OK, I assumed . . .

Amethya · Mar 2, 2017

This is why I had a ton of kids "dying" on me after the pacer and one of them had a panic attack/breathing trouble that day and I had that argument with the grandmother because she couldn't breathe and I wanted to call 911. The other kids were just being dramatic and after sitting in my office, they were fine.

Amethya · Mar 2, 2017

I have a letter for ANY bump to the head that explains what assessments I do, and that even though they did not have signs or symptoms in my office there is a list at the bottom of the letter of things to look for at home just in case. Just CYA and keeps me from having to make quite so many phone calls. I hold all head bumps for 10 minutes no matter how good the student feels. Then I have a checklist the CDC put out that has a spot for notes and Q15 min checks for when a student seems symptomatic. It's nice and I really like it. Yesterday I sent a kid to the ER with his checklist and the mom came back and said they told her that means nothing, and the checklist is useless to them.
I mean, it's from the CDC. For head injuries. And I had narrative notes that explained what I saw. But whatever, if the ER didn't like my paperwork...
Note that they didn't have any suggestion for what they would rather I do. Ugh.

Do you have a link for the checklist or anything like that? I would love to use this myself too!

NurseBeans, BSN, MSN, RN · Mar 2, 2017

HEADS UP to Schools: School Nurses| HEADS UP | CDC Injury Center (CDC link to concussion info/downloadable checklist I use for symptomatic kiddos)

And the full text of my letter for the "minor", no symptom, just FYI and CYA kiddos

Report of Minor Head Injury:

Date___________________

To the Parent/ Guardian of ______________________________________

Your child had a bump to the head today. There may also be a cut or scrape. If so, I cleaned it and applied a bandage. After checking your child, I saw no immediate problems and your child returned to class. Itis important to remember the size of the bump has no relationship to the seriousness of the injury. A big bump can be nothing dangerous, and no bump can be serious or nothing at all!

Students who have any bump to the head receive a nurse check that includes the following:

ï‚·How they walk, talk, think, their balance and their memory

ï‚·Watching for a period of 10 minutes or more in the health office

ï‚· Check for symptoms of dizziness, nausea or vomiting, and loss of consciousness

This letter is to let you know it does NOT seem that your child's injury requires any additional care.

PLEASE NOTE:I will immediately call you, for ANY head injury that I believe needs more medical attention.

Even though it does not seem this is a serious injury, you should be aware of signs of a concussion (listed below). Please see your medical provider if your child shows any of these symptoms OR anytime you have general questions, concerns, or feel it is appropriate.

Possible signs of concussion:

ï‚·More fatigue or sleepiness

ï‚·Difficulty waking up

ï‚·Changes in vision including double or blurred vision

ï‚·Severe headache that does not respond to pain medication

ï‚·Constant headache or recurring head pain

ï‚·Vomiting

ï‚·Trouble thinking or concentrating

ï‚·Difficulty concentrating

ï‚·Changes in walking or balance

ï‚· Changes in mood and behavior

Please do not hesitate to contact me with any questions or concerns.

JenTheSchoolRN, BSN, RN · Mar 2, 2017

HEADS UP to Schools: School Nurses| HEADS UP | CDC Injury Center (CDC link to concussion info/downloadable checklist I use for symptomatic kiddos)
And the full text of my letter for the "minor", no symptom, just FYI and CYA kiddos
Report of Minor Head Injury:
Date___________________
To the Parent/ Guardian of ______________________________________
Your child had a bump to the head today. There may also be a cut or scrape. If so, I cleaned it and applied a bandage. After checking your child, I saw no immediate problems and your child returned to class. Itis important to remember the size of the bump has no relationship to the seriousness of the injury. A big bump can be nothing dangerous, and no bump can be serious or nothing at all!
Students who have any bump to the head receive a nurse check that includes the following:
ï‚·How they walk, talk, think, their balance and their memory
ï‚·Watching for a period of 10 minutes or more in the health office
ï‚· Check for symptoms of dizziness, nausea or vomiting, and loss of consciousness
This letter is to let you know it does NOT seem that your child's injury requires any additional care.
PLEASE NOTE:I will immediately call you, for ANY head injury that I believe needs more medical attention.
Even though it does not seem this is a serious injury, you should be aware of signs of a concussion (listed below). Please see your medical provider if your child shows any of these symptoms OR anytime you have general questions, concerns, or feel it is appropriate.
Possible signs of concussion:
ï‚·More fatigue or sleepiness
ï‚·Difficulty waking up
ï‚·Changes in vision including double or blurred vision
ï‚·Severe headache that does not respond to pain medication
ï‚·Constant headache or recurring head pain
ï‚·Vomiting
ï‚·Trouble thinking or concentrating
ï‚·Difficulty concentrating
ï‚·Changes in walking or balance
ï‚· Changes in mood and behavior
Please do not hesitate to contact me with any questions or concerns.

I like this a lot!

I have my seen in my office today letters I have sent home on occasion (i.e. "I hit my head on the desk and my teacher sent me, but my head doesn't even hurt" all said while dancing around in my office).

But I also know that with the older kids, it just gets buried in their backpacks. So I always call home for a head bump that I don't suspect concussion on, but has a visible wound (bump, scrap, etc.).

NurseBeans, BSN, MSN, RN · Mar 2, 2017

Oh, yeah I should have added that I always call with a visible mark on the face or head. Just a heads-up to parents so they don't wonder where the mark came from. Or call me angry the next day.

MrNurse(x2), ADN · Mar 2, 2017

Oh, yeah I should have added that I always call with a visible mark on the face or head. Just a heads-up to parents so they don't wonder where the mark came from. Or call me angry the next day.

Yeah, tried to do that with a horrible road rash to the face. I texted a picture with explanation and all she saw was the rash and she saw an allergic reaction. Mom was ticked that I texted without calling (just wanted to diffuse the shock when she picked up from aftercare) and now I can no longer text AND I have to call/ email EVERYTHING. And of course, she only texted admin with the picture only, she somehow separated the text, which I showed to my AP.

BeckyESRN · Mar 2, 2017

I text, but only my generic "please call the school nurse @ phone number" Parents respond way faster to text than to voicemails. I call home for any face injuries or anything that may leave a gnarly mark on any body part. I don't call home about every bump to the head because, I swear, these kids have never developed the neck control to not hit their forehead on the desk when sneezing! Anything that occurred with enough force for me to worry or to leave even a red mark, I call about. I sent out 2 that were confirmed concussion just this week(kinder and 4th grade)

JenTheSchoolRN, BSN, RN · Mar 2, 2017

I would have to text from my personal cell phone, which only a few select parents know the number to. I don't like sharing it much, but I'll text if needed (or have the student text with a message that says "call the school nurse at..."). Typically I stick to phone calls from my office :).