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Head Injury

• Most head injuries are not serious and simply cause a bump or a bruise to the head or face.

• Hold an ice pack (or a bag of frozen peas in a tea towel) to the area regularly for short periods in the first few days to bring down any swelling.

• If your child’s head is bleeding, apply pressure for 5 to 10 minutes. If it continues to bleed, they may need to have it glued (stitches are very rarely required). If you have a minor injuries unit or walk in centre near by, they can usually do this but otherwise you may need to attend A&E.

• A 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 or learning.

Operation Ouch - Head Injury

When should you worry?

If your child has any of the following:

• The head injury was high impact for example:

• A road traffic accident

• Fall from a height of more than 1 metre (more than the child’s own height, or more than 5 stairs)

• A bruise, swelling or cut more than 5cm on the head

• Vomits repeatedly, for example 3 times or more (at least 10 minutes between each vomit)

• Behaves oddly, becomes confused or unaware of their surroundings

• Loses consciousness, becomes drowsy or difficult to wake

• Has a convulsion or fit (uncontrolled jerking, twitching movements)

• 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

• Bruising around their eyes or behind their ears

•Does not wake for feeds, is irritable or cries constantly and cannot be soothed

• Has memory loss of events before or after the injury

• Takes blood thinners or has a bleeding or clotting disorder

You need urgent help

Go to the nearest Hospital Accident and Emergency Department or phone 999

If your child has any of the following:

  • Develops a persistent headache that doesn't go away (despite painkillers such as paracetamol or ibuprofen)
  • Develops a worsening headache with none of the RED symptoms above

You need to contact a doctor or nurse today

Please ring your GP surgery or call NHS 111

We recognise that during COVID, at peak times, access to a health care professional may be delayed. If symptoms persist for 4 hours or more and you have not been able to speak to either a member of staff from your GP practice or to NHS 111 staff, then consider taking them to your nearest A&E

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 with your GP

Self care

Continue providing your child’s care at home. If you are still concerned about your child, call NHS 111 or contact your local community pharmacist

This guidance has been reviewed and adapted by healthcare professionals across West Yorkshire 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 checking that they are responding normally to you.     

•  For the first couple of days after a bump to the head it is normal for your child to:

- have a mild headache

- feel sick and not want to eat

- have difficulty concentrating

- feel more tired than usual 

• You should:

- make sure you or another adult stays with your child for at least the first 24 hours after a head injury

- let your child rest

- keep a regular sleep routine going to bed and waking at the same time each day

- you do not need to keep your child awake as it may make them irritable and bad tempered

- encourage them to drink plenty of clear fluids and try a little food

- allow them to play as normal but encourage quiet play and avoid strenuous activity until their symptoms have settled

- avoid loud noise, TV and computer games

- increase activity as symptoms improve at a manageable pace

- Give them paracetamol and, or ibuprofen if they are in pain

 

Return to normal activities

Most children only need 24 to 48 hours of rest before they are able to return to light day to day activities

They can return to school once they are symptom free but may need to start gradually with regular breaks

Avoid rough play and contact sports for 3 weeks

 

Concussion following a head injury

Symptoms of concussion include mild headache, feeling sick (without vomiting), dizziness, bad temper, problems concentrating, difficulty remembering things, tiredness, lack of appetite or problems sleeping. This can last for a few days, weeks or even months. Some symptoms resolve quickly whilst others may take a little longer.

Concussion can happen after a mild head injury, even if they haven’t been “knocked out”.

9 out of 10 children with concussion recover fully. Some can experience long term effects, especially if they return to sporting activities too quickly. It is really important that your child has a gradual return to normal activities.

It is best to avoid computer games, sporting activities and excessive exercise until all symptoms have improved.

If you are very concerned about these symptoms or they last longer than 2 months, you should seek medical advice from your doctor.

Here is a leaflet on returning to normal activities after concussion.

Return to sport

Repeated head injury during recovery from concussion can cause long term damage to a child’s brain.

Expect your child to stay off sport until at least 2 weeks after symptoms have fully resolved. 

Speak to your child’s school and sports club about a gradual return to full activity.

Further information on return to sport:

How long will your child’s symptoms last?

