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VERY concerned about DS's fall--need advice!!


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DS10 slipped on the wet vinyl floor getting out of the bath. He hit HARD.

 

He is a solid boy for his age....tall and about 90 lbs. He fell on his back, and on his way down, his head hit the rounded tiled corner of a ledge on the garden tub, then also hit the floor when he landed. He has a large goosebump behind his ear where his head hit the tiled corner.

 

I am used to big falls, bruises, huge goosebumps, etc. but with this fall I am particularly concerned about a concussion.

 

However, I don't want to rush him to urgent care unnecessarily.

 

He did not lose conciousness and is not confused....just very much in pain. We gave him ibuprofen and are icing the bump.

 

What would the Hive do?

 

ETA: Thanks for the advice, everyone. He is doing much better now, with only some pain on the actual bump!

Edited by besroma
Update on son
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Is he nauseated? Are you sure he didn't lose consciousness for even a few seconds?

 

If the answer is no, I'd probably watch him (I am a nurse so I would probably feel comfortable with this plan). I would hold off on the ibuprofen as well. Keep up the ice. If ANYTHING changes, take him to the hospital.

 

:grouphug:

Edited by Nakia
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Is he nauseated? Are you sure he didn't lose consciousness for even a few seconds?

 

If the answer is no, I'd probably watch him. I would hold off on the ibuprofen as well. Keep up the ice. If ANYTHING changes, take him to the hospital.

 

:grouphug:

 

 

He let out a very loud scream *immediately* and did not lose conciousness. His brother and sister saw him fall, so this is certain. I was there within 30 seconds.

 

He is not nauseated now.

 

We already gave him the ibuprofen.

 

You recommend we do not give him any if he wakes (after he does go to sleep....he has not gone to sleep yet)?

 

Thank you!

Edited by besroma
ETA: he has not fallen asleep
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This is going to sound strange, but I promise it works. Get a paper towel and fold it in half twice. Put 1 -2 TBS of sugar on it, and wet it. Put that on the bump and keep it there for about 10 minutes. It's not as painful as ice, doesn't damage (freeze) any surrounding tissue, and the bump should entirely go away by morning or before. I don't know why it works, but it does. As far as taking him in. As long as he doesn't slur his words, have dilated pupils, or complain of sleepiness, I would probably just observe him carefully.

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I would go straight to the ER.

 

Concussions are nothing to mess around with. I had one and it was an awful experience (and I stupidly did not go straight to the ER).

 

:iagree: :iagree: :iagree:

 

It is absolutely better to be safe than sorry.

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He let out a very loud scream *immediately* and did not lose conciousness. His brother and sister saw him fall, so this is certain. I was there within 30 seconds.

 

He is not nauseated now.

 

We already gave him the ibuprofen.

 

You recommend we do not give him any if he wakes?

 

Thank you!

 

Is he asleep now? If so, wake him up. Immediately. You want to make sure he doesn't lose consciousness at any point.

 

No, I wouldn't give him anymore ibuprofen. Ibuprofen can increase bleeding.

 

Have you given his doctor a call? I'd definitely get the pediatrician's advice. If that's not possible, I'd probably just head on to the ER since you are worried (and I don't blame you!!). It won't hurt anything to have him looked at.

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What will they do at the hospital?

 

We don't want unnecessary MRIs, etc.

 

It depends. Sometimes they will do nothing except send you home with instructions to watch him. My dd got kicked by a horse two years ago and had a severe concussion. She had a CT scan to check for bleeding and swelling on her brain.

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What will they do at the hospital?

 

We don't want unnecessary MRIs, etc.

 

I don't remember everything because I was really out of it. I do know they asked me a ton of questions, they check your pupils, blood pressure, etc.

 

I did have a cat scan also.

 

If you think a MRI, cat scan, etc is unnecessary than say so.

 

I would just go for peace of mind.

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Is he asleep now? If so, wake him up. Immediately. You want to make sure he doesn't lose consciousness at any point.

 

No, I wouldn't give him anymore ibuprofen. Ibuprofen can increase bleeding.

 

Have you given his doctor a call? I'd definitely get the pediatrician's advice. If that's not possible, I'd probably just head on to the ER since you are worried (and I don't blame you!!). It won't hurt anything to have him looked at.

