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A Bump on the Head: How to Tell If It's Serious

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Angela Rosas
By Angela Rosas M.D.
"The most enjoyable thing for me in practicing general pediatrics is to use my professional training and my experiences as a mother to help families to improve the health of their children," says Angela Rosas. "It is a wondrous feeling to watch children heal and develop into healthy young adults, knowing that you played a small role in the process."

Angela Rosas M.D., graduated from Stanford University with a degree in human biology. She attended medical school and completed her residency in pediatrics at the University of California at San Diego. She has been a fellow in the American Academy of Pediatrics since 1991. Dr. Rosas has practiced general pediatrics for eight years in community clinics, private practice, and university hospitals. She is currently Assistant Professor of Pediatrics at the University of California at Davis Medical Center in Sacramento, California. Her clinical and research interests are breastfeeding, asthma, adolescent care, children with disabilities, child abuse and neglect, and accident prevention. Dr. Rosas has published several articles in peer-reviewed journals and contributed to various pediatric textbooks. She frequently lectures on pediatrics issues at medical conferences and for community agencies. Dr. Rosas is married to another pediatrician and has three young daughters.
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At one point or another, all kids knock themselves on the noggin. Fortunately, most of these knocks cause more parental alarm than actual harm, despite impressive-looking goose eggs. Generally, for a head injury to be serious, a child must either fall more than four feet, be thrown a distance, land on something with a sharp edge, or be purposely hit with something by a large person. But it's always good to know what to look for when a head knock occurs.

  Concussion and Other Symptoms

  Take These Steps

  Count on This





Concussion and Other Symptoms

If a child suffers a concussion, she will lose consciousness, perhaps only for a few seconds. She'll be confused, unable to tell you who and where she is. She also won’t remember what caused the injury. All kids with concussions need to see a doctor right away and be observed for a period of time.Other worrisome signs to look for after a head injury include:

 
    • vomiting more than three times right after the injury, or once four to six hours afterward;
 
    • clear fluid or blood coming from the ear or nose;
 
    • abrupt onset of severe ear pain right after the injury;
 
    • bad headache that persists more than an hour;
 
    • complaints of dizziness or of blurred or double vision;
 
    • difficulty staying awake and confusion and incoherent speech when woken;
 
    • staying sweaty and pale;
 
    • irregular or funny breathing. If any of these symptoms are present, bring your child to a physician or an emergency room right away.
 

What to Expect

Remember that it’s perfectly natural for a child to be upset after she’s received a bump. You can expect her to be clingy and to want to rest. You’re the one who knows your child best, so you’re in the best position to judge whether her behavior is any cause for worry. What you’re looking for is an essential change or a real downturn, over hours or days, that is very different from how your child normally behaves.

Take These Steps

After a bump on the head, there are things you can do to monitor the seriousness of the injury:

 
    • Have your child rest for at least two hours, and keep a close eye on him during that time.
 
    • Give him only clear liquids and no pain relievers during the observation time. If he really needs pain relief, he needs to be checked by a doctor.
 
    • If there is a scalp cut, clean it well and apply pressure for at least 10 minutes. If it’s longer than 1 inch, won’t stop bleeding, or involves the eyebrow, lip edge, or earlobe, bring the child to a health care provider for evaluation.
 
    • Small cuts can be taped so the edges come together for better healing.
 
    • If there is a lump on the scalp or forehead, apply ice for about 20 minutes, using an ice bag, loose frozen vegetables in a bag, or crushed ice in a tied-off washcloth.
 
    • In the first night after an injury, check your child twice, or about every three to four hours. After waking him, make sure he’s not dizzy, confused, or talking nonsense. Check that the pupils of his eyes are of equal size.
 



Count on This

The bumped area will turn colors over the next several days. If your child was knocked on the forehead or in the middle of the face, he'll soon have a black (or yellow or green) eye.

Head injuries bleed a lot and cause big bumps and lots of bruising because of the rich blood supply in this area. It always looks worse than it is. I still remember my mom's response when my brother was hit by a golf club and was covered with blood from a scalp cut. She passed out, hit her head, and had to stay overnight in the hospital. My brother was fine.

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Side note
I'd like to add that the advice given in the article was not bad advice, just out-dated. The old pr..

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