These include:. You have answered all the questions. Based on your answers, you may be able to take care of this problem at home. Babies' heads are easily damaged, and their neck muscles are not strong enough to control the movement of the head. Shaking or throwing a baby can cause the head to jerk back and forth. This can make the skull hit the brain with force, causing brain damage, serious vision problems, or even death. Based on your answers, you may need care right away. The problem is likely to get worse without medical care.
Based on your answers, you may need care soon. The problem probably will not get better without medical care. Sometimes people don't want to call They may think that their symptoms aren't serious or that they can just get someone else to drive them. Or they might be concerned about the cost.
But based on your answers, the safest and quickest way for you to get the care you need is to call for medical transport to the hospital.
Do not move the person unless there is an immediate threat to the person's life, such as a fire. If you have to move the person, keep the head and neck supported and in a straight line at all times. If the person has had a diving accident and is still in the water, float the person face up in the water.
Parents should watch their child for any problems 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. Be sure to follow the instructions given to you by your child's doctor. He or she will tell you what problems to look for and how closely to watch your child for the next 24 hours or longer. Do not give any medicine, including nonprescription acetaminophen , such as Tylenol, to a child you are watching for signs of a more serious head injury unless your doctor tells you to.
Call your child's doctor if any of the following occur during home treatment:. Each new learning stage for your baby requires increased attention on your part to prevent an injury. It may surprise you how fast your baby can move from one stage to the next. Being aware of your baby's abilities and what skills he or she is likely to develop next will help you prevent injuries.
Always be gentle with your baby. Be sure to protect your baby from a brain injury. Shaking or slapping a baby in anger can cause an injury to the brain. If a baby has been shaken or slapped, it is your responsibility to notify your doctor. You can help your doctor diagnose and treat your child's condition by being prepared to answer the following questions:.
Blahd Jr. Author: Healthwise Staff. Medical Review: William H. This information does not replace the advice of a doctor. Healthwise, Incorporated, disclaims any warranty or liability for your use of this information. Your use of this information means that you agree to the Terms of Use. Learn how we develop our content. To learn more about Healthwise, visit Healthwise.
Healthwise, Healthwise for every health decision, and the Healthwise logo are trademarks of Healthwise, Incorporated. Updated visitor guidelines. Topic Overview Head injury Almost all children will bump their heads, especially when they are babies or toddlers and are just learning to roll over, crawl, or walk. Head injury occurs more often in young children than adults. When compared with adults: Young children can't control the movement of their heads as well as adults.
Their heads are larger in relation to their bodies. Their neck muscles are not as well developed. Young children's legs are somewhat shorter in proportion to the rest of their bodies. This makes a child's center of gravity closer to the head than an adult's center of gravity.
Young children are more likely to have an accident or fall as they learn new skills such as walking, running, and jumping. Check Your Symptoms Has your child had a head injury? How old are you? Less than 4 years. Are you male or female? Why do we ask this question?
The medical assessment of symptoms is based on the body parts you have. If you are transgender or nonbinary, choose the sex that matches the body parts such as ovaries, testes, prostate, breasts, penis, or vagina you now have in the area where you are having symptoms.
If you have some organs of both sexes, you may need to go through this triage tool twice once as "male" and once as "female". This will make sure that the tool asks the right questions for you. Is the wound bleeding? If you think the wound may need stitches, it's best to get them within 8 hours of the injury.
Would you describe the bleeding as severe, moderate, or mild? Does your child have symptoms of shock? Do you think there could be a spinal cord injury? Are there any signs that the head injury is serious? Did a seizure occur after the head injury? Did the seizure occur within the past 2 days 48 hours? Is there a wound that goes through the skull, such as a knife or gunshot wound? Are there any symptoms of a skull fracture? Is there swelling anywhere on the head? Swelling in certain areas of the head can be a sign of a skull fracture.
Is the only swelling a bump or "goose egg" on the forehead? Swelling in any other area of the head, such as the temple area or the side or back of the head, could be more serious. Did your child pass out lose consciousness after the injury? When did your child pass out? Within the past 24 hours.
More than 24 hours 1 full day after the injury. Was there a lot of force involved in the head injury? Some examples are a fall onto the head from a height taller than the child, or a very hard blow to the head, such as in a car crash or a forceful sports injury. When did the head injury occur? About What is covered This NICE Pathway covers the assessment and early management of head injury in children, young people and adults.
It promotes effective clinical assessment so that people receive the right care for the severity of their head injury, including referral directly to specialist care if needed. Person-centred care People have the right to be involved in discussions and make informed decisions about their care, as described in your care. Making decisions using NICE guidelines explains how we use words to show the strength or certainty of our recommendations, and has information about prescribing medicines including off label use , professional guidelines, standards and laws including on consent and mental capacity , and safeguarding.
The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, professionals and practitioners are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or the people using their service. It is not mandatory to apply the recommendations, and the guideline does not override the responsibility to make decisions appropriate to the circumstances of the individual, in consultation with them and their families and carers or guardian.
Local commissioners and providers of healthcare have a responsibility to enable the guideline to be applied when individual professionals and people using services wish to use it. They should do so in the context of local and national priorities for funding and developing services, and in light of their duties to have due regard to the need to eliminate unlawful discrimination, to advance equality of opportunity and to reduce health inequalities.
Nothing in this guideline should be interpreted in a way that would be inconsistent with complying with those duties. Commissioners and providers have a responsibility to promote an environmentally sustainable health and care system and should assess and reduce the environmental impact of implementing NICE recommendations wherever possible. The recommendations in this interactive flowchart represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, health professionals are expected to take these recommendations fully into account, alongside the individual needs, preferences and values of their patients.
