Unless it’s COVID or dengue, there’s nothing that panics parents more, especially those who work outside their home, than a buss head. It seems that persistent exposure to American sitcoms and CNN horror stories has thrown common sense out the window. Luckily, there are still some grandparents around who remember what they did when their children got a blow to the head and can reassure their adult offspring.
Blows to the head often cause swellings to quickly appear. The scalp is rich in blood vessels, which bleed profusely at the slightest touch. Large bleeds may be the size of a small egg on the surface of the head. They contain blood from the torn blood vessels found in the tissue under the skin of the scalp. Blood collects under the skin but on top of the bones which protect the brain. Those bones are flexible until adolescence is completed and are joined by fibrous joints called sutures. In infants especially, these joints and soft spots, the fontanelles, are very flexible to allow for brain growth and passage through the birth canal, but the flexibility persists until adolescence. That’s why children can take blows to the head that would be harmful to adults. The vast majority of children with bumps are well and have no injury to the brain, which is what worries everyone.
If a cut is visible on the head, follow the procedure for treating a cut as outlined in last week’s Tuesday Guardian: “Press the cut hard with a clean cloth for at least five minutes. If bleeding continues, apply more pressure for another five minutes.” Then apply an ice pack for ten minutes each hour for at least six hours. Always consider taking the child to the A&E for prolonged bleeding. Make an ice pack by putting ice cubes into a plastic bag or by wrapping a clean cloth around the ice, but the best is a bag of frozen peas. It quickly moulds itself to almost any shape needed, and the frozen peas inside have a massaging-like effect which is very comforting. Ice controls swelling, decreases bleeding and eases pain. Unfortunately, most people put the pack on for a couple of minutes and then claim it does not work.
A child who has had a mild head injury will remain alert and his colour will be normal. He may vomit once or twice or complain of a headache right after the blow. This is normal. Give an appropriate dose of paracetamol for a mild headache and comfort the child to ease the vomiting.
Red flags: Get help if your child loses consciousness or cannot remember what happened; if he develops a persistent headache; if he exhibits unusual behaviour such as lethargy, fussiness, clumsiness or excitability, or a pallid colour in the 48 hours after the injury; if blood or fluid oozes from his ears or nose; if he has a seizure (fit or convulsion); or if he vomits repeatedly for more than six hours after the accident.
Black eye
When a child bumps his forehead or the area around the eye, blood leaks into the soft skin surrounding the eye, producing a bruise, or black eye, within 24 hours. This is often accompanied by a headache. As soon as the incident occurs, you need to apply an ice pack for ten minutes every hour for six hours. Paracetamol will relieve the pain of a mild headache. A black eye should heal in a week to ten days and is not dangerous since it usually does not affect the eye itself.
Red flags: See a doctor if your child’s headache persists or if he has other symptoms of a bumped head; if he has pain in one or both eyes; if he is sensitive to light; if the white of either eye turns red; or if you think foreign matter may be in the eye because the child is rubbing the eye or complaining of an itch.
Bruises
A bruise means there is bleeding into the soft tissue under the skin. Most bruises do not require treatment. But if your child gets hit especially hard, apply an ice pack for ten minutes each hour for six hours. After 24 hours, apply heat for about five minutes, three times a day until the pain subsides. Heat gets blood flowing to the area and speeds healing. A bruise generally heals within ten days. The head, legs and arms, which bruise easily, heal faster. The chest, back and abdomen take more time, something that battered women know very well.
Red flags: Streaks of blood under the skin might indicate more serious tissue damage. See your doctor at once.
