Even the most loving and responsible parents can turn away for a moment and leave the baby unattended. Sometimes a few seconds is enough for the child to fall out of bed and hit his head. Fortunately, most of these falls pass without consequences for the baby. But the tactics of correct behavior in such a situation should be learned by all parents.
Traumatic brain injuries usually mean any damage to the bones of the skull and / or everything that is under it - the brain and its membranes, blood vessels and nerves. But the symptoms of such injuries in children and adults can be very different. This is due to some features of the child's head:
On the one hand, such plasticity of the skull and a large amount of fluid in it soften the blow, so children are rarely seriously injured after falls. But due to the immaturity of the cerebral cortex, strong blows can provoke a violation in its development and provoke long-term consequences in the mental or emotional sphere.
If the child fell out of bed, first of all it is necessary to evaluate his reaction. If the child lost consciousness even for a minute - immediately to the hospital. If there is no disturbance of consciousness, we observe:
In order to correctly assess the condition of the child and not harm him with his actions, it is necessary to behave correctly immediately after the fall:
At the same time, it is very important for the mother to maintain self-control. You need to understand that the well-being and behavior of the child largely depends on what the mother is doing at this moment. If the mother sits and cries or throws accusations at the "not noticed" relatives, the baby may also not behave as usual.
As a reassurance to mothers, it should be noted that most babies fall out of bed without consequences for them. In this case, the nervous system of the parents is much more traumatized.
In fact, a consultation with a doctor and an examination some time after the fall will be useful in any case. But, there are situations when you need to rush to the hospital at breakneck speed, and in others, communication with the doctor about the stroke can be quite postponed until a scheduled visit to the pediatrician. The most dangerous symptoms, regardless of the age of the child:
Also, the reason for immediate treatment in the hospital are any violations of the senses. Of course, a baby won't tell you that he's seeing double or that he can't hear you well. How smaller child, the more difficult it is to identify violations. You can show him bright toys and see if he follows them, track his reaction to sounds.
The smaller the child, the more fluid in his head. Therefore, falling from the sofa upside down is less dangerous for a 6-month-old than for a one-year-old baby.
If there are no alarming symptoms, then there is no need for immediate admission to the hospital either. At the next scheduled visit to the pediatrician, you can tell him about the incident and ask him to pay more attention to the baby. You can go to the hospital if the mother is very worried and this threatens her health. It's better to spend a little time and make sure that everything is fine than to suffer in ignorance.
Of course, it will be difficult for the baby to convey to his parents that he sees double. But the main markers, such as vomiting, crying in pain, will be very clear. If the child fell out of bed, watch him for two days.
Small children fall frequently. As soon as the baby begins to learn to walk, falls become an integral part of his life. Nature, of course, protected our children from serious injuries, but parents should not relax too much. There are times when falls can have serious consequences. Especially if the child hit his head.
The bones of the child are quite elastic. And this applies to the skull in the first place. So in most cases, when they fall, they simply shift and then return to their place. In addition, thanks to a large number cerebrospinal fluid, the brain of a child of 6 months suffers much less from strokes.
But this does not mean that if a child hits his head, for example, by falling out of bed, then parents should not do anything. Evgeny Komarovsky, a TV presenter and well-known pediatrician, recommends carefully examining the baby and, if necessary, providing first aid.
According to Komarovsky, the fall of a child is a completely natural thing. If the baby calmly stood up after hitting his head and is not very naughty, then he definitely has no serious injuries. However, it must be observed at least during the day. If during this period a 6-month-old person does not feel well, you can forget about worries.
At the same time, Komarovsky points out a number of rather serious symptoms, in the event of which parents should immediately show the child to a traumatologist:
1. Loss of consciousness.
2. Unusual behavior.
3. Periodic bouts of vomiting.
4. Violation of coordination of movements.
5. Changing the size of the pupils (often the pupils become different sizes).
6. Dark circles around the eyes.
7. Bleeding from the nose or ears.
According to statistics, most often children hit their heads at a very young age - 4-8 months. During this period, babies begin to move actively, and young parents often do not take this fact into account. It is enough to put the baby on the sofa and turn away for a bottle, as the child has already fallen head down to the floor. Komarovsky believes that such situations happen at least once in every family.
In such cases, parents should immediately take the baby in their arms and calm them down. Most often, the child was simply frightened and, feeling his mother's caress, he quickly calmed down. If one of the above symptoms is observed, then, according to Komarovsky, the following measures should be taken:
1. Examine the baby.
2. If there is a bruise, apply something cold to this place. Then closely monitor the behavior of the baby.
3. If symptoms of a serious injury are detected, call an ambulance immediately.
4. Before the doctors arrive, ensure the baby is completely calm, but at the same time do not let him sleep. This will prevent you from missing the appearance of other symptoms.
5. When laying the child down, make sure that his head and spine are at the same level.
6. If there is vomiting, the child should be laid on its side so that it does not choke on vomit.
Evgeny Komarovsky prohibits taking all other actions. By the way, he's not alone. Most pediatricians believe that only a professional can perform an examination. A non-specialist will easily aggravate an already difficult situation.
A six-month-old baby is easy enough to protect against head injuries. This is still not the age when the offspring rushes around the house or the street like mad. To do this, it is enough to follow a few simple rules. Of course, they were not invented by Dr. Komarovsky himself, but he strongly recommends that his patients listen to them.
