Concussion In Children

WHAT YOU SHOULD KNOW:

A concussion (kun-KUSH-un) is an injury to the tissues or blood vessels of the brain. It is also called a "closed head injury" or "mild traumatic brain injury" (MTBI). Concussions happen when the soft tissues of the brain are forced against the bone of the skull. The injury can cause the brain to have trouble working normally for a short time. A concussion may happen because of a fall, motor vehicle accident, sports injury, or a blow to the head. Your child may be unconscious ("knocked out") for a short time. A mild concussion is common in childhood, and usually not a serious problem. Your child needs to be carefully watched after a concussion for more serious symptoms.

CARE AGREEMENT:

You have the right to help plan your child's care. Learn about your child's health condition and how it may be treated. Discuss treatment options with your child's caregivers to decide what care you want for your child.

RISKS:

• Your child may also have had other injuries at the same time as the concussion, like a neck or face injury. The longer your child was unconscious the more serious the concussion may be. The risk of serious problems are decreased if you and your child carefully follow your caregiver's advice.
  
  
• Each additional concussion your child has may increase his risk of having problems later in life. These problems may include poor coordination, or trouble thinking or concentrating. Having repeated concussions can be life threatening.

WHILE YOU ARE HERE:

• Activity: Your child may need to rest in bed after a concussion. Your child's caregiver will tell you when your child can return to regular activities. Talk to your child's caregiver if you have any questions.
  
  
• Call button: A call button will be in your child's hospital room. You or your child should use the call button if your child is having problems and a caregiver is needed. You can also use the call button if you or your child have questions for a caregiver. Be sure to keep the call button near you or your child at all times.
  
  
• Emotional support: You may stay with your child for comfort and support. Your child will feel safer in the hospital with you or a loved one close by. Ask caregivers if another family member can stay with your child when you cannot be there. Bring in something from home that your child likes, such as a blanket, a favorite toy, or clothing.
  
  
• Informed consent:
  
  
  • You have the right to understand your child's health problem. You should understand what tests, treatments, or procedures may be done to treat your child's problem. Your child's caregiver should also tell you about the risks and benefits of each treatment.
    
    
  • You may be asked to sign a consent form. If you are unable to give your consent, someone who has permission can sign this form for your child. A consent form is a legal paper that gives caregivers permission to do tests, treatments, or procedures. This form should tell you exactly what will be done to your child. Your child's caregiver should explain what the risks and benefits of each treatment are before you sign the form. Before giving your consent, make sure all your questions have been answered. This way you will understand what may happen to your child.

Tests and monitoring:

• Vital signs: This may include taking your child's temperature, pulse (heartbeats), respirations (breaths), and blood pressure. Your child's temperature may be taken in the mouth, ear, armpit, or rectum (rear-end). Caregivers may also listen to your child's heart and lungs by using a stethoscope (STETH-o-skop).
  
  
• Neuro (NER-o) signs: A caregiver may check your child's eyes, memory, and how easily your child wakes up. The strength of your child's arms, hands, legs, and feet may also be checked. These signs may tell caregivers how well your child's brain is working.
  
  
• Pulse oximeter (ok-SIM-e-ter): This is a machine that tells caregivers how much oxygen is in your child's blood. A cord with a clip or sticky strip is placed on your child's foot, toe, hand, finger, or earlobe. Tell a caregiver if the sticky strip or clip comes off of your child. The machine will alarm if the machine cannot read the oxygen level or if your child needs more oxygen. Tell a caregiver if the alarm sounds. Never turn the pulse oximeter off.
  
  
• Heart monitor: This is a machine used to see how your child's heart is handling the concussion. Sticky pads are placed on your child's chest. Each pad has a wire that is hooked to a TV-type screen or to a small portable box. This screen or box shows a picture of your child's heartbeat. Caregivers watch this picture to make sure your child's heart is doing well.
  
  
• Blood tests: Your child may need blood taken for tests. The blood may be taken from your child's arm, hand, finger, foot, heel, or IV (intravenous line). Your child may need to have blood drawn more than once.
  
  
• CT scan:
  
  
  • This may also be called a CAT scan. A special x-ray machine uses a computer to take pictures of your child's brain. It may be used to look at bones, muscles, brain tissue, and blood vessels.
    
    
  • Your child may be given dye before the pictures are taken. The dye is usually given in your child's IV. The dye may help your child's caregiver see the pictures better. People who are allergic to shellfish (lobster, crab, or shrimp) may be allergic to this dye. Tell the caregiver if your child is allergic to shellfish, or has other allergies, or medical conditions.
    
    
  • Your child must lay still for the short time it takes to have a CT scan. Some children are too young or cannot hold still enough to have a CT scan. Your child may need medicine to help him relax or fall asleep so the CT scan can be done.
  
  
• MRI: This test is called magnetic resonance (REZ-o-nans) imaging. During the MRI, pictures are taken of your child's head. MRI may be used to look at the brain, muscles, joints, bones, or blood vessels. Your child will need to lay still during a MRI. Always ask caregivers before entering the MRI room. Never enter the MRI room with an oxygen tank, watch, or any other metal objects. This can cause serious injury.
  
  
• C-spine x-rays: Your child may need cervical spine (c-spine) x-rays to make sure there is no neck injury. Several pictures may be taken of the seven bones in your child's neck. These neck bones are called vertebrae (VER-te-brah). Caregivers will carefully look at the x-rays for problems in your child's vertebrae.
  
  
• Skull x-rays: If caregivers think your child has broken bones in the head or face, skull x-rays may be done. Skull x-rays may also be done if your child cannot hold still for a CT scan. Several pictures may be taken of your child's head. These x-rays can help caregivers find broken bones in your child's head and face.

Treatments:

• Ice: Sometimes a blow to the head may cause bruising, swelling, or a cut on your child's skin. A caregiver may use ice to decrease your child's pain and swelling. It is best to start using ice right after an injury and up to 24 to 48 hours afterwards. Do not use ice directly on the skin, or for longer than 20 minutes at a time. If ice is not covered or is put on one area of your child's body for too long, it may cause frostbite.
  
  
• IV: An IV is a tiny tube placed in your child's vein. It may be put in your child's hand, arm, ankle, foot, or head. Your child's IV may be hooked to a machine that will give your child fluids and medicine. When your child gets enough fluid and medicine, a caregiver may disconnect the IV from the machine. Your child may still need to keep the IV in, or a caregiver may take it out. Let a caregiver know if your child has pain, burning, redness, or swelling at the IV site.
  
  
• Oxygen: Oxygen may be needed to treat your child's illness. Your child may need a nasal cannula (small tubes placed in the nose) or mask. Many children do not like having these on their face, so caregivers may place the mask next to your child's face. Some children are placed in an oxygen tent or plastic hood. Do not take off your child's oxygen without asking your child's caregiver first.

Medicine:

Your child may not be able to take medicines for some of his symptoms, such as headache or vomiting. This is because caregivers need to know how your child is feeling. Some medicines may hide or "mask" problems.

For more information:

You can contact one of the following national organizations for more information about concussions and head injuries:

• Brain Injury Association
  1608 Spring Hill Road
  Vienna , VA 22182
  Phone: 1- 703 - 761-0750
  Phone: 1- 800 - 444-6443
  Web Address: http://www.biausa.org
  

• Centers for Disease Control and Prevention
  1600 Clifton Road
  Atlanta , GA 30333
  Phone: 1- 404 - 6393311
  Phone: 1- 800 - 3113435
  Web Address: http://www.cdc.gov
  

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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

Learn more about Concussion In Children (Inpatient Care)