A child who has had what appears to be a minor head injury will often be observed at home by the parents or guardians. The patient needs to be re-evaluated if certain findings are noted in the child for the 48-72 hours following the injury.


The child may need to be re-evaluated if the child:

(1) has a worsening headache

(2) vomits 3 or more times

(3) has unequal pupils

(4) has a pupil that does not get smaller when a light is shined in the eye

(5) has seizures

(6) complains of neck pain or stiffness

(7) is confused or drowsy

(8) has difficulty in walking or talking

(9) complains of difficulty seeing

(10) has difficulty using the arms

(11) has uncontrolled bleeding from a wound despite continued pressure



(1) Wash any wounds with soap and water. Icing the site can reduce pain and swelling. Apply clean dressings.

(1) Do not give any pain medications (aspirin, Tylenol, etc.).

(2) Give the child clear liquids until the child goes 6 hours without vomiting.

(3) Look at the child's pupils for equality and light reaction several times during the day and night (on wakening, during meals, at bedtime).

(4) Have the child sleep in the parent's room, or have a parent sleep in the child's room.

(5) Awaken the child 2 or 3 times during the night, getting the child to walk and talk.


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