1. You can not leave the baby alone on the changing table or on the sofa. If there is a need to leave the room, it is better to return the baby to his crib or pram.
2. Even being near the baby, you need to hold it with one hand in order to control his movements.
3. Do not leave the baby for a long time, even in his crib. At this age, children are already trying to sit down, and some even get out of their permanent place of stay.
4. During walks, you should also not relax, because an active child can easily fall out of the stroller. If the baby is already walking in a walking vehicle, then it is better to fasten it with seat belts. Such a measure will prevent the offspring from falling to the ground.
Such simple precautions will not only protect the baby from possible injuries, but also protect the parents themselves from unnecessary worries.
The appearance of a child in the family requires constant attention and care from adults. And although, as a rule, all family members are well aware of this and are completely absorbed by the child, nevertheless, there are cases when children of the first year of life, left unattended even for a short time, fall from a height (from a changing table, from a crib, a stroller). , from the hands of parents, etc.) and get a head injury (traumatic brain injury).
Traumatic brain injury (TBI) is a mechanical damage to the skull and intracranial structures (brain, blood vessels, nerves, meninges). The manifestation of traumatic brain injury in children differs significantly from the symptoms characteristic of adults, and they are due to the characteristics of the child's body, namely:
Thus, on the one hand, the brain tissue has great compensatory capabilities and the so-called margin of safety (soft bones of the skull and more fluid in the brain than in adults can absorb a blow). On the other hand, since it is precisely the immature brain tissue that is injured, this can lead to a disruption in the development of its structures and provoke further limitation of mental development, emotional disorders, etc.
Traumatic brain injuries are of several types:
concussion- A mild form of traumatic brain injury. Damage to the brain occurs at the molecular level (molecules are shaken), while its functions are disturbed, but there are no pronounced changes in the structure of the substance of the brain.
Brain contusion (contusio)- damage to the brain, characterized by the occurrence of a focus / foci of destruction of the medulla of varying severity. Foci can be single, multiple, different in depth and location. In this case, the patient develops neurological disorders (for example, the inability to make a certain hand movement, etc.) and / or psychological changes.
Brain compression (compressio)- severe damage to the substance of the brain, which, as a rule, occurs against the background of a brain contusion and extremely rarely without it. The causes of brain compression are the accumulation of blood inside the skull as a result of a ruptured vessel, or the brain can be compressed by fragments of the skull in the so-called depressed fracture.
Since the relative weight of the baby's head is much greater than the weight of the body, when it falls, it first of all hits the head and more often the parietal region. Very rarely, the frontal and occipital regions of the head are injured. After a fall, the child develops redness in the impact zone, the baby feels pain. If within a few minutes a pronounced rapidly growing edema does not appear in this place, but only a slight swelling is noted, then, as a rule, this indicates a bruise of the soft tissues of the head (which does not apply to TBI). Something cold must be applied to the sore spot (an ice pack, a towel moistened with cold water - do not forget to re-wet it periodically - etc.). A cold compress is applied for at least 5-15 minutes (or at least for as long as the baby allows it - often this procedure causes active protest), and most importantly - stay calm and try to calm the child. External signs of concussion in children of the first year of life are rather meager. For infants, loss of consciousness on the background of a concussion is a rarity, in contrast to children of preschool and school age and adults. Nor can they complain of a headache. They just immediately begin to cry loudly, there is motor anxiety. After screaming, they can fall asleep. Waking up, they are capricious, refuse food. Then there is vomiting (usually single) or frequent regurgitation. On the first night after an injury, children do not sleep well. The more pronounced these violations in the behavior of the child and the longer they last, the more likely the brain suffering. Another reaction to trauma is also possible: after sleep, the child's outward signs of trauma disappear and a false idea of recovery is created. This is a dangerous delusion: the baby's condition can deteriorate dramatically. If after the fall there was a long period of time (from one to several minutes) between the fall itself and the cry of the baby from the blow, most likely there was a loss of consciousness. The presence of such a symptom often indicates a brain injury. But sometimes in such a situation, parents lose track of time, it is difficult for them to navigate, a lot of time has passed since the child's fall or a little, there was a loss of consciousness or not. Even if the child just started screaming from the blow, but before that it was quiet for some time, this situation should alert parents and should be attributed to a more severe pathology. This will allow, without wasting time, to seek medical help and find out the severity of the injury. A contusion of the brain is accompanied by a violation of its blood flow of varying severity (from a decrease to a complete cessation), swelling of the brain substance, hemorrhages in the brain, and the development of paresis and paralysis is possible. Other signs of pathology are the same as with a concussion, but only more pronounced: repeated vomiting, prolonged anxiety, etc. With severe bruising of the brain, a coma develops. If, during a brain injury, a hemorrhage occurred in its substance, then this leads to compression of the brain, in which damage to the vital centers of respiration and cardiac activity is possible, which disrupts their functioning up to the complete cessation of the body's vital activity. As a rule, depression of consciousness is noted in children with intracranial hemorrhages. The degree of impaired consciousness may vary depending on the degree of brain damage - from severe drowsiness to coma. When falling from a height in children, fractures of the bones of the skull (open TBI) are possible, which can also compress the brain. Fractures of the skull bones in infants are most often identified by fissures and linear fractures. According to their localization, length, width, one can judge the severity of the injury. Thus, the divergence of the edges of a bone fracture may indicate that there is a rupture of the dura mater, and this is an indication for surgery. Depressed fractures (dents) are more rare. In this case, the bone is concave inside the skull, bone fragments compress the brain. These fractures also require surgery. A rapidly growing edema appears in the fracture zone, which may be the result of accumulation of blood in soft tissues (hematoma) due to damage to them by bone fragments. Often, it is the presence of such a swelling (bump) on the head of a child that makes parents see a doctor, while the very moment of injury or its consequences go unnoticed.
