Head injury question

[Nurse ABC]

What is typical protocol for a kid brought to the ER for signs/symptoms of a concussion?

I'm a school nurse and my son hit his head hard on the ground getting tackled in a football game. (I'm not asking for personal advice-this happened last fall and I want to know what to do in future). My husband was a coach and he noticed he wasn't acting right several minutes later so I went down and checked him. I did a neuro check on him. His responses were very slow, he was confused, didn't remember what happened along with bad headache. We had him rest for a few minutes and he started feeling very nauseated and sleepy. We took him to the ER where they made us wait almost 2 hrs. The dr finally sees him and his responses are back to almost normal and he's feeling better except for a bad headache/stomachache. The only thing the dr did was another neuro check. No scans of any kind. He released him to go home. He didn't go back to school for 3 days because his head was hurting and everything wore him out. We ourselves cut out his video games and limited TV to give his brain a break. It took him about 3 weeks at least to feel back to normal.

So my question is, if this happens again do I even bother taking him in, are there other signs I need to look for that would warrant a trip, should I go to a different ER, should I have waited longer? Since he had signs of a concussion I thought I should have him checked but the dr didn't do anything I hadn't already done. They made me feel stupid for bringing him in quite frankly and being a nurse I don't take my kids to dr unless I feel they REALLY need to go. I'm confused about what to do. Thanks for any advice.

[NutmeggeRN, BSN]

Biomarkers could tell doctors when concussed athletes are safe to compete - Medical News Today

Intersting article on a more objective assesment. I will be curious to see where this goes.

[1fastRN]

You did all the right things. The more concussions they have, the more severe the symptoms/damage can be. You did right to limit tv video etc. When I have a kiddo at school (HS) with a head injury, I email teachers and guidance and asst principal, because the symptoms can play out in a variety of ways. All our student/athletes do a baseline neuro cognitive assessment(ImPact testing -www.impacttest.com ) This is ONE tool in the process that determines return to play. There are other programs out there as well.

It sounds like he had a doozy of a concussion and as such it would warrant medical followup in the event he gets hurt again.

Was just going to post about doing the baseline test. I've done it myself and I'd suggest you have your kiddo do it.

And AMEN on contacting the school! My brother had a severe concussion in high school with some retrograde and minor anterograde amnesia from a 120mph rollover. He looked fine on the outside but suffered for years. His whole attitude changed; he had a short temper/mood swings, he couldn't concentrate, his memory was terrible, and he was always tired. The school gave him SUCH a hard time and offered no support as his academic performance went down the drain. The teachers/principals/guidance counselors were not understanding at all. It's hard to take into account an injury that is invisible. If he broke his leg accommodations would have easily been made but unfortunately people don't understand brain injuries. So bring it to his teachers attention if you believe it may be an issue, sometimes they just need a little education.