Neck and eye injuries

[conscientiousnurse]

Today I had a child get pushed to the ground and had some pain to his upper neck/occipital area. He was also a little dizzy and said he was tired. I ended up sending him home even though he didn't have severe symptoms (with a head bump letter). There was also a boy who had a ball hit right over his eye area (with closed eye), but it didn't swell up or make the eye bleed. He said vision was a little blurry, but could still read with that eye, so I called Mom but sent back to class. What would you all do in these situations? How do you tell how concerned to be about a neck injury?

[BunnyBunnyBSNRN, ASN, BSN]

You did the right thing to send the kid home - with the report of pain and dizziness, I probably would have instructed the parent to seek medical attention or at least call the kid's doctor.

With the c/o of blurry vision I would have done a quick vision screening with the kid. If there was no change from his last vision screening, I would have sent him back to class and then called mom - also, would have assessed for a head injury just b/c he was hit in the head. If the vision screening had changed (for the worse) I would have called mom and instructed to p/u and seek medical attention.

You did the right thing, always follow your gut!

[rdsxfnrn]

when in doubt err on the side of caution. wouldnt you rather call the parents and have it checked out and its nothing, rather that not calling and not having it checked and its a big problem? always take the safest route for the child. :)

[Purple_Scrubs, BSN, RN]

Yes, I would have called and referred as well. I always try to think what is the worst case scenerio that could happen with this injury and base my decision on that. Unfortunately, it is a CYA world and it is better safe than sorry!

[mustlovepoodles, RN]

Today I had a child get pushed to the ground and had some pain to his upper neck/occipital area. He was also a little dizzy and said he was tired. I ended up sending him home even though he didn't have severe symptoms (with a head bump letter). There was also a boy who had a ball hit right over his eye area (with closed eye), but it didn't swell up or make the eye bleed. He said vision was a little blurry, but could still read with that eye, so I called Mom but sent back to class. What would you all do in these situations? How do you tell how concerned to be about a neck injury?

I would do what you did: Call the parents, give them the low-down, and let them decide what happens next. I have often suggested to parents that they might want to come to school to check something out. I always call for any sort of head, face, neck or eye injury, no matter how trivial it may look to me. What the parent decides to do with that information is their business. As long as there isn't any serious stuff happening (altered consciousness, obvious eye injury, lacerations,etc) I just put it in the parents' court.

[marilyn jenkins]

My rule is always assess first, then call parents and have them pick the student up; head injuries are too unpredictable and can turn south quickly. I deal with the teenage crowd and my first week on the job involved two head injuries!