宝宝跌伤头部,切忌用力按压.doc

5宝宝跌伤头部，切忌用力按压哭闹不停或出现喷射性呕吐、持续发热、嗜睡等症状应马上就医头部有包块时别用万花油揉搓，而应用冰敷处理，以免血管破裂日前，一个头部跌伤的婴儿紧急从广东省惠州市人民医院转到了广州医科大学附属第三医院儿科病房。原来，宝宝的父亲在倒车时，撞了一下抱着孩子的 母亲的一只手，母亲被撞击后，失手将宝宝跌落在地，头部着地受伤。幸好送院及时，经CT检查发现，宝宝颅内出血，经颅内放置引流管减压治疗后，才转危为 安。专家介绍，小儿头部跌伤时早期症状可能不明显，但若处理不及时，容易出现病情恶化，严重时危及生命。专家提醒，孩子跌伤后，首先要观察小儿的意 识状态和反应是否异常；其次要观察是否有凹陷性骨折和血肿，有包块时别用万花油揉搓，而应用冰敷处理；第三要观察七天以免出现慢性颅脑损伤。如何处理？第一步：观察反应是否哭闹不停或发热、嗜睡广州医科大学附属第三医院儿科主任崔其亮介绍，由于照顾者的疏忽，幼儿跌伤头部的情况并不鲜见。对于没有学会走路的宝宝，大多是从没有围栏的沙 发、床上或者童车上一头栽下来，相当一部分小宝宝因为还没有足够的防御能力而造成头部着地的意外跌伤。稍大一点的幼儿，大多是从窗台、桌子等高处摔下来或 者摔跤时跌伤头部。小儿头部跌伤，家长究竟如何处理呢？崔其亮说，家长应正确评估孩子的病情，并及时处理，尽量将伤害减至最低。首先是判断小儿的意识状态。崔其亮说，如果孩子头部着地跌落，父母应严密观察。由于小儿言语表达能力未完善，因此，孩子跌伤头部时，最好先观察 他跌伤后的反应。“一般情况下，小儿跌伤后会因为疼痛而出现哭闹，如果哭闹过后与以往比较，精神、行为没有太大异常变化，家长可不用特别担心；但是，如果 哭闹不停或出现喷射性呕吐、持续发热、嗜睡、面色苍白或发黑、四肢冰凉、呼吸不规则、运动异常增强或减弱，都应马上送医。”崔其亮提醒，送院时应将孩子放平，平卧在一块板上，头侧向一方。“慢性颅脑损伤7天内仍可能产生症状，因此，孩子头部跌伤一周内，都需严密观察是否出现以上症状。”他说，而且，在此期间不应让小儿剧烈运动，而应多卧床休息。第二步：观察外伤看是否有凹陷性骨折和血肿崔其亮说，观察了孩子的反应后，再仔细观察孩子的外伤。如果跌伤后没有皮损、出血等情况，应观察孩子是否有凹陷性骨折和血肿，前囟未闭的孩子，需轻轻按压感觉其是否饱满，如果有异常，应立刻送院治疗。崔其亮提醒，孩子跌伤头部，切忌用力按压头部任何位置，以免颅骨骨折尖锐处挫伤脑组织。同时，头部有包块时，不应用万花油等揉搓，以免导致血管 破裂，加重出血，而应用冰敷处理。“如合并有伤口，应注意消毒和止血。”消毒时可用棉签蘸碘酒，由内往外消毒伤口。“止血时不应用止血药物。出血严重时可 用卫生纸、纱块压迫包扎止血，然后马上送医院处理。”第三步：定期复诊检查陈旧性出血是否完全吸收崔其亮说，如果孩子出现严重的颅脑损伤，经治疗后，仍需定期回医院检查。“部分颅脑损伤，如颅内出血，出院时陈旧性出血未完全吸收，脑脊液循环 未完全通畅，脑组织仍暂时受压。”他说，因此，必须在孩子出院后一周内到医院检查其吸收恢复情况，必要时行康复治疗，以将后遗症减至最少。如何预防？注意房屋家私设置的安全性崔其亮说，年幼的宝宝步履不稳，行走时磕磕碰碰在所难免，如果头面部碰到家具突出的坚硬部分或墙角、树干等物体，容易造成头部外伤，或在爬高时不慎跌落导致头部受伤。为防止小儿跌伤，父母必须注意房屋家私设置的安全性。2岁以内宝宝：应学习认识洞开的窗户及楼梯的危险性：1.用安全背带。安全背带可以保护宝宝，抱婴者不慎摔倒，宝宝不易被摔出而造成意外。但是，要注意婴儿在03个月的时候，背袋要有良好的颈部支托。2.用推车时注意安全。宝宝乘坐童车时，必须系腰部安全带。不要让宝宝从车子上站起来。宝宝坐在车上时，不要在车筐以外的地方吊挂重的包裹、物品。童车有可能翻倒而导致婴儿掉下并受伤，成人转身或去它处拿物品时，必须固定好轮闸，并确认童车不会移动，更不要随意离开。3.宝宝床必须有围栏，坚固稳当。无论宝宝是在床上睡觉还是玩耍，都应注意拉好床栏；而床栏的插销应安装在小儿接触不到的地方，以防小儿在玩耍中无意将插销打开而坠床。另外，床栅的间隔不能过宽，免得宝宝从较大的缝隙中跌下床。4.当家长做事时，宝宝一定要待在视线可以看到的安全地方。刚学会坐的小宝宝背后放软枕，防止宝宝后仰跌倒的时候头后枕着地，对脑袋造成震荡伤害。5.学步的宝宝自幼需要学会注意地面的高低及前方物品，并且要让宝宝认识洞开的窗户及楼梯的危险性。26岁儿童：崔其亮说，有26岁儿童居住的地方，父母应该做好以下两点：1.窗户楼梯位置应安装半截栅栏，围栏应有一定高度，阳台边不能放置小板凳，阳台围栏设置不要有横杆，避免宝宝攀爬导致意外。2.地面不应过滑，可以垫上地毯或软垫，家具的四个边角位凸出处最好为圆角，可以减少撞伤伤害程度。Low kept crying or projectile vomiting, persistent fever, lethargy and other symptoms should immediately go to a doctorWhen low head bag piece dont rub with flower oil, and application of ice, so as to avoid blood vessels ruptureA few days ago, a babys head falls emergency from huizhou city of guangdong province peoples hospital affiliated to Guangzhou medical university third hospital pediatric ward. When reversing, it turns out that the babys father, in the one hand holding the childs mother, mother had been, baby will fall to the ground, wounded head hit the ground. Fortunately, the hospital in time, found by CT examination, baby intracranial bleeding, after treatment with placed tube drainage from the intracranial pressure, to turn danger for Ann.Expert introduction, when the children head falls early symptoms may not be apparent, but if treatment is not timely, prone to deterioration, serious life-threatening. The expert reminds, after the children fall, the first to observe the meaning of infantile state and reaction is the exception; Secondly to observe whether there is a concave fractures and hematoma, have a bag piece dont rub with purple flower oil, and the application of ice; The third to seven days so as not to appear on chronic traumatic brain injury.How to deal with?The first step: to observe the reaction - whether kept crying or fever, lethargyThe third hospital affiliated to guangzhou medical university, director of pediatric Cui Jiliang introduction, owing to the negligence of caregivers, baby falls the head of the case is not rare. With no baby learning to walk, mostly from no fence sandy hair, bumped down a bed or on the buggy, quite a number of baby because not enough defense capabilities and cause accidental falls head hit the ground. A little older infants, mostly from fell windowsill, table and so on high or wrestling falls the head.Just how to deal with childrens head falls, parents? Cui Jiliang, says parents should correctly evaluate the childs illness, and handled in time, as far as possible reduced the damage to the minimum.The first is determine infantile state of consciousness. Head down fall Cui Jiliang says, if a child, parents