fifth HOME CARE • If there are any signs of concussion, see your doctor. While waiting to see the doctor, have the child rest in bed with the head on a pillow. • If there is a head injury with no signs of concussion, have the child rest in bed with his or her head on a pillow. • The child may sleep but must be wakened every hour so that you can check on the child's condition. • Continue bed rest until at least one day after the child seems fully recovered. • Give only aspirin or acetaminophen for headache. PRECAUTIONS • Do not try to treat the child at home if there are any signs of concussion. • Do not give painkillers, sedatives, or any medicine stronger than aspirin or acetaminophen to a child with a head injury. • If the scalp is depressed (pushed in) at the site of the injury, see your doctor. • If gentle tapping of the skull produces the dull sound of a broken melon, see your doctor. A concussion is an injury to the brain. It is caused by a fall or by a blow on the head from a blunt object. In many ways, a concussion is like a bruise of the brain. There is swelling in the brain, and sometimes blood escapes into the brain tissue. Since a concussion is an injury to the brain matter itself, it may occur even if the skull is not fractured. Concussions range from mild to serious. Most children suffer one or more blows to the head at some time during childhood. Typical reactions to head injuries are immediate crying, headache, paleness, vomiting once or twice, a lump or cut at the site of injury, and sleepiness for one or two hours. These are not the signs of a concussion-they are usual reactions to a blow on the head. SIGNS AND SYMPTOMS Any of the following are signs of a possible concussion: unconsciousness at the instant of the injury, no memory of the accident or of events that occurred before the accident, confusion (the child doesn't recognize his parents or know his own name), persistent vomiting, inability to walk, eyes not parallel, pupils of different sizes (however, some children normally have unequal pupils), pupils that do not become smaller when a bright light is shined into the eyes, blood coming Every child, who suffers a concussion should be examined by a doctor in case there has been a skull fracture, which may cause bleeding inside the skull. Simple frac from the ear canal, bloody fluid that does not clot coming from the nose, headache that continues to become more severe, stiff neck (the chin cannot be touched to the chest with the mouth closed), increasing drowsiness, slow pulse (less than 50 to 60 beats per minute), and abnormal breathing. There are two rare forms of concussion in which symptoms do not develop until hours after the injury (called epidural bleeding) or until days or weeks afterward (called subdural bleeding). HOME CARE If the child shows any of the signs of a concussion, see your doctor. If there are no signs of a concussion, or if you are waiting to see the doctor, have the child rest in bed. roseola