Patient education: Head injury observation in children (The Basics)

What is head injury observation? — A head injury happens when a person hits their head on a hard surface or is hit in the head with an object. Head injuries can be mild or more serious. Sometimes, they can affect the brain.

"Observation" means watching a person for problems after a head injury. Some effects of a head injury might not be seen right away. This is why observation is important.

The following is information about observing a child or teen (under age 18) after a head injury.

Why does someone with a head injury need to be observed? — Some effects of a head injury can show up in the first few hours. Others might not show up for days to weeks after the injury. It is important for you to help watch for these signs in the person who had the head injury.

Symptoms that can happen minutes to hours after a head injury include:

●Memory loss – People sometimes forget what caused their injury, as well as what happened right before and after the injury.

●Confusion

●Headache

●Dizziness or trouble with balance

●Nausea or vomiting

●Feeling very tired or sleepy

●Acting cranky, irritable, or not like themselves

Other symptoms that can happen hours to days after a head injury include:

●Trouble walking or talking

●Memory problems or problems paying attention

●Trouble sleeping

●Mood or behavior changes

●Being bothered by noise or light

●Changes in eyesight

What should I watch for at home? — Ask the doctor or nurse how you should watch your child at home. Make sure that you understand exactly what you need to do to care for your child. Ask questions if there is anything you do not understand.

●Watch the child for the first 12 to 24 hours after they are home. Call the doctor if they have any problems. Make sure that the child is breathing normally, not vomiting, and not moaning while they sleep.

●For the first night, sleep in the same room with the child. This way, you will know if they have any problems during the night. When they wake up, make sure that they are acting normally and recognize you. If you see changes in how they look or act, call for help or go to the emergency department.

What else should I know? — After a head injury, the child might need to rest for a while and avoid any activity that makes their symptoms worse. Some suggestions to help their recovery:

●Offer bland foods and plenty of fluids to help with nausea.

●Encourage them to rest their body for the first day or 2. They do not have to stay in bed. Light activity is OK as long as it doesn't make their symptoms worse. This includes things like taking a shower or a walk. They should avoid heavier activities like sports, running, or rough play.

●Help them rest their brain. This involves avoiding things that make symptoms worse. Examples include reading, playing video games, or using a smartphone, tablet, or computer.

●The doctor might want them to take a day or 2 off from school. Talk to the doctor about the best time for them to return to school. Although most children are much better in a few days, some children can have symptoms like trouble thinking, remembering, or paying attention that can last for weeks to months. It might help to let a teacher or caregiver know about their head injury.

●Offer them an over-the-counter pain reliever for headaches. These include acetaminophen (sample brand name: Tylenol) and ibuprofen (sample brand names: Advil, Motrin). These medicines should only be used for a few days.

●Help them avoid another head injury. They should avoid sports, climbing, bicycle riding, or other activities where they can hit their head. Check with the doctor about when it is safe to return to these activities.

When should I call the doctor? — Call for an ambulance (in the US and Canada, call 9-1-1) if the child:

●Cannot be fully woken up

●Is acting confused or disoriented

●Has a sudden and persistent change in their behavior

●Cannot walk normally

●Has trouble speaking or slurred speech

●Has severe weakness, or cannot move an arm, leg, or 1 side of their face

●Has a seizure or jerking of their arms or legs that they cannot control

Call the doctor or nurse for advice right away if the child:

●Has trouble concentrating, thinking clearly, or remembering things

●Has trouble waking from sleep or staying awake

●Has nausea or vomiting that is not improving

●Has blurry eyesight, double vision, or other problems seeing

●Has blood or clear liquid draining from their ears or nose

●Feels dizzy or faints

●Seems weak or has numbness in an arm, leg, or other body part

●Has a stiff neck

●Has a headache that is severe, gets worse, feels different, or does not get better with over-the-counter medicines

If any of the above symptoms seem severe, or if you are concerned about the child but cannot reach the doctor or nurse, seek emergency help. These things don't always mean that there is a serious problem, but seeing a doctor or nurse is the only way to know for sure.

More on this topic

Patient education: Head injury in children and teens (The Basics)
Patient education: Head injury in babies and children under 2 years (The Basics)
Patient education: Headaches in children (The Basics)
Patient education: Vertigo (a type of dizziness) (The Basics)

Patient education: Head injury in children and adolescents (Beyond the Basics)
Patient education: Headache in children (Beyond the Basics)
Patient education: Vertigo (Beyond the Basics)