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Head Injury
- Most head injuries are not serious and simply cause a bump or a bruise, and often they do not require medical attention.
- 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.
- 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.
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 or develops bruising around both eyes or behind an ear
- Does not wake for feeds or cries constantly and cannot be soothed
- Has memory loss of events before or after the injury
- Takes blood thinners or Any history of bleeding or clotting disorders
- The head injury was high impact such as:
- a road traffic accident
- a fall from a height of greater than 1 metre or greater than child’s own height or more than 5 stairs
- Your child is younger than 6 months or under 1 year with a bruise ,swelling or cut of more than 5 cm on the head
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 out of hours contact NHS 111 for advice – dial 111 or for children aged 5 years and above visit 111.nhs.uk
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, please ring your GP surgery or out of hours contact NHS 111 for advice – dial 111 or for children aged 5 years and above visit 111.nhs.uk
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.
- 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.
- Ensure that they have plenty of rest initially. A gradual return to normal activities/school is always recommended.
- Increase activities only as symptoms improve and at a manageable pace.
- It is best to avoid computer games, sporting activity and excessive exercise until all symptoms have improved.
- Try not to leave your child alone at home for the first 48 hours after a significant head injury
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Concussion following a head injury?
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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 – these 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, but 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 and that they are assessed by a doctor before beginning activities that may result in them having another head injury.
- If you are very concerned about these symptoms or they last longer than 2 months, you should seek medical advice from your doctor.
Return to sport?
- Repeated head injury during recovery from concussion can cause long term damage to a child’s brain.
- Expect to stay off sport until at least 2 weeks after symptoms are fully recovered.
- Always discuss with your child’s school and sports club to discuss a gradual return to full activity.
For further information:
Rugby: Click here.
Football: Click here.
After Concussion, Return to Normality (ACoRN)
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.
Where should you seek help?
- If it is non-urgent, speak to your local pharmacist or health visitor.
- If your child has any of the above amber features, urgently see your GP. If your GP surgery is closed, please call NHS 111.
- You should only call 999 or go your nearest A&E department in critical, life threatening situations or red signs above.
For wear and tear, minor trips and everything in between.
Self-care
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?
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, so they are a good first port of call. Your pharmacist will say if you need further medical attention.
Sound advice
- Visit a pharmacy if your child is ill, but does not need to see a GP.
- Remember that if your child's condition gets worse, you should seek further medical advice immediately.
- 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 to the child and adolescent mental health services.
Contact them by phoning your Health Visitor Team or local Children’s Centre.
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.
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.
Sound advice
You have a choice of service:
- Doctors/GPs can treat many illnesses that do not warrant a visit to A&E.
- 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.
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
Survey for parents/carers - what was the outcome of you looking at this page?
Survey for parents/carers - what was the outcome of you looking at this page?
