Most head injuries are not serious and simply cause a bump, bruise or cut.
If your child’s head is bleeding, apply firm pressure with a clean flannel or cloth for 5 or 10 minutes. If it continues to bleed, they may need to have it closed. Stitches are rarely required and very often paper stitches (Steristrips) or skin glue can be used. This can usually be done in a minor injuries unit or local Emergency Department. Some GPs also assess and treat minor injuries.
A significant head injury can result in concussion. A child or young person does not have to have been unconscious or ‘knocked out’ for concussion to occur. Common symptoms of concussion include headache, fatigue, poor sleep and difficulty concentrating / learning.
Watch this Operation Ouch video on head injuries that you can watch with your child:
Check if your child has any red symptoms:
- Your child is behaving oddly such as becoming confused or unaware of their surroundings.
- Cannot remember events (amnesia) for more than five minutes.
- Loses consciousness, becomes drowsy or difficult to wake.
- Has a convulsion or fit.
- Has a headache that is getting worse.
- Develops difficulty speaking or understanding what you are saying.
- Develops weakness in their arms and legs or starts to lose their balance.
- Develops problems with their eyesight.
- Has clear fluid or blood coming out of their nose or ears.
- Does not wake for feeds or cries constantly and cannot be soothed.
- Has a large swelling or laceration (cut) bigger than five centimetres (if your child is under one year of age).
- Has bruising around their eyes or behind their ears.
- Vomits repeatedly (more than twice, at least 10 minutes between each vomit) especially if there are no signs of another illness (such as fever or diarrhoea).
You should also bring your child to hospital if the ‘mechanism’ of injury was significant – such as being involved in a road traffic collision – and displaying any symptoms.
Actions to take if your child has any red symptoms
- Your child may require emergency treatment.
- You should call 999 or take them to your NEAREST Emergency Department where they can be assessed.
If there are no red symptoms, check if your child has any amber symptoms:
- Your child develops a persistent headache that does not go away (despite painkillers such as paracetamol or ibuprofen).
- Develops a worsening headache.
Options if your child has any amber symptoms
Your child does not need to be taken to the Emergency Department immediately, but you should seek medical advice today.
- ring your GP surgery during their usual opening hours
- contact the out of hours GP if the surgery is closed
If symptoms continue for four hours or more and you have not been able to speak to your GP or the out of hours GP, consider going to your nearest Emergency Department.
If your child develops any of the red symptoms above, go to your nearest Emergency Department.
- Your child is alert and interacts with you.
- Vomits, but only up to twice.
- Experiences symptoms of concussion such as mild headaches, struggling to concentrate, lacking appetite or having problems sleeping – if you are very concerned about these symptoms or they go on for more than two weeks, contact your GP surgery.
If no red or amber symptoms are present:
- your child does not seem to have any symptoms of serious illness or injury
- you can get general advice on the NI Direct website or from your local pharmacy
If your child develops any of the red or amber symptoms above, follow the advice in these sections.
How you can help manage your child’s head injury at home
- This app from the Child Brain Injury Trust can provide you with more information about concussion.
- In general, if your child cries immediately after a head injury and returns to their normal self in a short time, they can be managed at home. You should observe them closely for the next couple of days, checking that they are responding normally to you. They may be pale or quieter than normal for the first couple of hours after a head injury, but this is normal.
- Let your child rest and try to avoid strenuous activity until their symptoms have settled.
- Give them paracetamol every six hours and / or ibuprofen every eight hours if they are in pain.
- If your child has been concussed, a graded return to normal activities / school is always recommended. It is best to avoid computer games, sporting activity and excessive exercise until all symptoms have improved.
- Download this advice leaflet on concussion from Alder Hey Hospital – please note NHS 111 is not available in Northern Ireland.
- Download this advice leaflet on head injury from Alder Hey Hospital – please note NHS 111 is not available in Northern Ireland.
- Your child is likely to return to normal within a few hours of a minor head injury.
- In the few days following a more significant head injury, your child may experience mild headaches, be irritable, struggle to concentrate, lack appetite and have problems sleeping. If these symptoms go on for more than two weeks, contact your GP surgery to arrange a review.
- If it is non-urgent, speak to your local pharmacist or health visitor.
- Alternatively, you can contact your GP practice and a qualified member of the clinical team will check whether your child needs to be seen urgently. Out of hours GP details are available here.
- You should only call 999 or go your nearest Emergency Department in critical or life-threatening situations.
- See our section: How does the Children’s Emergency Department Work?