To never know whether it’s an A&E job or not?

[WhenZogateSuperworm]

I always struggle with making the judgment call of when to get medical attention for DC.

DC today has fallen and hit his face on a wooden coffee table. I didn’t see the fall but was in the same room so heard the bang and it was significant. He had a big nose bleed and also has a cut to the outside of his nose so I assume this is where he hit.

He is a toddler so unable to explain properly where hurts. He seemed his usual self an hour later but his nose is very bloody. He has gone to bed and is sleeping, nose seems to just be a bit of dried blood inside now- no clots that I can see.

I am now in bed feeling very anxious that I should have taken him to be seen. He would have had a major tantrum and not allowed a doctor to come near him, but I am still anxious I made the wrong call.

I’ve felt the same in other cases, I seem to feel guilty if I do take him that I may be wasting doctors time, but then anxious if I don’t!

How do people make that judgement call of whether a child needs to be looked at or not?

It's so hard, isn't it. A

If you're worried about him through the night wake him up - if he can be woken, even if he's sleepy, he's probably okay. You're doing the right thing letting him sleep. If you notice any bruising behind his ears, swelling to his soft spot (if he still has it), unusual drowsiness, using one side less, change in behaviour, or black eyes take him to A&E.

I would have done the same. Personally I o my take the dc to A&E if I noticed them behaving differently after a fall or bang to the head - like being dizzy, tired, blurred vision or being sick.

I am a nurse so possibly I feel more able to recognised worrying symptoms.

When working it out I tend to start from thinking what I want staff to do - stitch a wound or prescribe meds or something. If there isn't something specific then I don't go.

Oh, and it's worth saying, if you're worried about him tomorrow make an urgent GP appointment. Almost all GPs have appointments set aside every day for under 5s.

He hasn’t been sick at all, he said his eye hurt at one point but then hasn’t mentioned it since. I’ve checked on him twice already and he stirs when I go in.

I kept him up an hour later so I could keep an eye on him and he had a bath and seemed normal, albeit a little quiet.

I’m fairly sure it’s a nose injury rather than a head injury but then I’ve scared myself reading up on nasal septal hematomas!

It’s a good point to think about what I would want a doctor to do and looking at him there isn’t really anything. I guess just reassurance that he is ok.

I will ring the GP in the morning if I am still worried.

Have you looked to see if there's a minor injuries unit near you? It's a great middle ground for situations like this.

I don't feel it's my place to advise you either way but I empathise and I hope all is well with your boy.

@PowerslidePanda yes we do have a minor injuries unit but it isn’t very heavily staffed so often you are sent to A&E instead. I probably should have taken him there to be seen.

Is this the sort of thing a pharmacist could check over?
I am an over worrier in all things health related. I’m lucky that we have a dr within close family so I can always call them if I’m unsure.
I think for this sort of thing I would just monitor to make sure they seem alright. I would probably bring the baby monitor to bed with me so I can also monitor periodically through the night without having to go into their room

As the nurse said I think you can tell when it’s serious or not . I have had the same and watch them fairly closely
I thing you Made the right call . Toddlers are made of rubber to offset their epic falls a bit !

We are fortunate that at a&e there's a walk in gp/nurse practitioner service as well (joint triage) check if that's the case at your hospital, means you don't need to worry if it's really an a&e matter

@WhenZogateSuperworm when a childs fall & head injury is not witnessed (seen by an adult or an older child) the health care professional asks the parent if the child was heard crying immediately after the thud was heard to find out if the child was knocked out/lost consciousness. The loudness of the thud is in itself not significant. It's common for a child to be tired and want to sleep after hitting their head, and sometimes they vomit once ot twice. Calpol and/or ibuprofen will help with scalp pain from bruising, simple over the counter painkillers won't hide the signs or headache of a brain injury. If you're still worried let your little one sleep in with you tonight or wake them before you go to bed, and during the night. There's good advice in the links below
www.nhsinform.scot/illnesses-and-conditions/injuries/head-and-neck-injuries/minor-head-injury

www.nhs.uk/conditions/minor-head-injury/

Thanks everyone. I’ve checked on him a few times and he seems fine, fast asleep but stirring easily.

I didn’t see him bump as I was feeding the baby but I was right next to him and he definitely cried immediately. From what he was doing (jumping forwards onto “lily pads”) I’m sure he misjudged the jump and went face first rather than head into the table.

FWIW I wouldn't have taken him.

For a head injury I would always seek medical help

He is jumping around all over the place this morning. His nose is still rather bloody but he is his normal self and doesn’t say it is hurting. He is off to the childminders but I’ve banned the trampoline and asked if he can have a quiet day.

For the nose bleed, bump and cut as you describe, I wouldn't have taken him either. I would have also given him some Calpol before bed in case it was sore. I think you have done everything right.