Head Injuries

As the spring time approaches, I want to talk about a subject that is very serious, which is head injuries. As a resident in Birmingham, I took care of a six year old child named Michael who was simply riding his new bike and fell. His head hit the curb, and he suffered a severe bleed on his brain. After several surgeries and several months in the hospital, he was able to leave in a wheelchair, but was unable to speak. He was lucky. I also took care of several children who suffered head injuries and did not survive. These outcomes were possibly preventable; so let’s talk about helmet safety and head injuries.
Head injuries, unfortunately, are very common, and one of the biggest culprits is bicycle riding. Approximately 540,000 bicyclists visit emergency rooms with injuries every year. Of those, about 67,000 have head injuries, and 27,000 have injuries serious enough to be hospitalized. It’s estimated that 45-88% of all head injuries associated with bicycle crashes can be prevented by a $10 piece of plastic.

Other ways that children can have head injuries include skateboards, ATVs, scooters, and just simple falls. Over the last few years, with increased legislation, helmet use has increased, while injuries and deaths have decreased. But it’s not enough. The first step is that you have a helmet for your child, and if you ride together, buy one for yourself. Not only is it safer for you, it’s also a good example for your child. The second step is to ensure helmet use every time, no exceptions.

Next, let’s address what to do if your child suffers a head injury, whether it’s from a bike or scooter or just a fall in the house. First, call your doctor immediately if your child loses consciousness, complains of neck pain, is walking funny, or inconsolable. These might be signs of a serious head injury, especially if under the age of two years old. If your child has any abnormal breathing, obvious wound or skull injury, any blood or clear fluid from the nose, ear, or mouth, any muscle weakness, seizure or shaking activity, vomiting more than three times, or different sized pupils, then call 911. If a child is unconscious, then do not attempt to move them in case they have a neck injury. And if they are not breathing, it is a good idea to initiate CPR until help arrives.

Now most kids don’t have a serious head injury, but can suffer from what we call a closed head injury and possibly a concussion. These are kids that do not lose consciousness or have any of the scary symptoms above, but can have a large bruise, headache, “see stars,” and feel funny. If worried, call your doctor immediately, but most of these kids can be observed at home for about 24 hours to watch for any of the scary symptoms. But, contrary to popular belief, it is OK to let your child fall asleep after a knock on the head. It is a good idea to check on them periodically, but let them sleep.

The last word of advice is to trust your instincts. If are worried about your child, them seek medical advice or care immediately. And please, remind them to wear a helmet.

Robert L. Rux, M.D.

Robert L. Rux, M.D. is a Board Certified Pediatrician at Magnolia Springs Pediatrics. Originally from Mobile, he attended medical school at The University of Alabama School of Medicine (UAB) and completed residency at The Children’s Hospital of Alabama (UAB). He is married to Jaime and has three children, Adler, Walker and Mary McAtee.