Handle children head injury seriously

By Donya Betancourt

SANUR, Bali (JP): Nothing is more frightening to parents than an injury to their child's head. Head injuries can range from a minor knock on the noggin to a serious skull fracture.

Whether the injury occurs from falling off a bicycle, falls from windows or minor falls around the house (in the case of toddlers), no injury to an infant's head should be taken lightly. Head injuries can cover a broad range of severity from bleeding or tearing of tissue to brain swelling, when the brain moves inside the skull at the time of impact.

Symptoms are typically headache and nausea and light dizziness after the injury. Other symptoms can be ringing in the ears, blocked ear (if there is bleeding in the eardrum), or feelings of anxiety, irritability or tiredness. These symptoms usually go away in a few weeks, but if the headache gets worse after the passage of time, it should be viewed with concern and become a reason for a doctor's re-examination.

Most people recover from head injuries and have no long-term effects. There are a few terms concerning head injuries that will be helpful to you in understanding and communicating with your health professional should the need arise.

Concussion is a jarring injury to the brain. A person who has concussion passes out for a short while and may feel dizzy, lose vision or balance for a while after injury, including vomiting, or experiencing drowsiness.

Contusion is a trauma or bruise of the brain. It causes bleeding in the brain and brain swelling.

A skull fracture is when a skull cracks. It can range from a minor crack to shifting of bone to the brain and cause bleeding or other injury.

Hematoma is bleeding in the brain where the blood collects and clots. It may happen after the injury or last as long as several weeks.

If a head injury occurs what you should do is look for signs of concussion. If the child is running about and unaware of the blow or fall 10 minutes later, there is nothing to worry about. You must wait at least an hour after an injury before feeding your baby or child.

It is important that you monitor progress for at least 48 hours after injury. Your doctor will ask how the injury occurred and about the symptoms of the child after the injury. A child who has been injured may need to stay in the hospital for observation; some special investigation such as skull film or CT scan may be needed to find out more about the damage.

If you notice any signs of fits or seizure or conscious change such as confusion or irritability, severe headache or weakness in arms or legs, trouble in walking or speaking, nausea or vomiting that doesn't go away, get help immediately.

The other problems of injuries from falls are bleeding and shock.

Most small cuts do not present any danger. Larger wounds, particularly those where an artery has been damaged, can cause severe bleeding and shock.

How to deal with bleeding? Rinse the wound with water to clean out dirt, and use a clean cloth or gauze to apply pressure to the wound for five minutes. Do not stop to check the wound. If blood soaks through the gauze, apply another one on top. The following signs tell you that you should see a doctor right away.

What are the symptoms of mild shock? The child will look pale and clammy, will be sweating and/or shivering, vomiting and have an increased heart rate. What you should do is lie the child down and loosen the clothes, get the head lower than the feet, turn the head to one side (in the case of vomiting) and do not give anything to drink. Watch the child carefully; if after an hour the child has not recovered, call a doctor.

Symptoms of severe shock are pale, grayish-blue skin, sweating and cold clammy skin, weak and rapid pulse and the child may collapse or go unconscious. If you see any of these symptoms, get medical help quickly, lie the child down with the feet higher than the legs, loosen tight clothes and turn the head to one side to prevent aspiration. Treat any bleeding if you see it and keep the child warm.

Head injuries will inevitably occur as it is part and parcel of growing up; most times they result in nothing more than a lump on the head but there are times when they are serious, so be aware of the possibilities of shock and always monitor your child after a fall.

The writer is a pediatrician based in Sanur, Bali. Questions? Contact her at drdonya@hotmail.com or features@thejakartapost.com.