 

He is not asleep yet. He is quite alert.

 

I have not called the pediatrician.

 

Amazingly, today was DH's first day on a new job. We were supposed to spend this evening choosing health insurance. I wouldn't even know where to go to be covered.....

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However, I don't want to rush him to urgent care unnecessarily.

 

He did not lose conciousness and is not confused....just very much in pain. We gave him ibuprofen and are icing the bump.

 

What would the Hive do?

 

For how you described his fall and hit, I'd take him to the ER. Both of my kids have had this happen, and both times I took them to the ER, the staff said I did the right thing. After doing various physical exams, they also did neurological exams (where they asked the child to do certain things with their arms, legs, etc. - maybe Nurse Nakia can explain further?). It was a huge relief to be in the hospital and having them checked out, and then to be directed about how to care for them in the days afterwards.

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:grouphug::grouphug::grouphug:

 

An ER cannot turn you away with no coverage. Honestly, I understand the concern about not having coverage...but if he smacked it that hard, I'd want to rule out blot clot or bleeding on the brain. If it is *just* a concussion, knowing how to to treat it is important to protecting the brain and fully recovering.

 

:grouphug: Saying a prayer for him and for peace and calm for you. :grouphug:

 

Also...you *may* be grandfathered in by your dh's *start* date...you never know.

Edited by MSPolly
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I would take him into his dr to get checked. Natasha richardson felt FINE after she took a tumble and hit her head. just because none of the typical 'serious' head injury symptoms are present doesn't mean there isn't something that should be checked out by a professional.

 

later (after the head is doing better), I would take him to my chiro to get checked. smaller falls than that can move things around. My son was "fine" after a fall - it was only much, much later (as in weeks/months) we learned he fractured a vertebra in that fall and it was pinching a nerve.

Edited by gardenmom5
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We don't want unnecessary MRIs, etc.

 

After a head injury, I don't think you should worry about tests being unnecessary. He probably needs a CT scan or an MRI to see what's going on inside his head -- and if he doesn't, they can tell you that at the ER.

 

I know a lot of people are anti-testing, but in a situation like this, where things can go very badly incredibly quickly, I don't think this is a time to worry about the long term effects of a given test. He's not having a CT scan or an MRI every day; it's just tonight, and for a very good reason.

 

As far as insurance goes, I think your son's health is the only important thing right now. Deal with getting the bill covered after you know your son is OK.

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Head to the urgent care center. You are worried enough to post here, it needs checked out. Follow your instinct! :grouphug:

 

I would tend to agree - let the professionals check him out to be safe. Think of that actress who refused medical treatment after a bump on the head in a skiing accident - she died. :-(

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When Cameron was around 7 he got a concussion. We took him to the doctor so he could decide if he needed to go to the hospital (we called the doctor and that's what he said to do). Cameron was unable to tell how many fingers we were holding up, was very slow to answer questions like what his own name is, etc. He was very sleepy Obvious signs of a concussion. Actually his signs were severe enough that the doctor said they were likely caused by a *second* concussion. As it turned out, the doctor determined he was recovering on his own and so we could just take him home. The doctor also said it's an old wives tale that you have to keep them awake. He said it's perfectly fine to let a kid with a concussion sleep. My cousin, a gymnast, got a concussion around the same time with similar signs. They took her to the ER and the doctor there said the same things about signs indicating a second (or later) concussion and that it was fine to let her sleep. At the ER they actually did nothing because she was recovering okay on her own. If she hadn't been improving, or Cameron hadn't and his doctor had sent him to the hospital, they would have done tests (CT scan likely) to see if there was bleeding or anything that they needed to take care of. Mostly they probably would have just done the observation thing. For most concussions there is no treatment but time. So given my experience and my cousin's, I'd just watch him at home. He sounds like he's just fine.

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My oldest ds suffered a concussion last week. He was taken to the emergency room and they performed a ct scan because he had memory loss and kept repeating himself. The scan did not show any bleeding so they sent him home. It was a few days before the fog cleared and we are still watching him. I would say you should look for any type of memory lose, confusion, nausea, or prolonged pain. If he exhibits any of those symptoms then you should take him in.

