Every parent knows the sound: the "clunk" in the middle of the night as a child hits the floor from falling out of bed. Unless the child is sleeping in a top bunk, falls from bed usually are no more than a few feet, and they rarely result in serious injury. However, falls from a height greater than 3 feet can result in injury, pediatrician and author Dr. William Sears states. Parents should be aware of signs of possible serious injury from any fall.
Children who have a head injury from a fall from the bed may lose consciousness. Passing out, even briefly, should be investigated by medical personnel. Call 911 if a child remains unconscious. Top bunk bed injuries are most serious, the Cincinnati Children's Hospital reports; skull fractures and concussion occur most often when children fall onto an uncarpeted surface. A child with an internal head injury may seem fine after the accident but may become progressively sleepy, unresponsive or lethargic. She may complain of a severe headache or cry for a prolonged period if she isn't old enough to verbalize what's bothering her. Any sign of altered mental status reqiures medical investigation.
Vital Sign Changes
A child with a head injury after falling out of bed may become pale or even blue and could present shallow, irregular breathing. Vomiting once is common after a fall, but vomiting three or more times may be a sign of head injury, so have the child checked by medical personnel.
A child who falls out of bed may break a bone; the clavicle is a common fracture, but arms and legs also can break in a fall. Inability to move an extremity, limping, complaining of pain when moving, swelling or abnormal position of the bone or the area around it may indicate fracture. Head injuries can cause a loss of coordination; a child may stagger, fall or be unable to walk in a straight line. If you suspect any type of neck or spinal injury, do not move the child; call 911 and wait for medical personnel.
Children who fall from the bed and have a head injury may have obvious visual changes. Their eyes may cross or roll or move rapidly from one side to another, a movement called nystagmus. One pupil may be more dilated than the other. Older children may complain of double vision or blurred vision, Dr. Sears notes. Ocular changes should be reviewed by a doctor.
Cuts and Bruises
A child who falls from the bed may be bleeding, especially if he fell onto an object on the floor. Check to see that the bleeding is controlled, stops easily and isn't spurting from the wound. Wounds that are gaping may need stitches and should be evaluated by medical personnel. Check the child for bruising, which may be a sign of injury that might not otherwise be immediately apparent. A large bruise on the forehead looks scary, but even big bumps are rarely serious, Dr. Sears advises. Watch for behavior changes and apply ice to the bump.