Baby falls, do you want to do head CT？ See what the pediatrician says.

Original medical xiaobai medical pediatric channel

What should I do immediately after a fall?

On duty today, a mother called and asked:

My baby is 4 years old. I was playing with a scooter at home around 2 pm, and I accidentally fell. My head hit the table, but there was no bleeding. At that time, I felt my scalp and bulged a bag. With ice, the lump went down, and the child didn’t say anything else was uncomfortable, so he continued to play. I had a headache at dinner just now, and I felt a little nauseous and nauseous. Do you need to have a head CT?

Open the news web page, enter "children fall" in the search engine, and you can see all kinds of events about children fall.

In real life, the incidents of falls are also endless, and almost every day there are children who come to see a doctor because of "falls" and "bumps".

▋ So, why do babies fall more easily?

Babies under 3 years old often fall down from the corridor due to poor care of adults, or sitting on a high platform without protection, or even teasing young children to throw their hands.

Children aged 5-9 have just left adult care to go out alone, lacking safe and dangerous experience, and often have been involved in risks without knowing it. At the same time, children of this age are curious and active, like to chase and fight, climb high at risk, lack safety self-control, and easily slip and fall in play, causing tragedy.

Children over the age of 10 fall mostly in sports and entertainment, such as falling when they are chasing and playing with classmates during recess, slipping or being knocked down while running in physical education class, or falling on skating or skateboarding.

▋ What factors are related to whether the baby falls seriously or not?

▼ Fall height

The higher the drop, the heavier the injury and the more complicated the injury. The study found that children with falling falls below 3m were mainly fractured limbs; The possibility of head and abdominal organs injury increases for those who fall more than 3 meters.

▼ Landing position

Compared with adults, children’s heads account for a large proportion of their bodies, and when they fall, their body center of gravity moves to the side of their heads, so that their heads often land first; If you fall from a height, trying to stretch your arms to stop the downward impact at the moment of landing often causes upper limb injuries and head injuries to coexist. Therefore, among the fall injuries, children have more brain injuries and limb fractures than adults.

▼ Age and weight also have a certain influence on the injury.

The greater the mass, the greater the impact force on the ground when landing, and the stronger the recoil force on the ground, thus aggravating the damage.

▋ What are the general performances after a fall?

Local hematoma

bleed

Headache, vomiting

agitated

somnolence

Irritate

lags in response

Coma convulsion

Limb movement disorder

▋ What circumstances should I see a doctor in time?

Fall from a height of 1-2m.

Hit by a high-speed flying object

Hit by a high-speed vehicle

Loss of consciousness after a fall or failure to wake up for several minutes

Frequent vomiting

Obvious headache, dizziness, or gradual aggravation of symptoms.

convulsion

Sleepiness after a fall (you can simply answer after waking up and fall asleep soon), poor spirit, blurred consciousness or coma (you can’t wake up)

Hemorrhage of nasal cavity and external auditory canal, ecchymosis behind ear, panda eye

Unresolved emotional excitement, screaming.

A child whose fontanel is not closed, whose fontanel bulges.

Weakness or rigidity of arms and legs, clumsy walking posture, slurred speech, squint or inability to see clearly.

Bleeding

▋ Possibly, 100% treasure mothers would like to know: What should the baby do the first time after a fall?

Although they are worried when they see their children fall or get hurt, they should keep calm.

Never pick it up immediately, wait for a few seconds, remember the baby’s falling posture, so as to judge where the impact is serious, so as to accurately inform the doctor.

At the same time, observe whether the baby is inconvenient to move, so as to judge whether the baby has serious trauma such as dislocation and fracture.

If you see your baby bleeding, be sure to press the wound to stop bleeding, and don’t rub it.

If the wound looks very light, but only scratches a little skin, iodophor can be used to disinfect the wound from the inside out.

If the injured part is swollen, it means that there is subcutaneous bleeding. You can use an ice pack for 20 minutes, and it is best to put a towel between the ice pack and the skin to avoid frostbite.

If the baby vomits, be sure to avoid eating and drinking, and let the baby lie on his side or tilt his head to one side to avoid aspiration.

After a fall, do you need to do a head CT?

Compared with the fracture, the treasure mothers are more afraid of the baby’s head injury, and they are afraid of falling out of their brains, so they always think about whether they need to have a head examination.

For those children who only have a history of trauma or have no clinical symptoms and signs, or have no changes in vital signs, CT examination of the head can be temporarily omitted.

However, parents should still pay attention to the baby’s situation in the next 24-48 hours. If there are any of the above situations that require medical treatment, they should send them to the doctor in time and improve the relevant examinations.

▋ Instead of being wise after the event, prevention is the key!

It is said that nip in the bud, in order to reduce the occurrence of tragedy, we can take the following measures:

Babies under 3 years old must be cared for by special people;

You can’t watch your children while playing with your mobile phone;

Don’t let the baby stay on the bed or chair by himself;

Install a protective mat at the corner of the table at home;

Keep the ground as clean as possible to avoid falling injury caused by toys or carpets;

Windows and balconies at home are locked, and tables and chairs that can be climbed cannot be placed next to them;

In the playground, children are not allowed to play with dangerous game facilities;

For school-age children, be sure to repeatedly tell them to obey the traffic rules before they go out.

So, after reading this article, do you know about the "4-year-old baby needs to do head CT" mentioned at the beginning?

References:

1. Huang Ye-li, Cai Wei-ping, Huo Shi-ying, Yang Gui-e. Research progress on causes and prevention of accidental injuries in children [J]. Journal of Naval General Hospital, 2005(01):41-43.

2. Tan Zongkui, Xu Yongnian, Chen Zhuanghong, et al. Chinese Journal of Pediatric Surgery, 1994; 15(5): 288.

3.Warner KG . Demling RH. Ann Emerg Med,1986; 15:1088.

4. Han Sufang. Diagnostic value and rational application of CT in children with acute craniocerebral trauma [J]. Journal of Practical Medical Imaging, 2002(02):94-95.

Source of this article: Medical Pediatric Channel

Author: Medical Xiaobai

Editor in charge: Li Xiaorong

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