A child bumping their head is a common occurrence, often causing immediate concern for parents. The rapid appearance of localized swelling, sometimes called a “goose egg,” is typically a superficial injury resulting from blood and fluid pooling under the scalp. While usually benign, a significant impact carries the potential for internal injury, such as a concussion or, in rare cases, a serious intracranial event. This guidance clarifies which signs warrant immediate professional medical attention and which can be managed with close observation at home.
Immediate Steps Following a Head Bump
The moments immediately following an impact require a calm and systematic assessment. First, observe the child’s immediate response: a child who cries immediately and is quickly consolable is generally less concerning than one who remains unresponsive or confused. Carefully check the impact site for any cuts, deep gashes, or noticeable depression or deformity of the skull, which could indicate a serious underlying injury.
To manage localized swelling and pain, apply a cold compress or ice pack wrapped in a cloth to the bump for up to 20 minutes. This helps minimize the size of the hematoma that forms under the scalp. While providing comfort, recall the mechanism of the injury, such as the height of the fall or the force of the object, as this detail will be important for a healthcare provider.
Keep the child resting quietly for a short period following the impact, avoiding activities that could lead to a second injury or overexertion. The initial assessment should focus on their alertness and ability to interact normally. If they are alert and their behavior quickly returns to baseline, the next step is a period of close monitoring for any developing symptoms.
Urgent Symptoms Requiring Emergency Care
Certain symptoms manifesting after a head impact indicate a possible serious injury, such as a skull fracture or significant brain trauma, requiring an immediate trip to the emergency room or calling emergency services. A loss of consciousness, even if brief, means a concussion has occurred and requires prompt medical evaluation. Persistent or forceful vomiting, particularly more than two episodes within a short period, can signal increased pressure within the skull.
Neurological changes require urgent attention. This includes having a seizure, which may appear as uncontrollable shaking, twitching, or a dazed, staring episode. Watch for signs of poor coordination, such as staggering, difficulty walking, or slurred speech, which point to issues with brain function. Severe or rapidly worsening headaches are also a cause for alarm, especially if the pain does not respond to standard pain relievers.
Changes in the eyes or drainage from the head should be treated as emergencies. If the child’s pupils become unequal in size or if they experience double or blurry vision, this suggests pressure on the brain. The presence of clear fluid or blood draining from the nose or ears is a grave sign, potentially indicating a fracture at the base of the skull. Unusually drowsy children, those difficult to wake up, or those who cannot recognize familiar people or places require immediate emergency medical services.
Monitoring for Delayed or Non-Urgent Symptoms
Symptoms may emerge hours or even days after the initial impact, making close observation necessary, typically for 24 to 48 hours. During this time, caregivers should look for subtle shifts in the child’s normal mood and behavior. Increased irritability, fussiness, or excessive crying that cannot be easily consoled, especially in infants, may be the only sign of discomfort or neurological upset.
Mild physical symptoms do not necessitate an emergency visit but warrant a call to the pediatrician for guidance. These symptoms include:
- A low-grade headache manageable with over-the-counter pain medication.
- Mild sensitivity to bright light or loud noise.
- A slight change in balance, making the child clumsy or unsteady.
- Refusal to nurse or eat.
Monitoring sleep is important, but it is usually acceptable for a child to nap or sleep on a regular schedule following a minor head bump. Parents must ensure they can easily wake the child from sleep, as difficulty rousing them or excessive drowsiness is an emergency sign. If any milder, non-urgent symptoms persist for more than a day or two, or if they seem to be getting progressively worse, consult a healthcare provider.