BY,
MR. ABHIJIT BHOYAR
LECTURER
M SC. NURSING
CHILD HEALTH

What Are Head Injuries?
• Head injuries are common in children and teens.
• They can hurt the scalp, skull, brain, or blood vessels.
• Head injuries can be mild, like a bump on the head, or more
serious, like a concussion.
• In kids, most are mild and don't injure the brain.

What Causes Head Injuries?
• Most head injuries in childhood are due to falls. They also
happen from:
CAR CRASHESH
BIKE ACCIDENTS
SPORT INJURIES
CHILD ABUSE

NEONATAL
CAUSES
BIRTH
INJURY
INSTRUMENTAL
DELIVERY

TODDLER AND
PRESCHOOLER
FALL FROM
HEIGHT
HEATING TO
HEAD BY OTHERS
ACCIDENTS
HARD OBJECT
FALLING ON
HEAD

OLDER
CHILDREN
Automobile accidents
Road traffic accidents
Sports and recreation
injury
Fall from height
Penetrating injury
through eyes
Crush injury
Fall of heavy object on
head

What Are the Types of Head Injuries?
Head injuries can be:
• Involve the
scalp
EXTERNAL
• skull, brain,
or blood
vessels
INTERNAL

An injury can cause a concussion, contusion,
fracture, or bleeding
• A concussion is a type of mild
traumatic brain injury.
• It happens when a blow to the
head or another injury moves
the head back and forth with a
lot of force.
• This causes chemical changes in
the brain and sometimes
damages brain cells.

CONTUSION
• 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.

SIGNS
&
SYMPTOMS
HAVE A SWOLLEN
SCALP
(because the scalp
has many small
blood vessels that
can leak)
HAVE A HEADACHE
(half of children
with a head injury
get a headache)
LOSE
CONSCIOUSNES
S (PASS OUT)
(This isn't common)
VOMIT ONCE OR
TWICE
(This happens in
some children after a
head injury)

Symptoms can occur a bit differently in each child,
and vary depending on how severe the injury is.
• Symptoms of mild head
injury may include:
• Raised, swollen area from a
bump or a bruise
• Small, shallow cut in the
scalp
• Headache
• Sensitivity to noise and light
• Irritability or abnormal
behavior
• Confusion
• Lightheadedness or dizziness

• Problems with balance
• Nausea
• Problems with memory
or concentration
• Change in sleep patterns
• Blurred or double vision
• Eyes that look tired
• Ringing in the ears
(tinnitus)
• Changes in taste
• Tiredness
• Lack of energy (lethargy)

Symptoms of moderate to severe head injury
may include any of the above plus
• Loss of consciousness
• Severe headache that does not go away
• Repeated nausea and vomiting
• Loss of short-term memory
• Slurred speech
• Trouble walking

• Weakness in one side or area of the body
• Sweating
• Pale color of skin
• Seizures or convulsions
• Blood or clear fluid draining from ears or nose
• Dark circle in the center of the eye (pupil) looks larger in one
eye
• Deep cut in the scalp
• Loss of consciousness and can’t be awakened (coma)
• Loss of thinking and awareness of surroundings (vegetative
state)
• Locked-in syndrome, a condition where a person is conscious
and can think, but can’t speak or move

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.

• If your child's skin color and breathing are normal, and you
don't sense a problem, let your child sleep unless the doctor
tells you otherwise. There's no need to keep a child awake
after a head injury.
• Trust your instincts. If you think your child doesn't look or
seem right, partly awaken your child by sitting them up. They
should fuss a bit and attempt to resettle. If your child still
seems very drowsy, try to awaken them fully. If you can't wake
your child, call your health care provider or for an ambulance.

What Should I Do if a Child Is Unconscious
After a Head Injury?
• Don't move the child in case there is a neck or spine injury.
• Call for help. If you have a phone with you, call 911.
• If the child is vomiting or having a seizure, turn them onto
their side while trying to keep the head and neck straight. This
will help prevent choking and protect the neck and spine.

TREATMENT
• Treatment is based on the severity of the injury.
• Mild injury
• Mild traumatic brain injuries usually require no treatment
other than rest and over-the-counter pain relievers to treat a
headache. However, a person with a mild traumatic brain
injury usually needs to be monitored closely at home for any
persistent, worsening or new symptoms. He or she may also
have follow-up doctor appointments.

IMMEDIATE EMERGENCY CARE
Maintained
A= Airway
B=Breathing
C=Circulation

MEDICATIONS
• Diuretics. These drugs reduce the amount of fluid in tissues
and increase urine output. Diuretics, given intravenously to
people with traumatic brain injury, help reduce pressure
inside the brain.
• Anti-seizure drugs. People who've had a moderate to severe
traumatic brain injury are at risk of having seizures during the
first week after their injury

• An anti-seizure drug may be given during the first week to avoid any
additional brain damage that might be caused by a seizure.
Continued anti-seizure treatments are used only if seizures occur.
• Coma-inducing drugs. Doctors sometimes use drugs to put people
into temporary comas because a comatose brain needs less oxygen
to function. This is especially helpful if blood vessels, compressed
by increased pressure in the brain, are unable to supply brain cells
with normal amounts of nutrients and oxygen.

SURGERY
• Removing clotted blood (hematomas). Bleeding outside or
within the brain can result in a collection of clotted blood
(hematoma) that puts pressure on the brain and damages
brain tissue.
• Repairing skull fractures. Surgery may be needed to repair
severe skull fractures or to remove pieces of skull in the brain.

• Bleeding in the brain. Head injuries that cause bleeding in the
brain may need surgery to stop the bleeding.
• Opening a window in the skull. Surgery may be used to
relieve pressure inside the skull by draining accumulated
cerebral spinal fluid or creating a window in the skull that
provides more room for swollen tissues.

Can Head Injuries Be Prevented?
• It's impossible to protect kids from every injury. But you can
help prevent head blows. Most important, childproof your
home to prevent household accidents.
• Kids should:
• Always wear a bike helmet that fits well and is approved by
the U.S. Consumer Product Safety Commission for biking.
• Use the proper sports equipment for inline
skating, skateboarding, snowboarding, skiing, and contact
sports.

• Use a child safety seat or seatbelt every time they're in the
car.
• Take it easy after a head injury, especially if they had a
concussion.
• Wait until the doctor says it's OK before returning to rough
play or sports. If the brain gets injured again while it's still
healing, it will take even longer to completely heal.

COMPLICATION
• Behavioural problems
• Communication problems
• Physical deformities
• Death
• Coma

NURSING MANAGEMENT
• Nursing assessment
• Check level of consciousness
• Nutritional management
• Provide comfort
• Post operative care
• Treat complication
• Encourage relative to participate in care

PREVENTING HEAD INJURIES IN CHILDREN
The following tips can help children avoid head injuries:
• Install safety gates at the top of a stairway
• Keep stairs clear of clutter
• Install window guards to prevent falls
• Put a nonslip mat in the bathtub or shower
• Use playgrounds that have shock-absorbing materials on the ground
• Make sure area rugs are secure
• Don't let children play on fire escapes or balconies