head injury

[farmgoat]

For the 99% percent of head injuries that turn out to not be concussions, which ones do you call home about? I work in an elementary and usually have head bumps of varying levels of intensity every day. Obviously actual concussions go to the ER, but what about everything else, those bumps and bruises that have no neuro changes when they present...?

I almost always send a note about "warning signs of concussions," but I debate the necessity of calling. I have had parents call me upset about not getting called, etc etc though, so I do call about most of them.

Just curious what others out there do! Thanks

[MrNurse(x2), ADN]

This was just discussed a few days ago, to give you a few more opinions. https://allnurses.com/school-nurses/head-injury-1034422.html

and this is referring to high school, but still has good info

https://allnurses.com/school-nurses/high-school-head-1033955.html

[vikivail26]

I only call if there is any swelling, redness, or bleeding. I usually call just avoid having a parent call back questioning why I did not call them.

[jhlpn]

Think what you would do as a parent. If my child hits his head at school I would want to know. I call home for any and all head injuries!

[OldDude]

I use a few factors to decide to notify a parent. I am on the elementary level. I always notify if the mechanism of injury has the potential to cause a brain injury, like falling out of a swing, colliding with another at recess, hitting head on gym floor, etc. I always notify if there is a sign of injury from the neck up regardless of the mechanism of injury. In most cases I'll text a photo of the injury to the parent after I talk to them - if they want one. I usually don't notify if the mechanism of injury is unlikely to cause a brain injury AND there is no sign of injury; no abrasion, redness, swelling - like dropping a pencil in class and bumping their head on the desk as they raise up or underneath playground equipment and bump their head as they are coming our from under it.

[Keepstanding, ASN, RN]

Our system's policy is to call for any and all head bumps whether minor or serious.....it all warrants a call.

[BeckyESRN]

I call for anything that leaves a mark(redness, bruise, scratch) on the face/head. Head injuries that leave no mark and have no SxS to be concerned over, I don't call. If it's something forceful, like OldDude said, I call to let the parent know how it happened and when. I won't call a "we bumped heads reaching for the same pencil", but will definitely call a "we bumped heads while we were running at each other trying to catch the ball" I've never had a parent upset with me for calling about something minor.