We strongly advise parents whose children have suffered a head injury: even if, in your opinion, the baby is not bothered by anything, he fell from an insignificant height, stopped crying, etc., immediately seek help from the following doctors: a pediatric neuropathologist, a traumatologist, a neurosurgeon. To do this, you need to call an ambulance team at home, and you and your child will be taken to a specialized hospital, or contact the indicated specialists yourself. If they do not confirm the pathology, it will be possible to safely return home. Failure to see a doctor is dangerous due to the late diagnosis of an injury, the aggravation of the course of its healing, and the possibility of coma. All this requires treatment in intensive care, in some cases - surgery. Seeing a doctor late increases the risk of death, prolongs the recovery period and worsens its outcome, to the point that the child may become disabled.
According to existing rules (standards), all children with traumatic brain injury must be hospitalized. Children with a concussion (a mild traumatic brain injury) can be treated in the neurological and neurosurgical departments. Patients with more severe forms of trauma should be treated in the neurosurgical department (if there is one in a particular region). To conduct reasonable targeted treatment, it requires a comprehensive examination of the child, which is possible only in a hospital. This examination includes thorough examinations of the nervous system, vestibular apparatus, organs of vision, hearing, and other studies. In the admission department, the child is examined, signs are identified that indicate damage to the bones of the skull or brain injury, parents are asked about the condition of the child after a fall, etc.
An important examination for head trauma in infants is neurosonography - a study of the structure of the brain using an ultrasound machine through the large fontanel of the child (such a study is possible until the large fontanel has closed - up to 1-1.5 years). This method is easy to use, does not have a negative effect on the body, provides enough information to determine the tactics of treating the patient. With its help, you can, first of all, exclude or determine the presence of intracranial hemorrhages (the most life-threatening). The only limitation of its use may be the lack of an ultrasound machine in the hospital or a specialist who knows how to work on it (for example, not all hospitals in the country with ultrasound machines can perform emergency neurosonography at night, since the specialist works during the day, etc. ).
If an intracranial hemorrhage is suspected (especially if neurosonography is not possible for various reasons), a lumbar puncture is performed - a therapeutic and diagnostic manipulation, in which a hollow needle connected to a syringe is punctured in the region of the second - fourth lumbar vertebrae of one of the spaces of the spinal cord (subarachnoid space) and taking a portion of cerebrospinal fluid for examination under a microscope. By the presence of blood cells in the cerebrospinal fluid, the presence of intracranial hemorrhage is judged. In addition, there are more sophisticated methods for examining a child's head: computed tomography (CT) and magnetic resonance imaging (MRI).
Computed tomography (CT) (from the Greek tomos - segment, layer + Greek Grapho - write, depict) is a research method in which images of a certain layer (slice) of the human body (for example, the head) are obtained using X-rays. With CT, the rays fall on a special device that transmits information to a computer that processes the received data on the absorption of x-rays by the human body and displays the image on the monitor screen. Thus, the smallest changes in the absorption of rays are recorded, which, in turn, allows you to see what is not visible on a conventional x-ray. It should be noted that the radiation exposure with CT is much lower than with conventional X-ray examination.
Magnetic resonance imaging (MRI) - a diagnostic method (not associated with x-rays), which makes it possible to obtain a layer-by-layer image of organs in various planes, to build a three-dimensional reconstruction of the area under study. It is based on the ability of some atomic nuclei, when placed in a magnetic field, to absorb energy in the radio frequency range and radiate it after the cessation of exposure to the radio frequency pulse. For MRI, various pulse sequences have been developed to image the structures under study to obtain the optimal contrast between normal and altered tissues. This is one of the most informative and harmless diagnostic methods. But the widespread use of CT and MRI in early childhood is difficult due to the need to conduct this examination in children in a state of immobility (under anesthesia), since a necessary condition for the successful implementation of the technique is the immobility of the patient, which cannot be achieved from an infant.
After the examination and clarification of the diagnosis, the tactics of treatment are determined. Children with mild traumatic brain injury are prescribed medication (therapy aimed at eliminating cerebral edema, lowering intracranial pressure, correcting brain metabolism, etc.). Surgical treatment is used (and necessary) primarily to eliminate compression of the brain. It is prescribed for children with depressed skull fractures and intracranial hemorrhages. Parents need to realize that only a comprehensive, adequate examination of the child allows him to correctly and timely treat his brain injury, achieve recovery and avoid his disability.
