Head Injuries

Picture the scene:

It’s 7pm and the kids have had their tea and bath and are now meant to be getting into their pyjamas and ready for bed. Instead they seem to have developed a “second wind” and are jumping around pretending to be Spiderman (or the latest television superhero!), when suddenly you hear a loud crash and wail…your 5 year old has jumped off the bed in an attempt to fly (or stick to the wall!) and has bumped his head on the bedside table. He has a small red bump on the front of his head and there are lots of tears.

So after a cool pack, cuddle, tears wiped and nose blown, its way past bedtime and your child is tired…..What to do? Should he sleep or should you keep him awake in case he “goes into a coma”?

After any traumatic experience it is normal for a child to feel sleepy and need to take a little nap, it should be a normal peaceful sleep and they should wake up fully after the sleep.

The problem comes when the accident happens just before bedtime. Yes you can let them sleep.  Sleep is good for recovery.  If you have any concerns, wake your child up after about an hour or so.  They may be grumpy, but that is reassuring and pretty normal!  You can then let them go back to sleep. 

If you are concerned enough to keep checking on them throughout the night then seek medical help/advice (NHS 111 service) or a trip to the A & E would be advisable.

Seek medical help quickly if any of the following symptoms occur after a head injury – DIAL 999

  • Under 6 months of age
  • Unconscious, even briefly
  • Crying for longer than 10 minutes or prolonged irritability
  • Vomiting repeatedly
  • Anything that you would deem to be “not normal behaviour” for your child.
  • Inability to remember events before or after the head injury.
  • Severe, worsening headache
  • Seizures (fits/ convulsions)
  • Dizziness, loss of balance or walking strangely.
  • Blood or clear fluid leaking from the nose or ear.
  • Great force of injury (car accident, long fall, cricket bat etc.)
  • Worsening symptoms or symptoms improve and then worsen

So what’s the reasoning behind the tale of “Not letting someone go to sleep after a bump to the head”?

The thought was that if you kept someone awake you would be able to prevent them from going into a coma, which of course does not work.

The reasoning behind the “stay with me” and constant rousing of a patient (like in the movies!) stems from the medic determining the patients ability to stay conscious.

The other reason for constant monitoring of a patient with a head injury in hospital is that if anything worsens it will be dealt with straight away (CT scan, surgery etc.).  Whereas if you left someone unmonitored they could deteriorate during the night and go into a coma.
