Head Injury, Age 3 And Younger: Emergencies

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Emergencies

• Breathing stops for more than a few seconds. Call 911 or other emergency services and begin rescue breathing.
• Loss of consciousness at any time after the injury
• A deformity of the skull, such as a sunken spot (other than the normal soft spots), bone fragments, or exposed brain
• A wound penetrates the skull, such as a knife or gunshot wound (open head injury). Do not remove objects from the wound.
• Seizure. Protect the child from injury during the seizure.
• Signs of shock
• Severe bleeding does not slow during the first 5 minutes of direct pressure. See how to stop bleeding.
• Signs of a spinal injury:
  • Inability to move part of the body (paralysis), such as an arm or leg
  • Severe pain in the neck or back
• Signs of a serious head injury:
  • Confusion or not acting normal. A child with a head injury may be very fussy, fretful, or may cry constantly.
  • Difficulty waking up or extreme sleepiness
  • Difficulty speaking or slurred speech
  • Loss of vision in one or both eyes, changes in the size or shape of the pupils and the reaction to light or abnormal eye movements, such as jerking motions or the eyes not working together
  • Dizziness, vertigo, or unsteadiness that prevents standing or walking
  • Persistent nausea and vomiting
  • Severe stiff neck

Last updated:	July 09, 2008
Author:	Jan Nissl, RN, BS
Reviewed By:	Michael J. Sexton, MD - Pediatrics, H. Michael O'Connor, MD - Emergency Medicine
Editors:	Susan Van Houten, RN, BSN, MBA, Tracy Landauer