Head injuries

• Observation and rest--Observe your child for the first 2 hours after the injury. Watch for symptoms such as confusion or trouble walking. Encourage your child to lie down and rest until he no longer has symptoms. It is all right for your child to sleep; trying to keep him awake continuously is unnecessary. Have your child sleep near you so you can periodically check on him. Call your doctor immediately if you don't think your child is acting normally.
• Diet--Give your child only clear fluids (ones you can see through) and no food until he has gone 6 hours without vomiting. Vomiting is common after head injuries.
• Avoid pain medicines--Don't give your child acetaminophen or ibuprofen because your doctor needs to know your child's reaction to the injury. If your child's head hurts badly enough to need a pain reliever, your doctor should check him.
• Special precautions and awakening--Although your child is probably fine, watching him for 48 hours will ensure that you don't miss any serious complication. After 48 hours, however, your child should return to a normal routine and full activity.
  • Awaken your child twice during the night: once at your bedtime and once 4 hours later. (Awakening him every hour is unnecessary and next to impossible.) Arouse him until he is walking and talking normally. Do this for 2 nights. If his breathing becomes abnormal or his sleep is otherwise unusual, awaken him to be sure a coma is not developing. If you can't awaken your child, call 911 immediately.
  • Checking pupils is unnecessary. Some doctors may ask you to check your child's pupils (the black centers of the eyes) to make sure they are equal in size and become smaller when you shine a flashlight on them. Unequal pupils are never seen before other symptoms like confusion and unsteady walking. In general, pupil checks are necessary only for a hospitalized child with a severe head injury