How To React and Examine A Child Who Fell Down A Flight of Stairs

The first thing to understand about a child falling down the stairs is that its no way as serious as it sounds. While an adult falling down the stairs is quite serious this is not the case with a child. An adult weighs more, is larger, and is taller than a child. When an adult falls down a flight of stairs we might suspect a head or spinal injury resulting from a head first fall. A child on the other hand is not only smaller and shorter than an adult, but their bones are more flexible and less susceptible to injury.

In 2002 the Archives of Disease in Childhood (ADC) released a study titled “Do Falls Down Stairs Cause Serious Injury In Preschool Children?” Data was collected over the course of 18 months from 437 children with ages ranging from under nine months to around four years old. The study concluded the following:

Only 6 children (1%) sustained proximal limb fractures. There were no rib fracture. There were no deaths or severe injuries such as cerebral hemorrhages/tears, visceral trauma or spinal fractures.

Conclusions: Severe injuries and death do not occur as a result of falls down stairs. The pattern of injury is peripheral with sparing of the trunk. Multiple injuries are rare.

(Please note that this post (and the above study as well), is not dealing with a fall down the stairs involving a baby in a walker. Falls of this nature are much more severe for several reasons which are beyond the scope of this post.)

What To Do
The one thing you shouldn’t do when your child falls down the stairs is scream, “OH MY G-D, OH MY G—D!!!, JENNIFER FELL DOWN THE STAIRS!!! OH MY G—D!!! JENNIFERRRRR!!! Even if your daughter’s name is not Jennifer.

Freaking out like that WILL NOT help the situation.

Scene Survey
As you are running to your child take note of the following:

• Is your child crying?
• Is your child moving?
• Is your child bleeding?

If the answers are yes, yes, and no, then that’s great.

Is your child crying?
Your child should cry after falling down a flight of stairs. Crying means that they are conscious and alert. Hopefully, there’s no serious head injury other than a bump on the head.

Is your child moving?
If your child is moving or can move their arms and legs then we can almost rule out any spinal injury.

Is your child bleeding?
It’s obviously a good thing if there is no external bleeding. If you see blood then chances are likely that they are bleeding from either their nose or mouth. The bleeding would probably be minor.

Examining Your Child
Once you reach your child its important to try to remain calm. Your child may be screaming but its important to examine them properly.

Here’s what you should look for:

• Injury to the head, neck, arms, legs
• If they can move
• If they can feel you touching their hands and legs

It’s good to start by asking your child where it hurts. If they tell you that their head hurts then gently feel their head for any obvious injury and bleeding. A bump is common and is generally no need for concern. If they aren’t complaining of any pain in the arms and legs then chances are they have no injury there. If they do complain of pain to either their arms or legs you can easily examine them for possible fractures by following the directions in this past post.

If you are neurotic and still concerned that your child suffered a more serious injury then you could examine their neck as well. Simply feel along the back of their neck for any obvious deformity. If you are not sure what to feel for then feel the back of your own neck to get an idea of what feels normal. After you’ve examined their neck you could ask them to move their arms and legs for you. You could then touch their feet and ask them if they can feel your touch.

Once you’ve determined that except for a few bumps and bruises your child is fine you could then decide if you want to take them to the doctor for further examination.

Like I mentioned before, chances are slim that your child suffered a serious injury from falling down the stairs. The worst thing you could do in this situation is overreact.

This post was submitted to the March 3 issue of the Carnival of Family Life hosted over at Discussing Autism.

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