Discussion: View Thread

For preschool students how do you handle head bumps. 

Example, if a student falls and bumps their head, but isn't crying, shows no signs of pain/concussion, no visible mark exct. What is your process for the teachers/school. At my school they are sending students (PK-1st grade) to my health clerk for any tiny little bump, weather students are clearly hurt or not, calling home and sending home paperwork and I just feel it's a bit excessive. But I just wasn't sure if there is a hard and fast rule on this. 

Any advice is greatly appreciated. 

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Cheyene Laidlaw
Parachute, CO United States
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Thank you for your insight. 

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Cheyene Laidlaw
Parachute, CO United States
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Original Message:
Sent: 08-29-2024 19:21
From: Laura Phillips, MPH, BSN, RN, NCSN
Subject: Head Bumps

This is a good question. 

Each school district writes their own guideline for head injuries, I would start there first to see the guidelines.

I understand that it could seem excessive to send each and every head bump to the health room, however, this is best practice. It is always best to practice on the side of caution. Receiving a head bump is a right of passage for a preschooler, and their skulls are resistant to many things, however, different the locations of the head are more susceptible to injury. 

When the head is bumped, no matter how small, the axons or nerve fibers that connect the neurons may stretch, tear, or pull. Even the smallest bump, depending on the location of the bump, could lead to a small amount of stretching. 

I personally would continue with the process of observing the student, calling parents, and sending home paperwork.

I would like to hear from more nurses with this subject.

Laura

 

	Laura L. Phillips, MPH, BSN, RN, NCSN, IHP, RYT 200 Colorado Dept. of Education Licensed School Nurse Nationally Certified School Nurse Child Care Health Consultant National Association of School Nurses, Director - Colorado email: llphillipsrn@gmail.com cell: 303-868-9902 ---Every student will be healthy, safe, and ready to learn.
	*The content of this email is confidential and intended for the recipient specified in message only. It is strictly forbidden to share any part of this message with any third party, without a written consent of the sender. If you received this message by mistake, please reply to this message and follow with its deletion, so that we can ensure such a mistake does not occur in the future.*

Hello Laura and Cheyene,

I too am looking for guidance on the best practice for head bumps.  

Laura,

Do you have a reference to where you have found the 'best practice'  for head bumps?  I have been doing a literature search on head bumps, but I am only finding research articles or evidence for formal concussion diagnosis.  From the Colorado Emergency Guidelines, I feel like the only two options are Head Injury, and then the flow chart directs you to bruises for 'only a head bump with no other complaints'.  In bruises it instructs to rest injury and ice for 20 minutes.  Neither feels like a great fit for the exact senario described by Cheyene.   Would love an link to any EBP or clinical guidelines you have have come across besides the emergency guidelines. 

• Colorado Emergency Guidelines for Schools (2022 PDF)

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Nicole Sigafoos
School Nurse
TOZER ELEMENTARY SCHOOL
Windsor, CO United States
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Original Message:
Sent: 08-29-2024 19:21
From: Laura Phillips, MPH, BSN, RN, NCSN
Subject: Head Bumps

This is a good question. 

Each school district writes their own guideline for head injuries, I would start there first to see the guidelines.

I understand that it could seem excessive to send each and every head bump to the health room, however, this is best practice. It is always best to practice on the side of caution. Receiving a head bump is a right of passage for a preschooler, and their skulls are resistant to many things, however, different the locations of the head are more susceptible to injury. 

When the head is bumped, no matter how small, the axons or nerve fibers that connect the neurons may stretch, tear, or pull. Even the smallest bump, depending on the location of the bump, could lead to a small amount of stretching. 

I personally would continue with the process of observing the student, calling parents, and sending home paperwork.

I would like to hear from more nurses with this subject.

Laura

 

	Laura L. Phillips, MPH, BSN, RN, NCSN, IHP, RYT 200 Colorado Dept. of Education Licensed School Nurse Nationally Certified School Nurse Child Care Health Consultant National Association of School Nurses, Director - Colorado email: llphillipsrn@gmail.com cell: 303-868-9902 ---Every student will be healthy, safe, and ready to learn.
	*The content of this email is confidential and intended for the recipient specified in message only. It is strictly forbidden to share any part of this message with any third party, without a written consent of the sender. If you received this message by mistake, please reply to this message and follow with its deletion, so that we can ensure such a mistake does not occur in the future.*

Hello Laura and Cheyene,

I too have been doing a literature review of best practice for head bumps at school.  Unfortunately, I am only finding articles about concussion management, and nothing related to the 'best practice' of required interventions aka what a health aide should do for a head bump.  So I fall back to the Colorado Emergency Guidelines for Schools .  Under Head Injury section, the first question box states, "If student only bumped head and does not have any other complaints or symptoms, see "Bruises".   Then in the Bruises section, it directs staff to "rest injured part, and apply ice/cold compress for 20 minutes".  No mention of informing parents unless there is "rapid swelling or great pain".   

Laura,

Can you share with me where the best practice you refer to in your response comes from?  I know that is most schools current practice, but I'm searching for the evidence to validate that protocol.  Would so appreciate any reference or link you could share with me. 

Thanks friend! 

Nicole Sigafoos

School Nurse for Weld RE-4 School District 

nicole.sigafoos@weldre4.org 

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Nicole Sigafoos
School Nurse
TOZER ELEMENTARY SCHOOL
Windsor, CO United States
------------------------------

Original Message:
Sent: 08-29-2024 19:21
From: Laura Phillips, MPH, BSN, RN, NCSN
Subject: Head Bumps

This is a good question. 

Each school district writes their own guideline for head injuries, I would start there first to see the guidelines.

I understand that it could seem excessive to send each and every head bump to the health room, however, this is best practice. It is always best to practice on the side of caution. Receiving a head bump is a right of passage for a preschooler, and their skulls are resistant to many things, however, different the locations of the head are more susceptible to injury. 

When the head is bumped, no matter how small, the axons or nerve fibers that connect the neurons may stretch, tear, or pull. Even the smallest bump, depending on the location of the bump, could lead to a small amount of stretching. 

I personally would continue with the process of observing the student, calling parents, and sending home paperwork.

I would like to hear from more nurses with this subject.

Laura

 

	Laura L. Phillips, MPH, BSN, RN, NCSN, IHP, RYT 200 Colorado Dept. of Education Licensed School Nurse Nationally Certified School Nurse Child Care Health Consultant National Association of School Nurses, Director - Colorado email: llphillipsrn@gmail.com cell: 303-868-9902 ---Every student will be healthy, safe, and ready to learn.
	*The content of this email is confidential and intended for the recipient specified in message only. It is strictly forbidden to share any part of this message with any third party, without a written consent of the sender. If you received this message by mistake, please reply to this message and follow with its deletion, so that we can ensure such a mistake does not occur in the future.*