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I would tend to agree - let the professionals check him out to be safe. Think of that actress who refused medical treatment after a bump on the head in a skiing accident - she died. :-(

 

While I agree with calling his doctor, an ER is probably not necessary. It's not nearly as simple as Natasha Richardson just died. She started having symptoms a short time after her accident. It was clear something was wrong. She did not stay perfectly fine like she said she felt immediately after.

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We are still assessing what to do as we get our other children to sleep.

 

From reading the posts, am I correct that his brain could be bleeding without our knowledge, even if he is free of the symptoms of concussion?

 

There are other kinds of head trauma besides concussions and if you think he has a trauma, time is very limited in treatment. I would take him in and let the doctors decide what tests are necessary based on his symptoms. Sometimes an MRI is necessary to evaluate and you won't know everything is fine until the MRI is done.

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We are still assessing what to do as we get our other children to sleep.

 

From reading the posts, am I correct that his brain could be bleeding without our knowledge, even if he is free of the symptoms of concussion?

 

While that is possible, it is not likely. How long ago did it happen now? In the example of Natasha Richardson, she had developed symptoms sufficient to take her to the ER 3 hours after her accident. Her biggest symptom at that point was a major headache. The odds of a brain bleed without confusion and such is very, very low. Remember, everyone was shocked about what happened to NR because it is not common.

 

I'd call his doctor and ask what to do. He may say not to worry about it or he may say to head to the ER since his office is (most likely) closed.

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It is kind of misleading to say that there is no treatment for concussion. If there is a concussion then he will need to rest his brain. No tv, no computer, no reading...lots of rest.

 

A doctor could fill you in.

 

A friend knew a girl with a concussion who did not rest her brain and she continued, for some time, to have periods of confusion and fogheadedness and forgetfulness. She also tired easily.

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We are still assessing what to do as we get our other children to sleep.

 

From reading the posts, am I correct that his brain could be bleeding without our knowledge, even if he is free of the symptoms of concussion?

 

It is very unlikely. Not impossible, but unlikely.

 

Disclaimer: I am not a doctor.

 

:grouphug:

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All they have ever done when we have gone to the hospital for head injuries is check the pupils, and do a neurologic exam. NO xrays, CT scans or MRIs. Even after ds was in his car accident they did xrays but no CT scan etc. I have been treated for a concussion in the past without ever having a CT scan. Each locale is different in how they handle these things. I tend to err on the side of caution when it comes to to head injuries.

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Besroma, what is your assessment of him? How is he behaving? How does he look? Is he able to answer questions correctly? How is his balance?

 

When my dh was watched for head injury, they were constantly checking for symmetry of movement and strength with his arms and legs. (A limb fell on him. He had many other injuries. He ended up NOT having a head injury...but that was something they kept expecting to manifest for a period of time.)

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The only thing that might cause me concern is the location of his injury. However, you said he had a goose egg from it, so that is actually a good thing. It's when the swelling "goes the other way" that there is serious cause for concern.

 

Here's a list of things to watch for in a child with a head injury:

 

A headache (not just pain from the bump) that gets worse or doesn't go away.

 

Slurred speech

 

Confusion

 

Dizziness

 

Irritability

 

Vomiting

 

Any kind of fluid, blood or clear, coming from the ears or nose

 

Excessive sleepiness

 

Unequal pupils

 

Unreactive pupils (do they constrict when you shine a flashlight in them, then dilate when you remove it)

 

blurry vision

 

seizures

 

not recognizing family members

 

weakness in any limbs

 

ringing in the ears

 

I would recommend at least a call to a doctor to seek his/her opinion. If you have an urgent care nearby, they can probably check him out for you and reassure you that it isn't serious. I highly doubt they will do anything other than a quick neuro check (follow my finger, squeeze my hand, balance on one foot, etc.) and examine the reactivity of his pupils.

 

Only give acetaminophen for pain.

 

If your son gets the ok from the doc...continue to observe him closely for the next 24 hours. If nothing changes, he's good. If any of the above symptoms develop...take him to the ER.

