Baby fell out of high chair and hit head

DS fell off the slide at nursery onto his head a few weeks back- they called me at work to say he was behaving fine, no warnings signs of concussion, but because it was a fall and a bump they had to let me know.

I went to check on him at lunch time, checked the bumps, checked his behaviour, gave him a kiss and a cuddle and went back to work, leaving strict instructions to call if they had ANY doubts.

He was fine- but I had to check myself or I wouldn’t have been able to concentrate at work.

Kids can fall for a variety of reasons. Sometimes it’s a toddler who fell down the stairs after slipping past the baby gate. Sometimes it’s a small child who fell out of bed during a restless night’s sleep. And older kids can play a little too hard and take a spill, especially when they start running around a favorite kids’ spot like Como Regional Park in St. Paul or Hyland Play Area in Bloomington. Most of the time, any minor bumps, cuts and bruises are the only sign that your child’s excitement got the best of them for a moment.

But if you’re reading this, you may not be dealing with your average fall. Instead, you might be asking yourself: What do I do if my child falls and really hurts themselves? Are there certain injuries or symptoms I should be looking for? When should I take my child to the emergency room?

Falls are the leading cause of emergency room visits for kids of all ages – especially for infants and toddlers. With the help of our team at the Regions Hospital Level 1 Pediatric Trauma Center, we’ll help answer your questions about falls, including steps for assessing your child’s injuries so you can get them the care they need.

How to know if your child is okay after a fall

Anytime your kiddo falls down, be sure to take time to assess their injuries. In many cases you can quickly determine if anything is seriously wrong. We recommend taking the following steps to take stock of the situation:

1. Try to remain calm. This can help ease your child’s fears and help you focus so you can assess any injuries.
2. Check for any bleeding. If there is, apply firm pressure directly over the injury with a clean cloth or bandage for five to 10 minutes.
3. Look for signs of painful or difficult breathing. If your child is experiencing these symptoms, don’t wait – head to a pediatric emergency room right away.
4. Look for other injuries. Oftentimes, a fall can cause injuries to more than one area of the body. Minor falls will likely mean minor injuries like scrapes, scratches and bumps in a couple areas, but more serious falls could include a combination of head, neck, back or spinal injuries, deep cuts, or broken bones.
5. Apply an ice pack or a cold pack for 15 to 20 minutes to injured areas. This can help reduce pain and swelling.

Signs and symptoms of a more serious fall-related injury to look for

When a child falls, head, neck, back or spine injuries, and broken bones are among the most common kid injuries that need special care. Some of the most common causes of these injuries include kids falling off playground equipment or trampolines, falling down stairs, or falling off a bed or another piece of furniture.

When these injuries are serious, kids often need the highest level of care – or what’s often called Level 1 trauma care. Why? These injuries can be more complex and may require expert care from several different pediatric trauma specialists.

Below, we cover common fall-related injuries, what you should watch for after a fall, and when urgent care, emergency care or even more specialized trauma care may be needed.

Head injuries in children

Concussions

Following a head injury, concussions (or traumatic brain injuries) are typically a big concern. Everybody can respond differently – particularly young children – so concussions can be a little tricky to diagnose. In general, some common concussion symptoms in children can include one or more of the following:

• Confusion or disorientation
• Clumsier that usual movements
• Deeper than usual sleep, difficulty waking up or extreme sleepiness
• Weakness or lack of energy – in children 3 months or older may not move for a long time or show any desire to move
• Vomiting
• Changes in behavior such as sadness, extreme fussiness or crying that won’t stop – which can be especially common concussion symptoms in babies and toddlers

Additional concussion symptoms in babies and toddlers to look for include:

• Lack of response to your voice or touch
• Inability to suck for more than two feedings in a row

When should I take my child to the hospital after they hit their head?

If your child hit their head and is experiencing any of the above symptoms, call their doctor right away. Your child’s doctor will likely recommend seeking care quickly, directing you to come into the clinic, go to an urgent care or head to the emergency room depending on the symptoms you describe.

