile napkin (it can be purchased at a pharmacy - the napkin is sold in a sealed package labeled “sterile”) and secure it with a bandage or adhesive plaster. If sterile dressings are not available, you can use a bactericidal patch.

Treatment of fractures

In the hospital, after an examination, the doctor may order an x-ray, and then, depending on the severity of the damage, the following measures will be taken:
Application of a splint - one-sided plaster in the form of a long strip - consisting of several layers of plaster bandage, which is shaped into the shape of the damaged limb and fixed with a bandage (for simple fractures without displacement of bone fragments).

The operation lasts several minutes under general anesthesia, followed by the application of a plaster cast (for displaced fractures and comminuted fractures). During the operation, bone fragments are compared, which is necessary for full restoration of function and the absence of complications after a fracture.

When applying a splint, you and your baby will need to visit a traumatologist for an examination.
once a week - provided that there is no redness under the bandage and there is no loss of sensitivity in the injured limb. (Parents should be alerted by paleness, as well as coldness of the injured limb relative to other parts of the body).

If surgery is required, you and your baby will have to stay in the hospital for 3-5 days so that the doctors can make sure that everything was successful. Then the baby will be discharged home with a cast, and a traumatologist will monitor him on an outpatient basis.

The cast and splint are removed when the bone is completely fused, which can be verified by taking an x-ray. Depending on the location of the fracture, the duration of this period can range from 2 weeks (for example, with a fracture of the phalanx of the fingers) to 3 months (with damage to the bones of the lower limb and pelvis).

Prevent Injuries

As already mentioned, children fall most often due to the fact that parents underestimate their capabilities. Very small, newly born children also fall - most often due to the fact that mothers leave them on the changing table unattended to run for cream or answer the phone call. Making chaotic movements, the baby is able to move quite well, so in no case should you leave even a newborn child alone where he could fall. In order not to be absent while changing a diaper, changing clothes, etc., prepare everything you need in advance. And if you need to answer the phone or open the door, it is better to take the baby with you or put him in a crib. You should not leave your baby unattended on an adult bed or sofa. Although their height is smaller than, for example, a changing table, for a small child this can be enough to cause serious injury.

It is also necessary to raise the side of the bed in a timely manner when the baby learns to roll over. And when the child starts to get up, it is necessary to lower the bottom of the crib - preferably to the lowest level, so that the baby cannot fall out, leaning over the sides.

To be able to leave your baby alone and not be afraid for his safety, you can purchase a playpen or make the floor in the room as safe as possible (remove wires, put plugs on sockets, remove all small and traumatic objects, put locks on drawers that the baby can reach, secure sharp corners of furniture).

Statistics show that very often babies fall out of high chairs or strollers. Therefore, when placing your baby in a high chair, be sure to fasten him with a five-point seat belt. A baby stroller should also be equipped with such belts, and you should definitely use them, even if the baby is constantly in your field of vision. After all, even if the mother is distracted for just a second, there is a risk that the child will fall. And the consequences of a fall, as we have already seen, can be very serious.

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