  • Your child is likely to return to normal within a few hours of a minor head injury
  • In the few days following a more significant head injury, your child may experience mild headaches, might be irritable, may struggle to concentrate, may lack appetite and may have problems sleeping. If these symptoms go on for more than 2 weeks, make an appointment to see your GP

For more information

Visit The Children's Trust website. They are the UK's leading charity for children with brain injury. They deliver rehabilitation, education and community services through skilled teams who work with children and young people, and their families children’s brain injury trust links

Further information on head injuries and concussion visit the NHS website. 

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 assessed urgently by a medical practitioner. Call your GP surgery or ring NHS 111.
  • If your child has any of the above features, they need urgent help. Call 999 or go to the nearest hospital emergency department.

You can treat your child's very minor illnesses and injuries at home.

Some illnesses can be treated in your own home with support and advice from the services listed when required, using the recommended medicines and getting plenty of rest.

Sound advice

Children can recover from illness quickly but also can become more poorly quickly; it is important to seek further advice if a child's condition gets worse.

For information on common childhood illnesses go to What is wrong with my child?

All community pharmacies across England are required to be Healthy Living Pharmacies. This means that they are able to offer advice on a range of healthy living matters which includes eating a healthy diet. They can provide information leaflets and give parents, carers and young people more information about other organisations that might also be able to help.

Pharmacists are experts in many aspects of healthcare, and can offer advice on a wide range of long-term conditions and common illnesses such as coughs, colds and stomach upsets. You don’t need an appointment, and many have private consultation areas. Your pharmacist will say if you need further medical attention.

Sound advice

  1. Visit a pharmacy if your child is ill, but does not need to see a GP.
  2. Remember that if your child's condition gets worse, you should seek further medical advice immediately.
  3. Help your child to understand. Watch this video with them about going to the pharmacy.

For information on common childhood illnesses go to What is wrong with my child?

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 the child and adolescent mental health services.

 

Contact your local Health Visiting Team:

Bradford Health Visitors or call - 01274 221223

Wakefield Health Visitors or call - 0300 373 0944

Craven Health Visitors or call - 01423 544265

Leeds Health Visitors or call - 0113 843 5683

Calderdale Health Visitors or call - 030 0304 5555 (local rate number)

Kirklees Health Visitors or call - 030 0304 5555 (local rate number)

Sound advice

Health visitors also provide advice, support and guidance in caring for your child, including:

For more information about what Health Visitors do: What does a health visitor do?

School nurses care for children and young people, aged 5 to19, 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.

 

Contacting the School Nurse

Primary and secondary schools have an allocated school nurse. Phone 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.

Contact your local school nursing team:

Bradford School Nurses 01274 221203

Wakefield School Nurses (0 to 19 service) 0300 373 0944 (local rate number)

Leeds School Nurses 0113 843 5683

Calderdale School Nurses 030 3330 9974 (local rate number)

Kirklees School Nurses 0300 304 5555 (local rate number)

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.

GPs assess, treat and manage a whole range of health problems. They also provide health education, give vaccinations and carry out simple surgical procedures. Your GP will arrange a referral to a hospital specialist should you need it.

All children should be registered with a GP. Anyone in England can register for free with a GP surgery. You do not need proof of address or immigration status, ID or an NHS number.

How to find your local GP.

Sound advice

You have a choice of service:

  1. Doctors/GPs can treat many illnesses that do not warrant a visit to A&E.
  2. Help your child to understand. Watch this video with them about visiting the GP or going to a walk in centre

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.

Please note, the online version of NHS 111 is only recommended for children over the age of 5. If your child is under 5 years old, please phone 111.

NHS 111 can also direct you to your nearest urgent treatment centre (minor injuries unit or walk-in centre).

Find your local urgent treatment centre.

When to visit an urgent treatment centre.

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
  • breathing difficulties
  • severe bleeding that cannot be stopped
  • major trauma such as road traffic collisions

If you’re not sure it’s an emergency, call 111 for advice.

Sound advice

  1. Many visits to A&E and calls to 999 could be resolved by any other NHS services.
  2. If your child's condition is not critical, choose another service to get them the best possible treatment.
  3. Help your child to understand. Watch this video with them about going to A&E or riding in an ambulance