More specifically, head to the emergency room – particularly one attached to a pediatric trauma center – if your child experiences:

• Skull deformity
• Short- or long-term unconsciousness – which is often the most easily recognized sign of a concussion in both children and adults, but not extremely common
• Memory loss surrounding the accident
• Crying that won’t stop
• Worsening of any other symptoms such as confusion, vomiting or weakness

Deep cuts to your child’s head or face

If your child falls and gets a cut on their head or face, it may bleed heavily even if the cut is minor. This is because there are a lot of blood vessels close to the skin’s surface.

When should I take my kid to the emergency room for a head wound?

Generally speaking, any significant cut on your child’s head or face – especially if it’s close to an eye – should be treated by a doctor.

Urgent care can be an option if:

• The cut has straight edges so the skin can be easily pushed together and stitched up
• The cut is more minor, but is embedded with dirt or debris, or caused by a dirty or rusty object

Take your child to an emergency room – again, ideally one with pediatric trauma specialists on-hand – if your child’s head or face wound is:

• Deeper or longer than a ½ inch
• Bleeding heavily or the bleeding hasn’t decreased after five to 10 minutes of direct pressure
• Causing numbness or inability to move fingers, toes, arms, legs, joints or other parts of their body
• Embedded with dirt, gravel or other debris
• Caused by a dirty or rusty object
• Has ragged or separated edges
• Extremely painful
• Showing signs of infection (e.g. increased warmth, redness, swelling or drainage, or foul odor)

Neck, back or spine injuries in children

Anytime your child hits their head or takes a bad fall, special attention should be paid to their neck, back and spine. The impact from a fall can cause a range of injuries to those body parts, from muscle strains to ligament tears to fractures.

When should I take my kid to the emergency room for neck, back or possible spinal injuries?

If your child fell on their back or neck, or hit their head, we suggest that you seek emergency pediatric trauma care if they have any of the following symptoms:

• Severe neck or back pain
• Inability to move a body part
• Weakness, tingling, or numbness in chest, arms or legs
• New loss of bowel or bladder control – which can be difficult to determine in infants and toddlers

Broken bones (or fractures) in children

If your child fractures a bone, medical attention will absolutely be needed. Some of the most common signs of a broken bone include:

• Pain
• Swelling
• Bruising
• Deformity – which means the limb, joint or bone doesn’t look like it normally does
• Difficulty moving that body part, or put any pressure or weight on the injured area

When should I take my kid to the emergency room for broken bones?

When it comes to seeking treatment at an urgent care or an emergency room, the severity and location of the fracture are two of the biggest factors.

Typically, urgent care – preferably an orthopedic urgent care – can be an option if the injury is not an open fracture (the broken bone did not puncture the skin) and is in one of the following areas:

• Hand
• Wrist
• Leg
• Ankle
• Foot

A trip to an emergency room or pediatric trauma center is likely needed if:

• There appears to be multiple fractures
• The bone has pierced through the skin
• The injury is to the:
  • Face
  • Neck
  • Sternum
  • Back
  • Hip
  • Ribs
  • Pelvis
• The swelling is increasing or skin begins to darken

Seek emergency care if your child is injured after a fall

Kids fall often and you’re always there to pick them back up. But if your child falls – and you’re not sure how serious their injuries are – call your doctor or go to the emergency room right away.

If you’re pretty sure your child’s injuries are serious and need specialized care, head to a pediatric trauma center. Level 1 trauma centers like ours at Regions Hospital have the staffing, resources and expertise to provide the highest level of care possible 24 hours a day, 7 days a week, and 365 days a year. In fact, our pediatric trauma program includes an ongoing partnership with Gillette Children’s Specialty Healthcare – an internationally renowned children’s health care provider that’s located just steps away from the Regions Hospital emergency wing.

Learn more about Regions Hospital Level 1 Pediatric Trauma Center – the east metro’s only Level 1 pediatric trauma center – located in downtown St. Paul.

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