When a child with a mild head injury is sent home without imaging, the safety net carries the risk. Give parents written advice on what to watch for over the next 24 to 48 hours and make sure someone can observe the child.
Return advice should name specific signs: repeated vomiting, increasing drowsiness or difficulty waking, a severe or worsening headache, new confusion, abnormal behaviour, unequal pupils, weakness, seizures or fluid from the nose or ears. Ask the family to return or seek urgent care if any occur, and document that advice was given.
- Give written head-injury advice to the parents or carers.
- Ask who will observe the child overnight.
- Name the warning signs: repeated vomiting, drowsiness, worsening headache, confusion, seizure.
- Document the advice and the persons who received it.
Why it matters
Not scanning is safe only when observation and return advice are reliable.
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