Research on the problem of traumatic brain injury shows that even a minor injury can cause undesirable consequences. Under the influence of trauma (the moment of mechanical damage to the substance of the brain) and its consequences, the functions of various parts of the brain are disrupted, and, consequently, the work of their subordinate organs and systems (endocrine, digestive systems, etc.). Blood flow may be disturbed, including the outflow of venous blood from the cranial cavity. The regulation of vascular tone suffers - they can narrow inadequately, leading to an increase in blood pressure. All this impairs the course of metabolic processes in the brain, as a result of which brain cells can be replaced by cystic cavities, that is, holes filled with fluid form in their place, and in the place where these cysts exist, certain brain functions fall out. For example, the frontal lobes are responsible for intelligence - So, the presence of cysts in this place reduces it. In addition, it is known that the normal brain, inside and out, has cavities filled with cerebral (cerebrospinal) fluid. After an injury, it can accumulate excessively in the cranial cavity - and therefore, intracranial pressure increases. The fluid under pressure compresses the substance of the brain, causing its slow atrophy (these phenomena are also characteristic of the formation of cysts). The triggering of these pathological mechanisms depends on the severity of the injury: the more severe it is, the more pronounced the violations, the worse the outcomes, and the longer the recovery period. With mild traumatic brain injury (TBI), the prognosis is usually favorable - subject to the recommended regimen and treatment. After recovery, asthenization phenomena are possible - the child quickly gets tired, becomes inattentive, irritable. In this case, the baby is more inhibited, which can lead to repeated injuries. These phenomena can affect the child's intellectual development in the future. With TBI of moderate severity, it is often possible to achieve a complete recovery of activity, although a number of children develop asthenia, increased intracranial pressure, frequent headaches, and impaired coordination. In severe TBI, the prognosis may be unfavorable - mortality in these cases reaches 15-30%. After recovery, a wide variety of consequences are possible: from varying degrees of motor disorders, pronounced convulsive seizures to gross mental disorders, consciousness, which leads to disability. With open TBI, purulent-inflammatory complications often occur (for example, meningitis - inflammation of the meninges, etc.). ), which can also lead to death. There is still no clear answer to the question of how long it takes for the body to fully recover even after mild TBI. It was believed that after such an injury, recovery occurs within a few days, a maximum of 2-3 weeks. Nevertheless, studies have shown that 1-3 months after a concussion, at least half of the children have some or other deviations from the norm, which sometimes persist for a longer time. The speed of recovery depends primarily on the severity of the injury, the age and previous state of health of the child.
Injuries in children occur most often in the presence of adults, and this once again indicates our inattention or frivolity and carelessness, as well as the fact that we have a poor idea of the motor skills of the baby. Parents should provide for the emergence of new motor skills in the child and take safety measures. So, a month-old baby, lying on his stomach, can push off with his feet from the side of the changing table, from the back of the sofa, bed and fall. Each next skill or movement of the baby (attempts to sit down, crawl, stand, etc.) can also lead to "unexpected" injuries. A child, trying to get up, may fall out of the stroller, out of the child's chair, especially if they forgot to fasten it. Parents, unaware of the new possibilities of the baby, are unnecessarily careless, leaving him unattended. If you need to move away, do not leave the child alone lying on any high (and not very) surface, put the baby in a crib, playpen, or even on the floor. Secure your child in the highchair and stroller. If your home has stairs, put up a safety rail to prevent your baby from falling down or climbing high and then falling. "Walkers" can also be unsafe: children, while in them, can strongly push off, hit something, roll over, and also fall down the stairs. It is better to refuse to use such a vehicle. "Jumpers" are dangerous because of the unpredictability of movements: for example, a child in them may collide with a wall. The most important role in reducing child injuries is given to prevention, and the main thing in it is the attentive attitude of adults to children and their safety. Among the various injuries of the body, head injuries account for 30-50% of all injuries in children. And every year this figure increases by 2%.
Unfortunately, often the baby is on the floor. What are the actions of parents in this case?
A small child is surrounded by care and attention from birth. His relatives are doing everything possible so that nothing threatens the health of the crumbs. But even the most attentive mother can make a mistake. Sometimes it is enough just to turn away for a second - and the baby is already on the floor.
The fact is that not everyone correctly imagines the possibilities of crumbs. Even a newborn child, making chaotic movements with arms and legs, may well move to the edge and fall, although the likelihood of this is small.
Especially dangerous places from which a fall is possible for babies under 6 months old are the changing table, the sofa, and the parents' bed. After six months, the baby begins to actively master new movements, learns to sit, crawl, stand on his feet at the support, and then walk.
At this age, he may fall out of his crib, from a highchair, from a stroller, etc.?
Most often, when falling, babies hit their heads: up to 1 year old, the head is the most vulnerable place due to its rather large size and mass in relation to the body. But damage to other parts of the body is also possible. Most often these are bruises, in rare cases - a broken bone or a traumatic brain injury (TBI).
Headbutting in babies under 1 year old is a fairly frequent phenomenon, while they do not have to fall at all, because the baby can accidentally hit the surrounding objects or furniture, making active movements. In this case, basically everything goes without consequences: there is not a traumatic brain injury, but only a bruise. However, when falling from a height, the likelihood of a traumatic brain injury (TBI) increases many times over.
Traumatic brain injury is a mechanical damage to the bones of the skull and soft tissues of the head (the brain, its vessels, cranial nerves, meninges).
