We need to remind parents that there are serious types of injuries that occur in sports-related accidents.

These are head injuries and blunt-trauma injuries to the abdomen. These types of injuries require a very different type of immediate attention.

According to the Academy of American Pediatrics, injuries to the head can be divided into two categories — external and internal. External, while frightening to see, usually just involves a scalp injury. While seeing your child’s scalp bleeding may cause your heart to skip a beat, internal head injuries are far more serious because of the implications of a life-threatening brain injury.

Some blows to the scalp may cause swelling below the skin from the blood leaking into the scalp, this is called a “goose egg” and may take days or weeks to disappear, depending on the amount of fluid/blood that leaked.

Below is a list of what to do and what to look for if a scalp injury occurs.

• If the infant or child loses consciousness, even for a brief moment, does not stop crying, complains of head or neck pain or is not walking normally, call your pediatrician immediately.

• If your child is not an infant and has not lost consciousness but is behaving normally after a blow to the head or a fall, apply an ice pack to the injured site for no more than 20 minutes at a time to reduce swelling. Wrap the bag of ice or frozen vegetables in a washcloth. Do not apply the ice directly to the injured area, as this will cause damage to the skin.

• Observe your child for 24 hours for any change in behavior. If you see any reason for concern, call the child’s pediatrician immediately. This may be a sign of an internal injury.

• If the trauma occurs near bedtime, check the child every few hours for twitching legs or arms and change in color or breathing.

• If color and breathing are normal and you observe or sense no other abnormalities, let your child sleep — unless your child’s doctor has advised otherwise.

• If color and/or breathing are not normal or if you aren’t comfortable with your child’s appearance — trust your instincts — arouse your child partially by sitting him or her up.

Your child should fuss a bit and attempt to resettle. If he or she doesn’t protest, try to awaken your child fully. If your child can’t be awakened or shows any signs of internal injury — see below — call your child’s doctor or an ambulance. 

Of a more serious and life-threatening nature are internal injuries to the head and/or abdomen.

Call for emergency medical attention if any of the following symptoms occur after a head or abdominal injury. For either type of injury:

  • Loss of consciousness;
  • Neck pain;
  • Pupils of unequal sizes;
  • Pale, clammy skin;
  • Bleeding from the nose, ears or eyes;
  • Abnormal or rapid-shallow breathing;
  • Weak pulse, which could be evidence of shock; and
  • For the abdomen, a guarded, curled up or fetal position.

Concussions are also considered a type of internal head injury. A concussion is the temporary loss of normal brain function as a result of an injury.

If your child sustains an injury to the head, watch for the following signs that indicate that he or she might have a concussion:

  • Feels dizzy or light-headed;
  • Trouble remembering things that have happened immediately before or after the accident;
  • Nausea or vomiting;
  •  Headaches;
  • Blurred vision and sensitivity to light;
  • Slurred speech or saying things that don’t make sense;
  • Difficulty concentrating, thinking or making decisions; and
  • Difficulty with coordination or balance.

If you suspect a concussion, call your child’s doctor for further instructions.

While it is impossible to prevent all childhood injuries, there are ways of helping your child in avoiding them.

Some of the ways to minimize the chances of injury are to childproof your home; make sure your child wears protective headgear and equipment when participating in sports activities; always have your children wear safety belts in the car or use an age-appropriate safety seat.

If your child is injured, make sure that he or she takes it easy and do not allow them to resume playing sports until the injury has healed completely.

Sally Robinson is a clinical professor of pediatrics at UTMB Children’s Hospital, and Keith Bly is an associate professor of pediatrics and director of the UTMB Pediatric Urgent Care Clinics. This column isn’t intended to replace the advice of your child’s physician.

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