 

You child can sleep, but usually we advise waking him every 2-3 hours and making sure that he is coherent and able to identify you and can move all four limbs normally.

 

A quick visit to urgent care tonight would allay your fears and make sure there was nothing more serious going on.

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Besroma, what is your assessment of him? How is he behaving? How does he look? Is he able to answer questions correctly? How is his balance?

 

When my dh was watched for head injury, they were constantly checking for symmetry of movement and strength with his arms and legs. (A limb fell on him. He had many other injuries. He ended up NOT having a head injury...but that was something they kept expecting to manifest for a period of time.)

 

 

DH has been reading to him since the accident (two hours) while I got the other children in bed. During that time, we have checked his pupils numerous times. They do not seem dilated, and appear reactive.

 

He knows his name, middle name, what today is, what tomorrow is, what our schedule is tomorrow (violin, piano, even added that art lessons start tomorrow for the first time :)).

 

He is answering math questions without difficulty.

 

He said that his head only hurts where the bump is. (We did give him some ibuprofen at 8pm and have iced it).

 

He has had some difficulty with how many fingers we are holding up, but that may be a vision correction issue. At his recent eye dr. appt., they said he would already be in glasses if he needed to see a chalkboard, but since he is homeschooled, we could wait a year. He says that he is not seeing spots and that his vision is not blurry.

 

He is not nauseated or dizzy.

Edited by besroma
Urgent Care is closed, so ER one hour away is our only option
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The only thing that might cause me concern is the location of his injury. However, you said he had a goose egg from it, so that is actually a good thing. It's when the swelling "goes the other way" that there is serious cause for concern.

 

Here's a list of things to watch for in a child with a head injury:

 

A headache (not just pain from the bump) that gets worse or doesn't go away.

 

Slurred speech

 

Confusion

 

Dizziness

 

Irritability

 

Vomiting

 

Any kind of fluid, blood or clear, coming from the ears or nose

 

Excessive sleepiness

 

Unequal pupils

 

Unreactive pupils (do they constrict when you shine a flashlight in them, then dilate when you remove it)

 

blurry vision

 

seizures

 

not recognizing family members

 

weakness in any limbs

 

ringing in the ears

 

I would recommend at least a call to a doctor to seek his/her opinion. If you have an urgent care nearby, they can probably check him out for you and reassure you that it isn't serious. I highly doubt they will do anything other than a quick neuro check (follow my finger, squeeze my hand, balance on one foot, etc.) and examine the reactivity of his pupils.

 

Only give acetaminophen for pain.

 

If your son gets the ok from the doc...continue to observe him closely for the next 24 hours. If nothing changes, he's good. If any of the above symptoms develop...take him to the ER.

 

You child can sleep, but usually we advise waking him every 2-3 hours and making sure that he is coherent and able to identify you and can move all four limbs normally.

 

A quick visit to urgent care tonight would allay your fears and make sure there was nothing more serious going on.

 

Glad we're on the same page! :D

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When ds hit his head against the tub, my dh said the same thing about the goose egg being visible as a positive thing. I did end up taking him to the ER, but when my (then) 4 yr old was ratttling on about automobiles, motors, car parts, etc., the dr said he was fine. :)

 

We have had numerous times been without insurance. I pray that you are able to make a clear decision. :grouphug:

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When ds hit his head against the tub, my dh said the same thing about the goose egg being visible as a positive thing. I did end up taking him to the ER, but when my (then) 4 yr old was ratttling on about automobiles, motors, car parts, etc., the dr said he was fine. :)

 

We have had numerous times been without insurance. I pray that you are able to make a clear decision. :grouphug:

 

Thank you for your prayers.

 

DH headed to the Urgent Care last night with him trying to get there before it closed. When we realized he couldn't make it, I asked him to pull over so that I could assess the information I was getting from the Hive to determine whether he or not he should drive so far to the ER.

 

They went to Rita's Custard to get something to eat. When I called to discuss it with DH, I heard DS jabbering in the background almost non-stop....quite alert, like your son was. :001_smile:

 

We decided to bring him home and watch him carefully.

 

He is doing well this morning, and we are trying to have him "rest his brain." We are doing no screens, no reading, no mental math, and trying to keep him still.

