What is a head injury?

Most head injuries hurt only the scalp, not the brain. Your child might have a big lump even if it was a minor injury because there is a large blood supply to the scalp. For the same reason small cuts on the head may bleed a lot. Only 1% to 2% of injured children have a skull fracture. Your child has not had a concussion unless there is temporary unconsciousness, confusion, and amnesia (loss of memory).

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How can I take care of my child?

• Wound care- Wash any scrapes with soap and water. Apply pressure with a clean cloth (sterile gauze if you have it) for 10 minutes to stop my bleeding. For swelling, apply ice fot 20 minutes.

• Rest- Encourage your child to lie down and rest until all symptoms are gone (or at least 2 hours). Your child can be allowed to sleep. You don't have to try to keep him awake. Just have him sleep nearby so you can check on him from time to time. Don't give any pain medicine. If the headache is bad enough to need medicine, your child should be checked by a physician.

• Diet- Give only clear fluids (ones you can see through) until your child has gone 2 hours without vomiting.

• Special precautions- Awaken your child twice during the night, once at your bedtime and once 4 hours later. Arouse him until he is walking and talking normally. Do this for 2 nights. After that, return to a normal routine.

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Call your child’s doctor right away if:

• The skin is split open and might need stitches.

• The headache becomes severe.

• Vomiting occurs three or more times.

• Your child's vision becomes blurred or double.

• Your child becomes difficult to awaken or confused.

• Walking or talking becomes difficult.

• Your child's neurological condition worsens in any other way.

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Written by B.D. Schmitt, M.D., author of "Your Child's Health," Bantam Books.

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