Bump to Head, Head Injury and Concussion Policy

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Amelia York
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1 Bump to Head, Head Injury and Concussion Policy Policy Type Non-regulatory Last Review Summer 2018 Next Review Autumn 2018

2 Bump to Head, Head Injury & Concussion Policy See Appendix 1 for a flow chart diagram on how head injuries are assessed, treated and communicated within school. Minor Bump To Head A minor bump to the head is common in children particularly those of primary school age. If a child is asymptomatic i.e. there is no bruising, swelling, abrasion, mark of any kind, dizziness, headache, nausea or vomiting and the child appears well then the incident will be treated as a bump rather than a head injury. Treatment in school: Child to be assessed by a First aider Observe, If pupil begins to display head injury symptoms then will be sent to school nurse for further assessment, if no change during observation then pupil returned to normal lessons Junior and senior school medical room staff to record the episode on ISAMS under read code Bump to Head. Minor Head Injury no loss of consciousness. A minor head injury often just causes bumps or bruises on the exterior of the head. Other symptoms Include: Nausea Mild headache Tender bruising or mild swelling of the scalp Mild dizziness Treatment in school: Paracetamol if needed for pain relief (Ibuprofen should not be given if a head injury is suspected) Ice pack to swelling Rest Observation Head Injury advice sheet given to pupil Junior school pupils to receive a sticker indicating they have had a head Injury so that staff can see easily that the girl has bumped her head that day. Accident form to be completed and entry made of accident on school medical database (ISAMS) under read code Accident.

3 Parent informed by read receipt informing that their daughter has sustained a minor head injury and requesting they read an attached head injury advice letter (Appendix 2) If any of the following symptoms are displayed, the girl would need to receive immediate medical attention in hospital, if there is a: Loss of consciousness/confusion or drowsiness Loss of balance or difficulty in walking Loss of power in arms/legs Clear fluid leaks from nose or ear Significant visual disturbance blurred or double vision Severe headache not eased by pain relief Vomiting Seizure Severe Head Injury loss of consciousness. A severe head injury will usually be indicated by one or more of the following symptoms: Symptoms: Unconsciousness briefly or longer Difficulty in staying awake Seizure Slurred speech Visual problems Difficulty in understanding what people are saying Balance problems Loss of power in arms/legs/feet Pins & needles Amnesia Leakage of clear fluid from nose or ears Bruising around eyes/behind ears Treatment in school: Suspect neck injury if unconscious and do not move CALL 999 FOR AMBULANCE

4 Notify parent by phone Complete accident form Sports Head injury policy on return to play following a head injury to be in place on return to school. Conclusion Concussion is the sudden but short-lived loss of mental function that occurs after a blow or other injury to the head. It is the most common but least serious type of brain injury. The medical term for concussion is minor traumatic brain injury. The cumulative effects of having more than one concussion can be permanently damaging. Concussion must be taken extremely seriously to safeguard the long-term welfare of the person. Symptoms include: Headache Dizziness Feeling in a fog May or may not have lost consciousness Vacant expression Vomiting Unsteady on legs Slow reactions Inappropriate or abnormal emotions irritability/nervous/anxious Confused/disorientated Loss of memory of events leading up to and after the concussion Treatment: If a head injury occurs during sport the player should be removed from the game and must not resume play Rest Ice pack Simple painkillers such as paracetamol. (Ibuprofen should not be given if a head injury is suspected) Observation Head injury advice sheet given and parent informed

5 If any of the above symptoms occur the girl must be seen by a medical professional in A&E, minor injuries or the GP surgery, the school nurse will advise on the best course of action. However, if in doubt the girl should be seen in hospital. PE staff to be notified of likely concussion and girl signed off PE until notification has been received that a girl does or does not have concussion. Guidance followed from Rugby Football Union on Return to Play after Concussion. This gives clear guidance on students returning to academic studies and sport following a concussion. Appendix 3. Girls with a suspected concussion should be advised to rest and to avoid the following initially before then gradually re-introducing them: Reading, T.V, Computer games, driving. Louise Howel (School Nurse) Reviewed - April 2018

6 Appendix 1

7 Appendix 2 ADVICE TO PARENTS AND CARERS CONCERNING CHILDREN WITH HEAD INJURIES This child has sustained a head injury and following thorough examination we are satisfied that the injury does not appear to be serious. It is expected that the recovery will be rapid and complete. Do Do Do Do expect the child to feel generally miserable and off colour. Do not force them to eat, but make sure she has enough to drink. expect the child to be more tired than usual. Allow them to sleep if they want to. Just pop in top see them every couple of hours. Do not be confused between normal sleep and unconsciousness someone who is unconscious cannot be woken up you need to be satisfied they are reacting normally to you. expect the child to have a slight headache keep the child quiet and resting as much as possible. Keep them away from school, discourage active games, watching TV and reading until the symptoms subside. These symptoms should improve steadily and the child should be back to normal within a few days. Even after a minor injury, complications may occur, but they are rare. If the symptoms worsen, or if you notice the following signs: Difficulty in waking from sleep Appears confused or not understanding what is said to them Vomiting Complaining of severe headache, or trouble with their eyesight Become irritable Has any kind of attack which you think is a fit Then you are advised to: CONTACT YOUR DOCTOR OR CONTACT THE ACCIDENT AND EMERGENCY DEPARTMENT WITHOUT DELAY Louise Howel School Nurse

8 Appendix 3 GRADUATED RETURN TO PLAY Step Time at Stage Rehabilitation Exercise Allowed Days Rest Complete Physical and cognitive rest without symptoms Objectives Recovery Signed Off and Date hrs Later hrs Later hrs Later hrs Later Light Aerobic Exercise Sports Specific Exercise Non-contact training drills Full contact Practice Walking, swimming, static bike. No resistance training Running drills. No head impact activities More complex drills E.g. passing drills. May start resistance training Normal training session rd Day Return to Play Player rehabilitated Increase heart rate and access recovery Add movement and assess recovery Add exercise + coordination and cognitive load. Assess recovery. Restore confidence and assess functional skills by coaching staff Safe to return to play

Emergency Department. Advice after your child s head injury Information for parents and carers

Emergency Department. Advice after your child s head injury Information for parents and carers Emergency Department Advice after your child s head injury Information for parents and carers Your doctor or nurse practitioner has examined your child and is happy for them to go home. When you get your