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Parent’s Guide

Parent’s Guide: Head Injuries

Head injuries are very common in children, especially toddlers learning to walk. Because the scalp has a rich blood supply, even minor cuts bleed heavily and bumps can swell into large "goose eggs" quickly. This guide will help you decide if it is a simple scalp injury or something more serious.

1

🚨 Is it an Emergency? When to Get Help

Most head bumps are minor. However, you must check for signs of brain injury or skull fracture.

Call 911 Now

  • Unconsciousness: Child was knocked out for more than 1 minute.
  • Seizure: Child has a seizure or convulsion.
  • Neck: Child cannot move their neck normally (Caution: Do not move them if you suspect a neck injury).
  • Status: Child is hard to wake up, confused, slurring speech, or unable to walk steadily.
  • Bleeding: Major bleeding that won’t stop.

Call Doctor Now or Go to ER

  • Age: Child is less than 1 year old.
  • Brief Knockout: Child was unconscious for less than 1 minute.
  • The Wound:
    • Skin is split open or gaping (may need stitches).
    • Bleeding hasn’t stopped after 10 minutes of direct pressure.
    • Large dent in the skull.
  • The Swelling: Large swelling (bigger than 1 inch).
  • The Cause: A high-speed blow (like a golf club) or a fall from a dangerous height.
  • Vomiting: Vomits 2 or more times.
2

🔎Is it a Concussion?

A concussion is a mild brain injury that changes how the brain works for a short time. You do not need to be “knocked out” to have a concussion.

  • Watch for: Confusion, memory loss, dizziness, acting dazed, headache, or vomiting.
  • Recovery: Concussions require Brain Rest (no screens, studying) and Physical Rest (no sports/gym) until symptoms clear.
3

🏠Home Care: The “Watch and Wait” Protocol

If your child cried right away, is alert, and has none of the severe symptoms above, you can treat them at home.

Step 1: Treat the Wound

  • Bleeding: Apply direct pressure with a clean cloth for 10 minutes.
  • Cleaning: Wash scrapes with soap and water.
  • Swelling: Apply a cold pack (ice wrapped in a wet cloth) for 10-20 minutes. This prevents large lumps and reduces pain.

Step 2: The 2-Hour Observation Rule

  • Rest: Have your child lie down and rest.
  • Sleep: It is okay to let your child sleep, but keep them nearby.
  • The Check: If they fall asleep, wake them up once after 2 hours. Check that they:
    • Are alert.
    • Know who you are.
    • Can talk and walk normally.

Step 3: Medication & Diet

  • Fluids: Start with clear fluids only (in case they vomit). If they hold it down for 2 hours, they can eat normally.
  • Pain Meds: You can give Acetaminophen (Tylenol) or Ibuprofen (Advil).
    • Rule 1: Wait 2 hours after the injury before giving meds (to ensure no vomiting).
    • Rule 2:NEVER give Aspirin (increases bleeding risk).

Step 4: Nighttime Supervision

  • Sleep in the same room as your child for the first night so you can hear if they vomit or develop a severe headache.
4

🕑What to Expect

  • Scalp Pain: May last for 2-3 days.
  • Swelling: The “goose egg” may take a week to disappear.
  • Bruising: A forehead blow may cause black eyes 1–3 days later (this is just gravity pulling the blood down).
5

➡️Follow Up

Call your doctor during office hours if:

  • Headache lasts more than 24 hours.
  • You are unsure about your child’s Tetanus shot status (especially for dirty cuts).

Medically Reviewed by Dr Michael Villadelgado
Disclaimer: This information is for educational purposes only. You assume full responsibility for how you use it. If you are unsure, always call your doctor.