Head Injury
- 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 (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 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
Allow your child to sleep as normal. We would encourage you to check on them a couple of times overnight to check:
- Do they appear to be breathing normally?
- Are they sleeping in a normal posture?
- Do they make the expected response when you rouse them gently? (E.g. pulling up sheets, cuddling teddy-bear)
- If you cannot satisfy yourself that your child is sleeping normally, then waken them fully to check.
Operation Ouch - Head Injury
When should you worry?
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)
- Becomes confused or unaware of their surroundings
- Loses consciousness, becomes drowsy or difficult to wake
- Has a convulsion or fit
- Develops difficulty speaking or understanding what you are saying
- Develops weakness in their arms and legs or starts losing their balance
- Develops problems with their eyesight
- Has clear fluid coming out of their nose or ears
- Does not wake for feeds or cries constantly and cannot be soothed
You need urgent help
Go to the nearest Hospital Emergency (A&E) Department or phone 999
If your child has had any of the following in the 48 hours following their head injury:
- Develops a persistent headache that doesn't go away (despite painkillers such as paracetamol or ibuprofen)
- Develops a worsening headache
You need to contact a doctor or nurse today
Please ring your GP surgery or call NHS 111 - dial 111
If your child:
- Is alert and interacts with you
- Vomits, but only up to twice
- Experiences 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 weeks, 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, call NHS 111 – dial 111
This guidance has been reviewed and adapted by healthcare professionals across North East and North Cumbria with consent from the Hampshire development groups.
What should you do?
- In general, if your child cries immediately after a head injury and returns to their normal self in a short time, they can be managed at home. You should observe them closely for the next couple of days, checking that they are responding normally to you. They may be pale or quieter than normal for the first couple of hours after a head injury – this is normal
- If your child is under a year of age, begins vomiting, has a headache that is getting worse, is behaving oddly or has fallen from a height taller than they are, they will need to be seen urgently by a medical practitioner. Call your GP surgery or ring NHS 111
- 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. Acorn's after concussion return to normal leaflet has lots of infomation to help with this. It is best to avoid computer games, sporting activity and excessive exercise until all symptoms have improved
- The Child Brain Injury Trust (CBIT) is the leading voluntary sector organisation providing emotional and practical support, information and learning opportunities for families and professionals affected by childhood acquired brain injury across the UK.
| Headache | Personality change | Anxiety | Difficulty remembering things or being able to complete tasks |
| Nausea (feeling sick) | Changes to appetite | Depression | Difficulties learning new things |
| Verigo (dizziness) | Sleep disturbance | Aggressive/impulsive behavior | Poor concentration |
| Tinnitus (ringing in ears) | Slower reaction times | ||
| Double/blured vision |
How long will your child’s symptoms last?
Most young people with concussion recover quickly and make a full recovery without any treatment. Some can have symptoms for 3-6 months or longer.
What is the treatment?
The best way to treat concussion is to start with a period of complete brain rest and ensre you get enough sleep. This is done by avoiding anything that will stimulate your brain including television, music, computer games, mobile phones, tablets and attending school. Once you have been symptom free for 48 hours then you can gradually retun to these activities but may need further rest if symptoms return. This may take 1-2 weeks. Download, print or view Acorn's leaftet after concussion return to activity
When can I go back to sport?
Further knocks/blows to the head while you are recovering from concussion can be potentially life-threatening and it is important to return to sport gradually. Hence, if you play for a team your coach must be informed that you have a diagnosis of concussion.
The schedule below is based upon advice from the rugby football union. You should only move to the next stage if you remain free of symptoms and if at any stage symptoms return you should move back a stage for at least 24-48 hours.
| Stage | Day | Exercise Allowed |
|---|---|---|
| Rest | 1-14 | Complete rest - do not enter next stage unless you: ▪ are symptom free ▪ and are off all painkillers ▪ and have retuned to normal studies |
| Light exercise | 14-16 | Normal PE lessons, light running/swimming/cycling |
| Sport specific & light exercise | 16-18 | Non-contact training drills |
| Sport specific & intense exercise | 18-19 | As above plus own normal running/swimming/cycling |
| Full scale practice | 19-21 | Full contact practice |
| Return to play | > 21 | Return to normal game playing |
It's important to follow a schedule related to your sport
Schedules can also be obtained through the Football Association and grassroots/general public info can be found on the ‘If In Doubt, Sit Them Out’ guidance.
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Where should you seek help?
- If your child is under a year of age, begins vomiting, has a headache that is getting worse, is behaving oddly or has fallen from a height taller than they are, they will need to be seen urgently by a medical practitioner. Call 999 or go to the nearest hospital emergency department.
- If your child has any of the above features, they need urgent help. Call 999 or go to the nearest hospital emergency department.
Health visitors are nurses or midwives who are passionate about promoting healthy lifestyles and preventing illness through the delivery of the Healthy Child Programme. They work with you through your pregnancy up until your child is ready to start school.