They should do so in light of their duties to have due regard to the need to eliminate unlawful discrimination, to advance equality of opportunity and to reduce health inequalities.
When exercising their judgement, healthcare professionals are expected to take these recommendations fully into account.
Nothing in this interactive flowchart should be interpreted in a way that would be inconsistent with compliance with those duties. Everything NICE has said on triage, assessment, investigation and management of head injury in infants, children and adults in an interactive flowchart.
What is covered This NICE Pathway covers the assessment and early management of head injury in children, young people and adults. Sources NICE guidance and other sources used to create this interactive flowchart. Andexanet alfa for reversing anticoagulation from apixaban or rivaroxaban NICE technology appraisal guidance Head injury NICE quality standard Video laryngoscopes to help intubation in people with difficult airways NICE medtech innovation briefing Head injury These quality statements are taken from the head injury quality standard.
The quality standard defines clinical best practice for head injury and should be read in full. CT head scans This quality statement is taken from the head injury quality standard. The quality standard defines clinical best practice in head injury care and should be read in full.
People attending an emergency department with a head injury have a CT head scan within 1 hour of a risk factor for brain injury being identified. Head injuries can be fatal or cause permanent disability if damage to the brain is not identified and treated quickly. A CT scan within 1 hour will allow rapid treatment and improve outcomes for people with head injuries that have damaged the brain.
Evidence of local arrangements to ensure that CT head scans can be performed within 1 hour of a risk factor for brain injury being identified in people attending emergency departments with a head injury. Proportion of emergency department attendances of people with a head injury for which a CT head scan is performed within 1 hour of a risk factor for brain injury being identified. Numerator — the number in the denominator having a CT head scan within 1 hour of a risk factor for brain injury being identified.
Denominator — the number of emergency department attendances of people with a head injury and a risk factor for brain injury indicating the need for a CT head scan. Data source: Local data collection. The Trauma Audit and Research Network TARN collects data for a subset of the population; however, data for the entire process measure are not currently collected. Directly standardised rate, all ages, 3 year average. Service providers emergency departments, hospitals and specialist neurological centres ensure that a CT head scan can be performed within 1 hour of a risk factor for brain injury being identified in people with a head injury.
Healthcare professionals ensure that CT head scans are performed within 1 hour of a risk factor for brain injury being identified in people with a head injury. Commissioners clinical commissioning groups and NHS England ensure that service providers can perform CT head scans within 1 hour of a risk factor for brain injury being identified in people with a head injury.
This may be achieved in a number of ways, which include the use of 1 hour targets in acute contracts, or enhanced monitoring and audit procedures.
People with a head injury who have any sign showing that the injury might have damaged their brain have a CT scan of their head within 1 hour of the sign showing. For adults with head injury, any 1 of the following risk factors indicates the need for a CT head scan within 1 hour of the risk factor being identified:. For children and young people with head injury, any 1 of the following risk factors indicates the need for a CT head scan within 1 hour of the risk factor being identified:.
In addition, children and young people with head injury and more than 1 of the following risk factors should have a CT head scan within 1 hour of the risk factors being identified:. CT head scans for people taking anticoagulants This quality statement is taken from the head injury quality standard.
People attending an emergency department with a head injury have a CT head scan within 8 hours of the injury if they are taking anticoagulants but have no other risk factors for brain injury. Some people who have no other risk factors for brain injury have an increased risk of bleeding after a head injury because they are taking anticoagulants. In these people a CT head scan within 8 hours of the injury will allow appropriate management.
Evidence of local arrangements to ensure that CT head scans can be performed within 8 hours of head injury in people attending emergency departments who are taking anticoagulants but have no other risk factor for brain injury. Proportion of emergency department attendances of people with a head injury who are taking anticoagulants but have no other risk factors for brain injury for which a CT head scan is performed within 8 hours of the injury. Numerator — the number in the denominator having a CT head scan within 8 hours of the injury.
A contusion bruise happens when a blow to the head injures the skin and the soft tissue under it. Blood from small blood vessels leaks, causing red or purple marks on the skin. Contusions often happen on the scalp or forehead. More serious head injuries can cause a brain contusion.
A skull fracture is a break in the skull bone. Skull fractures can happen in different parts of the skull. Bleeding can happen on and under the scalp and in or around the brain. A child with a head injury might: Have a swollen scalp: This is common because the scalp has many small blood vessels that can leak. Have a headache : About half of children with a head injury get a headache. Lose consciousness pass out : This isn't common. Vomit once or twice: This happens in some children after a head injury.
How Are Head Injuries Diagnosed? Signs that the injury could be serious include: loss of consciousness for more than a few minutes continued vomiting confusion seizures a headache that gets worse What Should I Do When a Child Has a Head Injury? Call your health care provider right away if your child had a head injury and: is an infant lost consciousness, even for a moment has any of these symptoms: won't stop crying complains of head and neck pain younger children who aren't talking yet may be more fussy vomits more than one time won't awaken easily becomes hard to comfort isn't walking or talking normally If your child is not an infant, has not lost consciousness, and is alert and behaving normally after the fall or blow: Put an ice pack or instant cold pack on the injured area for 20 minutes every 3—4 hours.
If you use ice, always wrap it in a washcloth or sock. Ice placed right on bare skin can injure it. Watch your child carefully for the next 24 hours. If the injury happens close to bedtime or naptime and your child falls asleep soon afterward, check in a few times while they sleep.
Don't move the child in case there is a neck or spine injury. Call for help.
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