Traumatic brain injuries include:
concussion (a mild form of TBI - there are no obvious changes in the structure of the brain, but functional activity may be impaired);
brain contusion of varying severity (accompanied by the destruction of the medulla in a certain area, causing severe functional disorders);
compression of the brain (severe pathology that occurs against the background of a brain contusion or rupture of a large blood vessel, which leads to the formation of an intracranial hematoma).
In children with typical falls, cerebral compression is extremely rare. To sustain this injury, the child must fall from a height of at least 2m or hit a very hard or sharp object.
We assess the situation. The symptoms of a traumatic brain injury in a child are not the same as in an adult, which is due to the peculiarities of the structure of the skull and the internal structures of the infant's brain. In some cases, a long asymptomatic course of TBI is possible or, conversely, a rapid manifestation of symptoms with minimal trauma. This is due to the flexibility of the bones of the skull, their mobility relative to each other in the region of the sutures, as well as to the age-related anatomical and physiological features of the brain. The brain cells in the baby are not yet fully differentiated, i.e. there is no strict division into zones of brain functions, therefore, the symptoms are most often blurred.
When hitting the head, the baby feels pain, redness appears at the site of impact. In the future, a slight swelling may develop. If nothing else has alerted you, you should not worry: this is not a traumatic brain injury, but a bruise of the head tissues. In this case, it is necessary to give the child a cold compress and calm him down. Cold constricts blood vessels, stopping subcutaneous bleeding, has anti-inflammatory and some analgesic effect.
For a compress, an ice pack, a small plastic bottle of cold water, and any cold non-traumatic object will do. It must be wrapped in a diaper or towel, applied to the site of injury and held for 10-15 minutes. It is important that the exposure to cold be directed strictly to the bruised place - the surrounding tissues should not be affected. If the child does not allow the compress to be kept - he is naughty, dodges, - you can moisten a gauze, bandage or piece of cloth in cold water and tie it to the damaged area. The bandage should be changed as it warms up for half an hour.
Loss of consciousness can be one of the symptoms of a brain injury. But for babies, this phenomenon is quite rare, and often it does not accompany even severe damage. This is due to the underdevelopment of the cerebellum and the vestibular apparatus as a whole in infants, which are responsible for the coordination of movements. You also can't tell if the baby is having a headache. Thus, the most characteristic signs of a traumatic brain injury in infants are:
These signs are characteristic of a concussion. For a brain contusion of varying severity (damage to the medulla itself), the following symptoms are characteristic, in addition to the above (or without them):
There are three ways to evaluate a child's consciousness after a fall:
You can make such an assessment a few minutes after the fall, when the baby has already come to his senses. Normally, he should move normally, coo (or utter syllables) and open his eyes in the same way as he always did.
A dangerous symptom is a temporary external improvement, when after sleep the external signs of trauma that were present earlier disappear in the child. But after that, the condition of the baby can deteriorate dramatically.
There are also open craniocerebral injuries, when the integrity of the bones of the skull, and possibly the dura mater, is violated. In this case, there is a risk of infection of the brain tissue.
Thus, there are a lot of signs of brain injury. Therefore, parents should be alerted by any deviation from the usual behavior of the baby. You need to see a doctor in any case if the child has fallen and hit his head. If everything was limited to a bruise of the soft tissues of the head without other pathological signs, you need to show the baby to a pediatrician and a neurologist in the clinic. If symptoms of a brain injury appear (especially loss of consciousness and lack of reactions to external stimuli - light, sounds), as well as with an open craniocerebral injury, an ambulance should be called immediately.
If the blow to the head was not accompanied by the appearance of dangerous symptoms (for example, loss of consciousness), the child should be shown to the pediatrician on the same day or, in extreme cases, the next day after the injury (you can call the doctor at home or bring the baby to the clinic). If necessary, the pediatrician will refer the baby for a consultation with other doctors (neurologist, traumatologist).
Delay in seeking medical help is fraught with a deterioration in the child's condition.
All that a mother can do before the doctor arrives is to calm the baby, put a cold compress on the site of the bruise and ensure peace for the baby. If a child has an open craniocerebral injury, you need to cover the damaged area with a sterile gauze bandage and urgently call an ambulance. With an open craniocerebral injury, cold cannot be applied.
When the doctor arrives, he will examine the child and, if necessary, take you and your baby to the hospital for additional tests and treatment.
The first link in the diagnosis is an examination by a doctor. The doctor assesses the general condition of the child, his consciousness, the state of reflexes, physical activity, the integrity of the bones of the skull. The appointment of further studies depends on the preliminary diagnosis after examining the crumbs and on the capabilities of a particular medical institution. Sometimes only one study is enough to make a diagnosis, and sometimes, if doctors have doubts, they have to be done several at once.
If the large fontanel on the top of the baby has not yet grown over, it is possible to conduct neurosonography in a hospital or clinic - an ultrasound examination of the brain through a large fontanel. X-ray computed tomography (CT) is widely used in the diagnosis of brain pathologies. Currently, CT is the most reliable method for examining the brain.
Magnetic resonance imaging (MRI) is not related to X-rays, but is based on the absorbing abilities of magnetic fields. MRI provides a more contrast image of brain tissue than CT. However, CT and MRI are rarely prescribed for infants, since one of the conditions for their implementation is the complete immobility of the patient, which is almost impossible to provide with a small child. These studies for babies are possible only under anesthesia if absolutely necessary.
