When to take your child to the emergency centre

Posted on 20 March 2015

It’s natural to panic when your child falls on their head – but when is it actually necessary to go to the emergency room? Dr Stephan Reid, a paediatrician at Mediclinic Potchefstroom, identifies warning signs exhibited by babies, toddlers and teenagers.

There’s nothing that makes you want to pursue a medical degree quite like being a parent does. We’re responsible for keeping our children safe, but sometimes we’re just not sure whether we’re overreacting or whether we should be rushing our child to casualty. This is especially true of head injuries, where the severity of the impact of a fall may not be immediately apparent.

According to babycenter.com, because baby and toddler bones are softer than those of older children they don’t fracture as easily. However, even if your child appears to be fine, keep an eye on him or her for about 24 hours to make sure nothing is out of the ordinary.

Dr Reid identifies the following age-specific signs that indicate your child should be checked out immediately:

All ages: Any fall from a height higher than the child’s own body height should probably be checked out. For example, a baby learning to sit or walk and then falling over and bumping their head should generally not be seen as a potential serious injury. But if a baby or toddler is standing on a chair and then falls, it’s a different situation. Secondly, any fall serious enough to cause a loss of consciousness or a very large bruise to the head should also be checked out.

A baby: Extreme fussiness or irritability, poor feeding, vomiting (especially starting a few hours after the injury, as babies and young children often vomit with the initial crying episode), excessive drowsiness or not waking up at expected feeding times.

A toddler or small child: Irritability, headache, confusion, vomiting (especially starting a few hours after the injury, as babies and young children often vomit with the initial crying episode), excessive drowsiness or inability to wake child after naps.

A teenager: Headache, confusion or disorientation, vomiting without feeling nauseous, excessive drowsiness or inability to wake him or her.

Examining your child’s eyes, regardless of their age, is also vital after a serious knock to the head. ‘Changes in pupil size and unusual eye movements indicate an almost certain brain injury, which most likely needs urgent neurosurgical intervention,’ says Doctor Reid. Also look out for swelling around the scalp – especially on the side of the head – that may indicate a deeper problem, suggests babycenter.com.

Aside from checking for telltale signs, trust your intuition – you know your children best. When you’re in serious doubt as to their wellbeing, it’s generally best to err on the side of caution and consult your doctor.



The information provided in this article was correct at the time of publishing. At Mediclinic we endeavour to provide our patients and readers with accurate and reliable information, which is why we continually review and update our content. However, due to the dynamic nature of clinical information and medicine, some information may from time to time become outdated prior to revision.

In the interest of our patients, in accordance with SA law and our commitment to expertise, Mediclinic cannot subscribe to the practice of online diagnosis. Please consult a medical professional for specific medical advice. If you have any major concerns, please see your doctor for an assessment. If you have any cause for concern, your GP will be able to direct you to the appropriate specialists.

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