Head Injury with Sleep Monitoring (Child)

Illustration of the head that shows movement of the brain inside the skull when the head hits a wall.

Your child has a head injury. It does not appear serious at this time. But symptoms of a more serious problem, such as mild brain injury (concussion), or bruising or bleeding in the brain, may appear later. For this reason, you will need to watch your child for the symptoms listed below. Once at home, also be sure to follow any care instructions you’re given for your child.

Home care

Watch for the following symptoms

For the next 24 hours (or longer, if directed), you or another adult must stay with your child. If your child is resting, he or she will need to be woken up every 2 hours, or as advised, to be checked for symptoms. This is called sleep monitoring. Symptoms to watch for include:

  • Headache

  • Nausea or vomiting

  • Dizziness

  • Sensitivity to light or noise

  • Unusual sleepiness or grogginess

  • Trouble falling asleep

  • Personality changes

  • Vision changes

  • Memory loss

  • Confusion

  • Trouble walking or clumsiness

  • Loss of consciousness (even for a short time)

  • Inability to be awakened

  • Stiff neck

  • Weakness or numbness in any part of the body

  • Seizures

For young children, also watch for crying that can’t be soothed, refusal to feed, or any signs of changes to the head such as bruising, bulging, or a soft or pushed-in spot.

If your child develops any of these symptoms, get emergency medical care right away. If none of these symptoms are noted during the first 24 hours, keep watching for symptoms for the next day or so. Ask the provider if sleep monitoring needs to be continued during this time. 

General care

  • If your child was prescribed medicines for pain, be sure to given them to your child as directed. Note: Don’t give your child other pain medicines without checking with the provider first.

  • To help reduce swelling and pain, apply a cold source to the injured area for up to 20 minutes at a time. Do this as often as directed. SPAN: Use a cold pack or bag of ice wrapped in a thin towel. Never apply a cold source directly to the skin.

  • If your child has cuts or scrapes on the face or scalp, care for them as directed.

  • For the next 24 hours (or longer, if advised), your child should:

    • Not lift or do other strenuous activities

    • Not play sports or any other activities that could result in another head injury

    • Limit TV, smartphones, video games, computers, and music or avoid them completely. These activities may make symptoms worse.

Follow-up care

Follow up with your child’s healthcare provider, or as directed. If imaging tests were done, they will be reviewed by a doctor. You will be told the results and any new findings that may affect your child’s care.

When to seek medical advice

Unless told otherwise, call the provider right away if:

  • Your child has a fever (see Fever and children, below)

Also call the provider right away if your child has any of the following:

  • Pain that doesn’t get better or worsens

  • New or increased swelling or bruising

  • Increased redness, warmth, drainage, or bleeding from the injured area

  • Fluid drainage or bleeding from the nose or ears

  • Sick appearance or behaviors that worry you

  • Lethargy or excessive sleepiness

  • Bruising behind the ears or around the eyes

  • Worsening headache

  • Vomiting that worsens

  • Double vision

  • Trouble walking or talking

Fever and children

Always use a digital thermometer to check your child’s temperature. Never use a mercury thermometer.

For infants and toddlers, be sure to use a rectal thermometer correctly. A rectal thermometer may accidentally poke a hole in (perforate) the rectum. It may also pass on germs from the stool. Always follow the product maker’s directions for proper use. If you don’t feel comfortable taking a rectal temperature, use another method. When you talk to your child’s healthcare provider, tell him or her which method you used to take your child’s temperature.

Here are guidelines for fever temperature. Ear temperatures aren’t accurate before 6 months of age. Don’t take an oral temperature until your child is at least 4 years old.

Infant under 3 months old:

  • Ask your child’s healthcare provider how you should take the temperature.

  • Rectal or forehead (temporal artery) temperature of 100.4°F (38°C) or higher, or as directed by the provider

  • Armpit temperature of 99°F (37.2°C) or higher, or as directed by the provider

Child age 3 to 36 months:

  • Rectal, forehead (temporal artery), or ear temperature of 102°F (38.9°C) or higher, or as directed by the provider

  • Armpit temperature of 101°F (38.3°C) or higher, or as directed by the provider

Child of any age:

  • Repeated temperature of 104°F (40°C) or higher, or as directed by the provider

  • Fever that lasts more than 24 hours in a child under 2 years old. Or a fever that lasts for 3 days in a child 2 years or older.

© 2000-2021 The StayWell Company, LLC. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare professional's instructions.
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