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Head injuries: is a trip to the ER always necessary?


(Chelsea Update would like to thank Dr. Barry Nemon and Chelsea Community Hospital for the information in this story.)

Well, it’s summer and as director of the ER, I’m discussing some of the more common seasonal complaints.

Two weeks ago, I talked about what do if you’re stung by a bee, this week I look at head injuries.

What should you do if your child fell off a picnic bench and hit his (or her) head?

Everyone has heard about serious head injuries when a diagnosis has been delayed. But, do you always need to be seen immediately and get a CT scan?

How is a parent to know?

  • Did your child lose consciousness more than a few seconds?
  • After the injury, is your child acting completely normal?
  • Is there persistent vomiting (not just one episode)?
  • Is there swelling of the scalp (most important if your child is less than 2)?
  • Is there a persistent headache?
  • Was it an accident that had a bad “mechanism” such as a bike?
  • Under 2 years, a fall greater than 3 feet or at high speed
  • Over 2 years, a fall greater than 5 feet or at high speed

These are general guidelines, but parents seem to know when things are not quite right.  If there is a concern, do not hesitate to have your child seen by a doctor.

Sometimes we are asked by parents if they have wasted the ER’s time by bringing in their child when we do not order a CT scan.   The simple answer is “no”.  We may not get a CT scan, but we would rather see your child if there are any concerns.

What if you twist your ankle, do you always need to be seen and get an x-ray? I’ll discuss this issue in two weeks.

Stay safe and enjoy your summer.



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