You have been given this leaflet because the hospital think your child is at risk of concussion. However, the vast majority of children who receive this advice leaflet will not develop signs of concussion.
Following a head injury an adult should supervise your child for the next 24 hours. They should also receive regular pain relief (for example, Paracetamol), avoid high stimulation activities and keep good sleep routine. If you are concerned that they are developing one of the problems listed below, please telephone NHS 111, or consider bringing them back to hospital.
The signs that you should look out for are:
- If your child is unusually sleepy or hard to wake up.
- Headache all the time, which painkillers don’t help.
- Repeated vomiting
- Weakness of arms or legs, for example unable to hold things.
- Confusion (not knowing where they are, getting things muddled.
- Fluid or blood coming from ear or nose.
- Fits (convulsions or seizures)
- Any other abnormal behaviour.
Allow your child to sleep as normal. We would encourage you to check on them a couple of times overnight to check:
- Do they appear to be breathing normally?
- Are they sleeping in a normal posture?
- Do they make the expected response when you rouse them gently? For example; pulling up sheets, cuddling teddy bear.
- If you cannot satisfy yourself that your child is sleeping normally, then wake them fully to check.
Important
If you have any concerns about any of the above please seek further medical review.
If signs of concussion (headache, fatigue, feeling sick, poor concentration, Poor balance/coordination, disrupted sleep, sensitivity to light or noise) are apparent after the first 24 hours, please use the guidance below.
For further advice, information and support around Childhood Acquired Brain Injury, please also contact the Child Brain Injury Trust online at childbraininjurytrust.org.uk
or via email: [email protected]
After Concussion, Return to Normality (ACoRN)
Expected signs of concussion
- Headache
- Fatigue, tiredness
- Feeling sick
- Poor concentration
- Disrupted sleep
- Poor balance, coordination
- Sensitivity to light or noise.
Please give pain relief for the next 24 hours and consider giving for up to one week. (For doses follow guidance on medicine packaging).
The traffic light system below gives a step-by-step guide on how to manage the expected signs of concussion detailed below.
- You can move forward to the next stage when you have been symptom free for 24 hours.
- If symptoms re-appear then please move back to the previous stage to help relieve symptoms.
- If symptoms become worse at any point, then please contact either your GP, NHS24 (111) or, if urgent care is required, call 999.
- If you still have symptoms after two weeks, please see your own GP.
Sport
For return to sport, we recommend a minimum of two weeks rest. You can access this guidance online www.sportandrecreation.org.uk/policy/research-publications/concussion-guidelines “If in doubt, sit them out UK”
STOP and rest both body and mind
Ok to try
- Board games
- Short telephone conversations
- Light crafts
Not yet
- No screen time (TV, computer games, mobile phones, tablets etc.
- No school
- No sports, physical play
- No reading.
If no concussion signs for 24 hours, then please move to the amber stage.
REST, but preparing to move
Ok to try
- Light reading
- Limited TV
- Short visits from friends
- 30 minutes of school work
- Short walks
Not yet
- No school yet
- Avoid computers and computer games
- No sports or physical play
If no concussion signs for 24 hours, then please move to the green stage. If signs return, go back to previous stage.
RETURNING to normal learning activities
Ok to try
- Phased return to school (perhaps half days or 3-5 days attendance as tolerated).
- Phased return to homework; beginning at 30 minutes and increasing
Not yet
- No sports or physical play for two weeks after injury
- No return to sport competitions before 21 days from injury and symptom free
- No tests or exams until full phased transition back to education.
Focus should be on returning to normal daily activities (like school) before unrestricted sporting activities.
Discuss with your child and agree when phased return to normality is completed. If this is taking more than two weeks, please see your own GP.
With thanks to the NHS Greater Glasgow and Clyde Health Board and Mark Lilley, Paediatric Major Trauma Coordinator for the conent of this leaflet and The Child Brain Injury Trust