Health Visitors can also make referrals for you to other health professionals for example hearing or vision concerns or to the Community Paediatricians or to the child and adolescent mental health services.
Contact them by phoning your Health Visitor Team or local Children’s Centre.
Click below to find information on your local health visiting team:
Sound advice
Health visitors also provide advice, support and guidance in caring for your child, including:
- Breastfeeding, weaning and healthy eating
- Exercise, hygiene and safety
- Your child’s growth and development
- Emotional health and wellbeing, including postnatal depression
- Safety in the home
- Stopping smoking
- Contraception and sexual health
- Sleep and behaviour management (including temper tantrums!)
- Toilet training
- Minor illnesses
For more information watch the video: What does a health visitor do?
Health visitors are nurses or midwives who are passionate about promoting healthy lifestyles and preventing illness through the delivery of the Healthy Child Programme. They work with you through your pregnancy up until your child is ready to start school.
Health Visitors can also make referrals for you to other health professionals for example hearing or vision concerns or to the Community Paediatricians or to the child and adolescent mental health services.
Contact them by phoning your Health Visitor Team or local Children’s Centre.
Click below to find information on your local health visiting team:
Sound advice
Health visitors also provide advice, support and guidance in caring for your child, including:
- Breastfeeding, weaning and healthy eating
- Exercise, hygiene and safety
- Your child’s growth and development
- Emotional health and wellbeing, including postnatal depression
- Safety in the home
- Stopping smoking
- Contraception and sexual health
- Sleep and behaviour management (including temper tantrums!)
- Toilet training
- Minor illnesses
For more information watch the video: What does a health visitor do?
School nurses care for children and young people, aged 5-19, and their families, to ensure their health needs are supported within their school and community. They work closely with education staff and other agencies to support parents, carers and the children and young people, with physical and/or emotional health needs.
Primary and secondary schools have an allocated school nurse – telephone your child’s school to ask for the contact details of your named school nurse.
There is also a specialist nurse who works with families who choose to educate their children at home.
What the school nursing service deliver may vary depending on your local area offer. Click the link below to find information on your local school nursing team:
Sound Advice
Before your child starts school your health visitor will meet with the school nursing team to transfer their care to the school nursing service. The school nursing team consists of a school nursing lead, specialist public health practitioners and school health staff nurses.
They all have a role in preventing disease and promoting health and wellbeing, by:-
- encouraging healthier lifestyles
- offering immunisations
- giving information, advice and support to children, young people and their families
- supporting children with complex health needs
Each member of the team has links with many other professionals who also work with children including community paediatricians, child and adolescent mental health teams, health visitors and speech and language therapists. The school health nursing service also forms part of the multi-agency services for children, young people and families where there are child protection or safeguarding issues.
School nurses care for children and young people, aged 5-19, and their families, to ensure their health needs are supported within their school and community. They work closely with education staff and other agencies to support parents, carers and the children and young people, with physical and/or emotional health needs.
Primary and secondary schools have an allocated school nurse – telephone your child’s school to ask for the contact details of your named school nurse.
There is also a specialist nurse who works with families who choose to educate their children at home.
What the school nursing service deliver may vary depending on your local area offer. Click the link below to find information on your local school nursing team:
Sound Advice
Before your child starts school your health visitor will meet with the school nursing team to transfer their care to the school nursing service. The school nursing team consists of a school nursing lead, specialist public health practitioners and school health staff nurses.
They all have a role in preventing disease and promoting health and wellbeing, by:-
- encouraging healthier lifestyles
- offering immunisations
- giving information, advice and support to children, young people and their families
- supporting children with complex health needs
Each member of the team has links with many other professionals who also work with children including community paediatricians, child and adolescent mental health teams, health visitors and speech and language therapists. The school health nursing service also forms part of the multi-agency services for children, young people and families where there are child protection or safeguarding issues.
If you’re not sure which NHS service you need, call 111. An adviser will ask you questions to assess your symptoms and then give you the advice you need, or direct you straightaway to the best service for you in your area.
Sound advice
Use NHS 111 if you are unsure what to do next, have any questions about a condition or treatment or require information about local health services.
For information on common childhood illnesses go to What is wrong with my child?
If you’re not sure which NHS service you need, call 111. An adviser will ask you questions to assess your symptoms and then give you the advice you need, or direct you straightaway to the best service for you in your area.
Sound advice
Use NHS 111 if you are unsure what to do next, have any questions about a condition or treatment or require information about local health services.
For information on common childhood illnesses go to What is wrong with my child?
A&E departments provide vital care for life-threatening emergencies, such as loss of consciousness, suspected heart attacks, breathing difficulties, or severe bleeding that cannot be stopped. If you’re not sure it’s an emergency, call 111 for advice.
Sound advice
A&E departments provide vital care for life-threatening emergencies, such as loss of consciousness, suspected heart attacks, breathing difficulties, or severe bleeding that cannot be stopped. If you’re not sure it’s an emergency, call 111 for advice.
Sound advice