To assess the integrity of the bones of the skull, craniography (X-ray of the skull) is performed. Ophthalmoscopy - examination of the fundus - is an additional method of research. It allows you to identify signs of increased intracranial pressure, which is important for the diagnosis of intracranial hemorrhage or cerebral edema.
Lumbar puncture is a more reliable diagnostic method for suspected intracranial hemorrhage. Liquor is taken with a needle inserted between the spinous processes of the 3rd and 4th lumbar vertebrae. But during the puncture, the child must be motionless, since there is a risk of damage to brain tissue.
Treatment is based on examination data and clinical studies. With concussion and bruises of the brain, treatment is usually medication. With a concussion, a baby is usually treated at home, and with bruises of the brain - in a hospital. As a rule, the child is prescribed drugs that have anticonvulsant, antispasmodic, hypnotic effects. Also, the crumbs will recommend rest for 4-5 days. The word “peace” for a baby should be understood as the absence of new impressions, limiting the number of people around to mom and dad, maintaining silence in the room where the baby is.
After a concussion, the brain usually recovers within 1-3 months without any long-term effects. With more serious injuries - bruises of the brain - the consequences depend on the severity of the damage. They can vary from dizziness and incoordination to increased intracranial pressure and epileptic seizures (convulsions with loss of consciousness).
The result of a severe injury may be psycho-emotional disorders (up to dementia) or movement disorders (for example, the inability to make any movements). With open craniocerebral injuries, there is a risk of infection of the brain tissue (encephalitis) and the development of meningitis - inflammation of the membranes of the brain.
If the baby does not hit his head ...
The first step is to quickly assess the condition of the child and examine the site of the bruise. If you saw the very moment of the fall, then finding the place of possible damage is not difficult. If you were not around, you should, if possible, reassure and carefully examine the baby.
We assess the situation. The site of the bruise can be seen by the characteristic redness that appears in the first seconds after the fall. Over the next few minutes, it is possible to increase the reddening of the skin, as well as the development of swelling, followed by the formation of a hematoma. A hematoma occurs when a large number of subcutaneous blood vessels rupture from impact, resulting in accumulation of liquid blood in the tissues, which has a red-burgundy color. A small hemorrhage cannot be called a hematoma - it's just a bruise (a bruise when a small number of subcutaneous blood vessels are damaged).
When the site of the bruise is found, you need to immediately make the baby a cold compress, as described above - in the section on TBI.
With a normal course, the hematoma decreases every day, and its color changes. A fresh hematoma is dark red, gradually turning blue, and then yellow. To speed up the resorption of the hematoma, you can use heparin-containing ointments that prevent blood clotting and, therefore, have a resolving effect, or make an iodine mesh, which has a similar effect.
Parents should be alerted by the reddening of the skin over the hematoma that suddenly appeared during the healing period (in the first 2-3 days after the injury), the baby’s general malaise, the rise in body temperature, the increasing pain at the site of the injury (the child in this case will begin to show anxiety, and when touched hematomas will respond with a sharp loud cry). All this may indicate suppuration. In this case, the baby must be urgently taken to the surgeon. He will open the hematoma so that the purulent contents can flow out, and apply a bandage.
If, after falling, the hematoma continues to increase in size, you should also urgently consult a surgeon, as this may indicate continued bleeding. If the baby remains restless with a visible bruise, it is better to consult a doctor, since the crumbs may have a bone crack. This phenomenon occurs in young children more often than a fracture. You can suspect a crack when swelling appears at the site of impact, and also if the baby starts to cry when you try to move his injured limb.
Inspecting the impact site, it is important to determine if there is a fracture. Its signs:
severe pain at the fracture site; if a limb is broken, it will be very painful for the baby to move it;
severe swelling and bruising at the fracture site;
change in the shape or length of a broken limb (shortening or lengthening);
limitation of limb mobility or, conversely, its excessive mobility;
crunching when moving the injured limb.
If one or more of these signs appear, you should call an ambulance. In this case, the injured area should, if possible, be immobilized, for example, with a stick or plank tied with any piece of tissue to a broken limb. If the child cannot calm down due to pain, you can give him an anesthetic based on PARACETAMOL or IBUPROFEN in accordance with the age of the baby and the dosage indicated in the instructions for the drug.
If there is an abrasion at the site of the bruise (this is possible when falling on an uneven floor), you need to do the following:
In the hospital, after the examination, the doctor may prescribe an x-ray, and then, depending on the severity of the damage, measures will be taken:
The imposition of a splint - one-sided gypsum in the form of a long strip - consisting of several layers of a plaster bandage, which is shaped into an injured limb and fixed with a bandage (for simple fractures without displacement of bone fragments).
An operation lasting several minutes under general anesthesia, followed by the application of a plaster cast (for fractures with displacement and comminuted fractures). During the operation, bone fragments are compared, which is necessary for a full restoration of function and the absence of complications after a fracture.
When applying a splint, you and your baby will need to visit a traumatologist for examination.
ra once a week - provided that redness does not appear under the bandage and there is no loss of sensitivity of the injured limb. (Parents should be alerted by blanching, as well as coldness of the injured limb relative to other parts of the body).