should be closely observed. Because infantile verbal expression ability is not perfect, therefore, when your child falls in the head, the best observation he falls before reaction. In general, children will appear because of the pain and the crying after the fall, if compared with the past after crying, spirit, behavior, no too big changes, but dont have to worry about parents; however, if kept crying or projectile vomiting, persistent fever, lethargy, pale or dark, cold limbs, irregular breathing, abnormal movements increase or decrease, should be hospitalized right now.Cui Jiliang reminds, children at the hospital should be flat, lay down on a piece of board, head lateral side. Chronic traumatic brain injury may produce symptoms within seven days, as a result, childrens head falls within a week, must be closely observe whether the above symptoms. He says, and, during this period should not let the children with vigorous exercise, and should stay in bed as much as you can.The second step: to observe the injury - see if there is a concave fractures and hematomaCui Jiliang said, observed the childs reaction, after again carefully observe the childs injury. If no skin, bleeding after falls, etc., should observe whether a child has a concave fractures and hematoma, fontanel is not closed before children, feel the need to gently press is full, if there is abnormal, should be immediately to hospital treatment.Cui Jiliang reminds, the child falls head, you push hard on the head of avoid by all means any position, so as to avoid sharp in skull fracture contusion brain tissue. At the same time, the head bag piece, should not be used purple flower oil knead, lest cause blood vessels break, increase bleeding, ice processing and application. As with wounds, should pay attention to disinfection and stop the bleeding. Use cotton swabs dipped in iodine disinfection, from outside to inside disinfect the wound. Stop bleeding without application of hemostatic drugs. Severe bleeding can use toilet paper, gauze piece of compression bandage hemostasis, then immediately to a hospital treatment.Step 3: regularly visit - check whether the pulmonary hemorrhage is completely absorbedCui Jiliang said, if the child severe craniocerebral injury after treatment, still need to back to the hospital regularly. Part of craniocerebral injury, such as intracranial hemorrhage, pulmonary hemorrhage was not fully absorbed, the discharge of cerebrospinal fluid circulation not completely unobstructed, compression of brain tissue is temporary. And he said, therefore, must be the children come to the hospital within one week after discharge its absorption recovery, its necessary rehabilitation, to sequela to a minimum.How to prevent?Pay attention to the safety of home furniture setCui Jiliang said, young baby steps instability, walking along is inevitable, if the head face furniture outstanding hard part or the corner, tree trunks, such as object, easy to cause head trauma, or when he fell to the climb a head injury. To prevent children falls, parents must pay attention to the safety of home furniture set.Within 2 years old baby:Should learn the danger of opens the window and the stairs:1. With a safety harness. Safety harness can protect the baby, the baby fell, the baby is not easy to fall out and cause accident. However, attention should be paid to the baby in 0 3 months, the neck of the bag should have good rest.2. Pay attention to safety when using a cart. Baby take a baby carrier, must wear the waist belt. Dont let the baby from the car to stand up. Baby sitting in the car, dont outside basked hangs heavy parcel, items. May overturned buggies and cause the baby fell off and hurt, turn or adults to take its place, must be fixed wheel brake, and confirm the stroller will not move, more do not leave at will.3. The baby to bed must have a fence, strong secure. No matter the baby is sleeping in bed or playing, pull a good bed bar should be paid attention to; And the latch bar the bed should be installed in the out of the reach of children, in case the children at play has no intention to open the latch and fall in bed. In addition, the bed grid intervals not too wide, so that the baby fell o