This applies to Junior school, Senior school and EYFS

Introduction

1.1 The National Institute for Clinical Excellence (NICE) defines a head injury as any trauma to the head other than superficial injuries on the surface of the face. Minor head injuries and knocks to the head are common, particularly in children and many of these happen at school.

1.2 The aim of this protocol is to provide a safe environment for all staff and students and to ensure all staff have a clear understanding of how to manage someone who has sustained a head injury.

Remember: IF IN DOUBT, SIT IT OUT

2.0 Head Injury Assessment & management

2.1 The majority of head injuries are minor and can be assessed and treated by a qualified first aider.

2.2 In the event of a head injury sustained by either student or staff, the school nurse or qualified first aider should be notified immediately so that an assessment can be made. The Head Injury Assessment Form can be used to aid this assessment (Appendix 1)

2.3 If you have any concerns about a head injury you should liaise with the school nurse immediately. If the school nurse is unavailable, or it is an evening or weekend sports fixture further medical advice should be sought by consulting NHS 111, or by calling 999 as per guidance below;

2.4 Serious Head Injury

In rare cases there may be a serious head injury and staff should look out for the following signs:

• Unconsciousness or reduced consciousness (e.g. can't keep eyes open)
• Any clear fluid from either or both ears or nose
• Bleeding from either or both ears
• Bruising behind either or both ears
• Any signs of skull damage or a penetrating injury
• The person has had previous brain surgery
• A forceful blow to head at speed (e.g. fall down the stairs, fall from a height of 1m or more)
• The person has had a previous problems with uncontrollable bleeding or a blood clotting disorder, or is taking a drug that may cause bleeding problems (e.g. anticoagulant)
• The person is intoxicated by drugs and/or alcohol
• There are any safeguarding concerns (e.g. non-accidental injury)

If any of the above apply an ambulance should be called and the person taken to A&E immediately

2.5 Staff should also look out for the following

• Problems with understanding, speaking, reading or writing
• New deafness in one or both ears
• Loss of feeling in part of their body
• Problems with balance or general weakness
• General weakness
• Change in eyesight
• Any convulsions/seizures
• Any problems with memory of events before or after injury
• A headache that will not go away
• Any vomiting
• Irritability or altered behaviour

If any of the above apply the person should also seek medical attention at hospital.

In either case parents should be informed at the earliest opportunity.

2.6 Details of the head injury should be recorded on CPOMS (& Sphera if appropriate), including any head injury symptoms.

2.7 If further medical assessment is not required at the time, parents should be informed and the NHS head injury advice guidance (see appendix 2) should be sent home with the student or emailed to the parent.

2.8 - If the student remains in school the following communications should take place:

Junior School - a ‘head bump’ wristband  should be given to the student with the date and time of the head injury noted on it, and the class teacher informed. Parents should be informed following usual school procedure and the NHS guidance sent home for parental reference.

Senior School – a ‘head bump’ wristband  should be given to the student with the date and time of the head injury noted on it, to show teachers in the remaining lessons of the day. Parents should be informed following usual school procedure and the NHS guidance sent home for parental reference.

3.0 Return to School and Sport Following a Diagnosed Concussion

3.1 Return to school and sport following any diagnosed concussion will be informed by medical advice and using the Concussion Guidelines from The Sport and Recreation Alliance

3.2 The medical letter and /or return to school care plan should be recorded on CPOMS and all necessary staff alerted.

3.3 It is the responsibility of the parents to inform the school if their child has had a head injury outside of school. If a concussion has been suspected or diagnosed a letter should be obtained from the injured person’s GP to confirm it is safe for them to return to sport. If a GP’s letter is not possible, confirmation must be given by the parents in writing that they have sought medical advice and have had confirmation that it is safe for their child to return to sport.

References:

https://www.headway.org.uk/news-and-campaigns/campaigns/concussion-aware/concussion-in-sport/

https://www.sportandrecreation.org.uk/policy/research-publications/concussion-guidelines

https://www.nice.org.uk/guidance/cg176/ifp/chapter/What-to-do-if-someone-has-a-head-injury

 Appendix 1

Appendix 2

what0-18.nhs.uk/application/files/8815/8643/3598/CS45385_NHS_Head_Injury_advice_sheet_April_20.pdf