We are not experts in first aid, this is just a guide from us to assist you, if you want to learn more about First Aid for Children you should contact your local health service and find out what courses are available in your area.

Treatment

Head Injury

Most falls which result in a knock to the head thankfully are on the scalp only, which is usually more frightening than threatening. An internal head injury could have more serious implications because the skull serves as the protective helmet for the delicate brain.

Scalp Injury

The scalp has so many blood vessels, that even a minor cut to the scalp can bleed profusely. The swelling that may appear on the scalp after a head blow results from the scalp's veins leaking fluid or blood into (and under) the scalp. It may take days or even weeks to disappear.

What to look for and what to do

Call doctor if your child has lost consciousness, even momentarily, or if your child of any age does any of the following:

• won't stop crying
• complains of head and neck pain
• becomes difficult to console
• isn't walking normally

If your child is a baby, but has not lost consciousness, is alert and behaving normally after the fall or blow, apply an ice pack or instant cold pack to the injured area for 20 minutes. If you use ice, always wrap it in clean tea towel, or soft muslin; don't apply ice directly to skin as it can cause frostbite.

Observe your child carefully for the next 24 hours. If he or she shows any of the signs of internal injury (see below), call your child's doctor immediately.

If the incident has occurred close to bedtime or naptime and your child falls asleep soon afterward, check him or her every few hours for twitching limbs or disturbances in color or breathing.

If color and breathing are normal, and no other symptoms are present, let your child sleep (unless your child's doctor has advised otherwise). There's no need to keep a child awake after a head injury.

If color and/or breathing are abnormal, or if you aren't comfortable with your child's appearance (trust your instincts), arouse your child partially by sitting him or her up. Your child should cry and be a bit cross, but then attempt to resettle. If he or she doesn't protest, try to awaken your child fully. If your child can't be awakened or shows any signs of internal injury (see below), call for an ambulance.

Suspected Internal Injury

The brain is cushioned by cerebrospinal fluid, but a severe blow to the head may knock the brain into the side of the skull or tear blood vessels. Any internal head injury - fractured skull, torn blood vessels, or damage to the brain itself - can be serious and possibly life threatening.

There are different levels of injury that require different levels of concern. It can be difficult to determine the level of injury, so it's always wise to discuss a head injury with your child's doctor. A clear indicator of a more serious injury is when your child loses consciousness or has signs of confusion.

What to look for and what to do:

Call an ambulance if your child shows any of the following symptoms:

• unconsciousness
• abnormal breathing
• obvious serious wound or fracture
• bleeding or clear fluid from the nose, ear, or mouth
• disturbance of speech or vision
• pupils of unequal size
• weakness or paralysis
• dizziness
• neck pain or stiffness
• seizure
• vomiting more than two to three times
• loss of bladder or bowel control

If your child is unconscious:

• Do not try to move him or her in case of neck or spine injury. Call for help.
• If you've been trained in CPR, follow the recommendations if they're appropriate.
• If your child is vomiting or has a seizure, turn him or her on the side while trying to keep the head and neck straight.
• If there's swelling, apply an ice pack or cold pack.
• If your child is conscious:
• Do your best to keep him or her calm and still.
• If there's bleeding, apply a sterile dressing (bandage).
• Do not attempt to cleanse the wound, which may aggravate bleeding and/or cause serious complications if the skull is fractured.
• Do not apply direct pressure to the wound if you suspect the skull is fractured.
• Do not remove any object that's stuck in the wound.
• Concussions are also considered a type of internal head injury. A concussion is the temporary loss of normal brain function as a result of an injury. Repeated concussions can result in permanent injury to the brain. One of the most common reasons kids get concussions is through sports, so it's important to make sure they wear appropriate protective gear and don't continue to play if they've had a head injury. However, it's possible to get a concussion that's mild and just requires observation.

If your child sustains an injury to the head, watch for the following signs that indicate that he or she may have a concussion:

• seeing stars and feeling dazed, dizzy, or light-headed
• trouble remembering things, such as what happened directly before and after the injury occurred (this can happen even with mild concussions)
• nausea or vomiting
• headaches
• blurred vision and sensitivity to light
• slurred speech or saying things that don't make sense
• difficulty concentrating, thinking, or making decisions
• difficulty with coordination or balance (such as being unable to catch a ball or other easy tasks)
• feeling anxious or irritable for no apparent reason
• feeling overly tired
• If you suspect a concussion, take your child to the Emergency Department.

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