If an operation is required, then you and your baby will have to stay in the hospital for 3-5 days so that the doctors make sure that everything went well. Then the baby will be discharged home with a cast, and the traumatologist will observe him on an outpatient basis.
The gypsum, as well as the splint, are removed when the bone is completely fused, which can be checked by taking an x-ray. Depending on the site of the fracture, the duration of this period can range from 2 weeks (for example, with a fracture of the phalanx of the fingers) to 3 months (with damage to the bone lower limb and pelvis).
As already mentioned, babies fall most often due to the fact that parents underestimate their capabilities. Very young, newly born children also fall - most often due to the fact that mothers leave them unattended on the changing table to run for cream or answer the phone. Making chaotic movements, the baby is able to move quite well, so in no case should you leave even a newborn child alone where he can fall. In order not to be absent during a diaper change, changing clothes, etc., prepare everything you need in advance. And if you need to answer the phone or open the door, it is better to take the baby with you or put it in a crib. Do not leave the baby unattended on an adult bed or sofa. Although their height is less than, for example, a changing table, for a small child this can be enough to cause serious injury.
It is also necessary to raise the side of the bed in a timely manner when the baby learns to roll over. And when the child starts to get up, it is necessary to lower the bottom of the crib - preferably to the lowest level, so that the baby cannot fall out, leaning over the sides.
In order to be able to leave the baby alone and not be afraid for his safety, you can purchase a playpen or make the floor in the room as safe as possible (remove wires, put plugs on sockets, remove all small and traumatic objects, put blockers on boxes that the baby can reach, protect sharp corners of furniture).
Statistics show that very often babies fall out of highchairs or strollers. Therefore, putting the baby on a chair, you should definitely fasten it with a five-point seat belt. A baby carriage should also be equipped with such belts, and you should definitely use them, even if the baby is constantly in your field of vision. After all, even if the mother is distracted only for a second, there is a risk that the child will fall. And the consequences of a fall, as we have seen, can be very severe.
Responsible parents know that a baby should not be left unattended even for a minute. But it is simply unrealistic not to take your eyes off him for 24 hours. After all, adults have a lot of things that they try to do while the baby sleeps or entertains himself. Often the carelessness of parents leads to very deplorable consequences for the child. Just a couple of minutes ago, my mother admired the crumbs dozing on the parental bed, and after a moment the child fell out of bed.
Babies are quite mobile and often parents underestimate the level of their activity. If newborn babies lie quietly in one place, then slightly grown-up babies make attempts to roll over from their back to their stomach or crawl towards an object. And their efforts can be crowned with success at any moment, resulting in a fall out of bed. Therefore, when the baby is 3-4 months old, parents need to tighten control over him.
According to statistics, a third of infant injuries are accidental falls due to neglect by adults.
Toddlers break off the edges of sofas, crawl over the sides of cribs, roll off chairs and changing tables, fall out of strollers. Fortunately, the lion's share of such incidents is pumped with bumps and a general slight fright. However, in some cases, much more serious consequences are observed. After all, when falling, children usually hit their heads. This is due to the disproportion of the infant body. The head of the baby is almost four times heavier than its body. As a result of a blow, the crumbs can experience a concussion or swelling of the brain, and even a traumatic brain injury.
In critical situations, many people panic and behave irrationally. The category of such cases includes the fall of the baby from the bed. If some parents start sounding the alarm out of the blue and immediately call the ambulance, others, on the contrary, try to maintain their composure, not reacting to injuries and heart-rending cries of the baby. Meanwhile, there is a certain algorithm of actions that must be followed when a child falls.
Let's describe it in more detail:
Nature has taken care to protect the baby's body from various damages. For example, the fontanel prevents light tremors, softening the effect of a blow. In any case, the fall of the child from the bed should be a serious lesson for parents, which will teach them a more responsible attitude towards the safety of the baby.
Komarovsky Evgeny Olegovich, pediatrician: “Nature has provided certain protective mechanisms for babies that make hitting the head less risky than for grown children. This is due to the presence of fontanelles, which act as a kind of shock absorbers. In addition, between the bones of the skull and the brain in any person there is a certain amount of fluid that performs a protective function. Small children have much more of it. Therefore, in most cases, the fall of babies ends safely.
First of all, you need to examine the bruised place. If abrasions appear in a child as a result of falling upside down, they should be treated with a solution of hydrogen peroxide. It is recommended to attach a piece of ice wrapped in a towel or any other cold object to the swelling cone. As practice shows, forehead blows are much less dangerous than bruises in the temporal or occipital regions. If after the fall the baby cried a little and calmed down, do not relax and lose vigilance. After all, the consequences of an injury can appear after several hours and even days. Therefore, parents need to monitor the condition of the crumbs for two days and consult a doctor in case of changes in behavior.
After falling out of bed, the child may act normally. After crying a little, he begins to eat or play with his parents with appetite. However, after some time, alarming symptoms may appear, indicating the presence of a concussion. Among them it is worth mentioning:
What to do if the baby fell out of bed and after some time at least one of the mentioned symptoms appeared? The only answer is to take the child to the hospital. If, as a result of a bruise, the baby lost consciousness, but then came to his senses again and began to behave as usual, he should still be scheduled for an appointment with a doctor.
