Head Injury

Advice following Emergency Department attendance

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Head Injury (266kB pdf)

Introduction

Most head injuries are not serious and simply cause a bump or a bruise.

If your child’s head is bleeding, apply pressure for 5-10 minutes. If it continues to bleed, they may need to have it glued or have steristrips (sticker stitches) applied (normal stitches are very rarely required). This can usually be done in a minor injuries unit, an urgent treatment centre or a walk in centre. Some GPs will also assess and treat minor injuries.

A significant head injury can result in concussion. A child or young person does not have to have been unconscious, or “knocked out” for concussion to occur.

Common symptoms of concussion include headache, fatigue, poor sleep and difficulty concentrating / learning.

Any child who has had a head injury should be carefully watched, especially in the 2 days following the injury. Do not leave your child alone at home for the first 48 hours after leaving hospital.

What can I do to help my child after a head injury?

Let your child rest and try to avoid strenuous activity until their symptoms have settled.

Give them paracetamol (calpol) and/or ibuprofen if they are in pain.

If your child has been concussed, a graded return to normal activities/school is always recommended. It is best to avoid computer games, sporting activity and excessive exercise until all symptoms have improved –

*(See or ask for our information leaflet on ‘Concussion in children’)

Is it alright to let my child go to sleep?

Yes normal naps and sleep appropriate for your child is absolutely fine.

If your child would normally be awake and sleep longer, make sure they are easily rousable (wakeable). If you have any concerns about this please get them assessed by a medical professional.

When you go home, your child may:

Have a mild headache but it should be relieved when treated with paracetamol or ibuprofen

Be irritable and grumpy
Feel dizzy for a few hours
Not remember things about the injury
Have problems sleeping
A poor memory and short attention span
Be exhausted by the injury and hospital stay, but is not more sleepy or difficult to wake than normal.

If you feel very concerned about any of these symptoms in the few days after discharge take your child to their GP. If the symptoms do not go away after two weeks you should take your child to their GP so they can be referred onto a specialist. The majority of children who are referred on to a specialist have completely recovered by the time they are seen and do not need any further care.

Returning to normal activities/ Playing sports following head injury

Unless told otherwise by the emergency clinician, wait until your child has no symptoms for at least one week before they play sports at home or at school.

This includes rugby, football, trampolining or engaging in any rough play that is likely to injure their head.

When to seek further help?

RED	If your child has had any of the following in the 48 hours following their head injury: Vomits repeatedly i.e. more than twice (at least 10 minutes between each vomit)Is confused or unaware of their surroundingsCannot remember events (amnesia) for more than 5 minutesHas lost consciousness, becomes drowsy or difficult to wakeHas a convulsion or fitHas difficulty speaking or understanding what you are sayingHas weakness in their arms and legs or starts losing their balanceHas problems with their eyesightHas clear fluid coming out of (leaking from) their nose or earsDoes not wake for feeds or cries constantly and cannot be soothedA large swelling or laceration (cut) bigger than 5cm if your child is under one year of ageHas bruising around their eyes or behind their earsHas a very boggy (squashy) swelling that developsYou should also consider bringing your child to hospital if the ‘mechanism’ of injury was significant ie falling from greater than their own height or being involved in a road traffic collision and displaying any symptoms	Your child needs urgent help Either take them to your nearest Emergency Department or Ring 999 immediately for help
AMBER	If your child has had any of the following in the 48 hours following their head injury: Has a persistent headache that doesn’t go away (despite painkillers such as paracetamol or ibuprofen)Has a worsening headache	You need to contact a doctor or nurse today. Please ring your GP surgery or call NHS 111 – dial 111
GREEN	If your child: Is alert and interacts with youVomits, but only up to twiceExperiences mild headaches, struggles to concentrate, lacks appetite or has problems sleeping – if you are very concerned about these symptoms or they go on for more than 2 months, make an appointment to see your GP.	Self care Continue providing your child’s care at home. If you are still concerned about your child, speak to your health visitor, local pharmacist or call NHS 111– dial 111

This leaflet only gives general information. You must always discuss the individual treatment of your child with the appropriate member of staff. Do not rely on this leaflet alone for information about your child’s treatment.

This information can be made available in other languages and formats if requested.