By My Le, MD
Pediatric Resident at The University of Texas at Austin Dell Medical School
Member, Texas Medical Association
Pediatric Resident at The University of Texas at Austin Dell Medical School
Member, Texas Medical Association
When you hit your head, it can be difficult to determine
whether the injury is serious enough to visit the emergency room or an urgent
care center
– especially when there are no open wounds, and you’re awake, alert, and
feeling pretty normal. If you decide to make the trip, it can be frustrating to
be sent home with no action by the doctor besides instructing you to pay
attention to your symptoms and come back if they worsen. On the other hand, if
you don’t go, there could be serious medical repercussions.
First and foremost, if you or the person who has suffered a closed-head
injury (meaning no penetrating or open wounds) is showing any changes in
alertness or wakefulness, or you can feel a skull fracture, go to the emergency
room. A trained medical professional will usually assess that patient with a cranial computed
tomography (CT) scan. This test, which takes detailed scans of features
inside your head, allows doctors to look for potential injured blood vessels,
blood clots, bruised/damaged brain tissue (contusion), bleeding in the brain
(hemorrhage), and swelling.
Below are some concerning symptoms by age group that can appear
after a closed-head injury. If you or the patient do not have any of these
symptoms and are otherwise feeling well, going to the emergency room or an
urgency care center might not be necessary. However, the more of these symptoms
you have, the higher the risk your head injury
is serious.
For patients less than 2-years-old:
- Scalp hematoma – This is essentially a collection of blood under the scalp and can be described as a large, boggy area of swelling.
- Severe injury – This can be pretty
subjective, but it’s always good to consider multiple factors, such as height
of the fall, the material that the head struck, and the speed of injury. For example, some literature considers a high-speed
accident (more than 40 miles per hour), a fall greater than three meters, or an
injury from a high-speed projectile or object as severe.
- Loss of consciousness for more than five seconds (i.e. blacking out).
- Abnormal behavior as witnessed by family or friends.
For patients ages 2 to 18-years-old:
- ANY loss of consciousness
- Vomiting
- Severe injury (see above for details)
- Severe headache
Your head is a delicate – and essential – part
of your body. Understanding what physicians and other trained medical professionals
look for when caring for a patient with a potential closed-head injury, and understanding
the injury’s warning signs, can guide you when deciding whether you need to
visit your local emergency department or urgent care center.
Reference(s):
PECARN Pediatric Head Trauma CT Decision Guide
Reference(s):
PECARN Pediatric Head Trauma CT Decision Guide
1 comment :
Great post! Very informative.
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