 

Does anyone know what he *can* do? Can I read aloud to him?

 

His piano lesson is tonight. I just don't know how much resting he needs and what exactly to do.

 

Thanks for everyone's insights into this.

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I think the activity probably depends upon the severity. Your ds does not seem to be having the issues that the girl I mentioned had...the confusion and foggy headedness, headaches, etc.

 

If he were mine, just because of how hard he smacked it, I might keep him off the *screens and books* as you said. Read to him, or book on cd and see if it overwhelms him.

 

Maybe let him try practicing piano for his lesson and see if it overwhelms him.

 

If he develops a headache or feeling overwhelmed or like his head is spinning, then I'd back off. If those things go well and he doesn't worsen, I might try adding stuff in a little at a time while keeping watch on how he feels.

 

I'm so glad this doesn't seem to be bad! What a smack! :grouphug:

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Sounds like he's fine. You might want to phone your doctor's office and ask if they want to see him today or what their recommendations are, but other than that, I wouldn't worry about it too much. If he isn't exhibiting any of the symptoms I listed previously...I doubt he has a concussion.

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While that is possible, it is not likely. How long ago did it happen now? The odds of a brain bleed without confusion and such is very, very low. .

 

I'd call his doctor and ask what to do. He may say not to worry about it or he may say to head to the ER since his office is (most likely) closed.

It may not have been a concussion, but my friend's daughter had a spontanious brain bleed with NO confusion. her only symptom was vomiting IF she was in an upright position. If she was laying down, she stopped. (she had a bleeding AVM - usually diagnosed after head injury x-rays or on the autopsy table.) and a headache - that was it.

 

Dr's will not say "oh, sounds fine" over the phone - they will say "bring him in and let's check him out".

Edited by gardenmom5
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The only thing that might cause me concern is the location of his injury. However, you said he had a goose egg from it, so that is actually a good thing. It's when the swelling "goes the other way" that there is serious cause for concern.

 

.

 

I just wanted to address this old wives tale. There is no such thing as a knot on the head "going the other way." You hear this a lot, but it isn't real. There is no way for a knot to form on the inside of your skull. You can crack your skull, have a brain bleed etc., but the goose egg growing the other way doesn't happen.

:D One of the benefits of spending part of my pre-kid career working in a traumatic brain injury floor of a hospital.

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I just wanted to address this old wives tale. There is no such thing as a knot on the head "going the other way." You hear this a lot, but it isn't real. There is no way for a knot to form on the inside of your skull. You can crack your skull, have a brain bleed etc., but the goose egg growing the other way doesn't happen.

:D One of the benefits of spending part of my pre-kid career working in a traumatic brain injury floor of a hospital.

I doubt she was saying the goose egg grows on the inside. She was referring to where the swelling is located.

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Are you sure? If I said that, that wouldn't be what I meant. I don't think she meant that either.

 

Actually, I think a lot of people do believe this (goose egg going inwards rather than outwards). I have heard my mom say this before. When I read it last night on this thread, I asked my husband, who is a dr., about it and he also said it is an old wives tale.

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I just wanted to address this old wives tale. There is no such thing as a knot on the head "going the other way." You hear this a lot, but it isn't real. There is no way for a knot to form on the inside of your skull. You can crack your skull, have a brain bleed etc., but the goose egg growing the other way doesn't happen.

:D One of the benefits of spending part of my pre-kid career working in a traumatic brain injury floor of a hospital.

 

I thought Diane (who is a nurse) meant a cave-in (not sure the technical term - concave? Where the skull goes inward - like an indentation from the collision?), which I believe is a valid concern.

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I just wanted to address this old wives tale. There is no such thing as a knot on the head "going the other way." You hear this a lot, but it isn't real. There is no way for a knot to form on the inside of your skull. You can crack your skull, have a brain bleed etc., but the goose egg growing the other way doesn't happen.

:D One of the benefits of spending part of my pre-kid career working in a traumatic brain injury floor of a hospital.

 

Diane is long-time pediatric nurse, so I'm sure she didn't mean an actual egg on the inside.

 

I'm sure there are people who do believe that though. Some people have next to no knowledge of how their bodies work.

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