It is quite obvious that babies can only show their discomfort through crying. Whereas older children are already able to complain to adults about ailments. In addition to these symptoms, children may experience tinnitus, visual and olfactory hallucinations. A speech disorder after hitting the head is also an alarming sign that requires medical attention.
According to doctors, about 90% of all falls of babies end in the worst case with only a slight concussion, and at best with bumps and abrasions. The remaining 10% includes more serious injuries requiring urgent medical attention. In order to take timely action and send the child to the hospital, parents need to assess the possible consequences of a fall. Let's dwell on them in more detail:
The baby screamed after the fall, but soon calmed down and began to behave as usual. But after a few hours or even days, a soft swelling appeared on the scalp of his head with fluid accumulated under the skin. In this case, it is necessary to consult a doctor to exclude the possibility of brain injury. Confirmation of the diagnosis is fraught with the occurrence of headaches in the baby up to the age of two, as well as a decrease in vision and hearing.
The baby did not start screaming immediately after the fall, or after crying immediately, he cannot calm down for a long time. The baby refuses food, does not take a breast or a bottle.
His movements are uncoordinated, his condition is lethargic and drowsy. The child shows irritation and discontent for any reason and without it. His pulse accelerates or, on the contrary, slows down, the fontanel swells, cold sweat appears on the body. Vomiting may also occur. Particular attention should be paid to the pupils of the baby. Their unequal size is an obvious evidence of traumatic brain injury. If these symptoms are found, it is necessary to immediately call an ambulance and prevent the baby from falling asleep until the doctors arrive. A clear liquid oozing from the child's ears with an admixture of blood is a sure sign of a fracture of the cranial vault, requiring urgent surgical intervention.
Svetlana, mother of six-month-old David: “At 5 months old, my son fell off the changing table. A friend came to visit, I went to the kitchen to make coffee and left the baby with her. She did not keep track of her son and David fell to the floor. He did not lose consciousness, but turned pale for a couple of minutes, went limp in his hands, his movements became inhibited. I decided to play it safe and called an ambulance. We were taken to the hospital. While the doctors were examining my son, he was cheerful and cheerful, "communicated" with them, roared. There was no vomiting, on the contrary, the baby ate tightly. Imagine my surprise when we were diagnosed with a fracture of the left temporal bone. I was immediately reassured and told that there was nothing to worry about. Soon the crack will grow and everything will be forgotten like a bad dream.”
It is worth noting that all these signs apply to children of any age. Whether a 6-month-old baby falls out of the crib or a 3-year-old accidentally slips off the couch, the consequences can be exactly the same. The only difference is that older children are able to describe the symptoms that disturb them.
The surest way to keep your baby safe is to keep your eyes on him. But it is unlikely that this recommendation will be implemented. After all, parents also need to eat, sleep, go to the bathroom and toilet, and do household chores. Therefore, the best solution would be organization of a safe place for games and pastime baby. If the baby is barely 3 months old, and he still does not know how to crawl, the best option would be a floor covered with a bedspread. Surrounded by toys, the baby will be able to learn coups on the side and tummy in a comfortable environment. Babies up to three months of age should be placed on an adult bed, only with pillows on all sides.
The best solution for babies 7-8 months will be spacious arena. In it, parents will be able to leave an already briskly crawling baby without fear that he will get to forbidden and dangerous objects. Of course, in this case, it is necessary to take care of the crumbs' leisure, otherwise, very soon, he will get bored and begin to demand the attention of his parents. Children who have learned to sit love to throw toys out of the arena, watching them fly. And older babies learn to stand up and walk, holding on to high sides. However, pediatricians recommend using this device only in special cases, because it limits the motor activity of the crumbs.
Side on the bed will become an indispensable assistant for parents who care about the safety of their baby. After all, a significant part of the falls occurs in a dream, when an already grown child tosses and turns from side to side. If the bars of the baby crib reliably protected the baby, then when moving to a more “adult” bed, the baby is exposed to certain risks. Special bumpers, enclosing the lion's share of the bed, will protect the child from falling during night or daytime rest. In this case, the baby will be able to independently climb onto the bed and get off it. Devices are both unilateral and bilateral. You can take them with you on vacation or to visit with an overnight stay, which is very convenient. The limiter consists of a metal frame and a bed net stretched over it. Fastening the accessory is very simple - just refuel it lower part under the mattress.
Elena, Kira's mother (1 year 7 months): “When my daughter was one and a half years old, we bought her a nice bed with drawers at the bottom. The little girl liked her very much. However, on the very first night, the daughter fell to the floor and cried for a long time. Apparently, before the baby was "saved" by the rods on the old crib. For the next few nights, I couldn't sleep well. Constantly shuddered, if the daughter began to spin, followed her. By the way, we live in the same apartment with our parents and sleep with the child in the same room. Upon learning of my torment, a friend advised me to buy a side on the bed, which I immediately did. The whole family breathed a sigh of relief, because now the baby is safe.
Thus, the most vulnerable place in an infant is the head. It is with it that the baby first of all hits the floor, falling from a height. Fortunately, most of these incidents end with a maximum of a small concussion. However, in some cases, the consequences of hitting the head can be very, very deplorable. Therefore, parents need to be extremely responsible for the safety of the child, protecting him from possible threats and traumatic situations.
