To think that this child needed to go to A&E?

[Petuniasforsally]

I was at a children’s event today. A child fell head first from a height of around a metre onto concrete. I arrived around an hour later and was asked to take a look at the child as I have basic first aid training (though no further medical training). By this time the child had vomited, was struggling to stay awake, seemed quite confused about what had happened & had a noticeably swollen face. I advised the parents to take her straight to A&E but they refused, stating that they had medical backgrounds (though neither of them are doctors) and A&E was ‘pointless’. I did see the child later up & running around but I can’t get it out of my head. This should have been an A&E thing, right?

In the past I'd have agreed with the posters above. However, my sons have had concussion 4 times now. On each occasion, we've been to A&E and been sent home after the briefest look in their eyes. My friend was told that unless the vomiting continued a one off up chuck was not a worry. I take each occasion on its own merits, but I won't always go in future unless I feel there are symptoms I haven't seen before or something doesn't feel right. I kept the leaflet and know what to look out for. I check every couple of hours through the night.

I’m curious, how old was the child? To be left unsupervised on I’m assuming playground equipment - was either parent watching them?

I wonder if the reason they refused to go to A&E was because of the risk of them being reported to SS? If their child has had previous injuries and they’ve been, this visit could have been the straw that broke the camel’s back and got them reported, especially if their child is young, it sounds like neglect.

Thanks for your replies. I should have said that child is 10 & I don’t think there was any question that she wasn’t being supervised at the time of the fall, it was just one of those unfortunate things that happen when children are larking around. I’ve been thinking about it all night & am going to try & find out how the child is (I don’t know the family but everyone at the event is connected to the organisers in some way so someone knows them).

Any child vomiting and subdued after a head injury should automatically be taken to emergency. I would have been very uncomfortable too.

It isn't just the vomiting...or even the sleepiness & confusion. But the swelling to the face and - I'm going to say it again - the mechanism of injury. The child needed to be assessed for skull & face fractures too.

When assessing the need for A&E you should always take into account how the injury occurred, not just the presenting symptoms. Head injuries are particularly tricky. A metre fall onto concrete is serious.

Far better to be sent away from A&E for the 8th time than not go in when someone has a brain haemorrhage or brain swelling.

Well that's scary! Last year my son, then two, fell about two metres from some play equipment (knocked off by an older child by accident). He was fine with no symptoms of concussion etc thanks to the bark flooring but we still took him to A&E and didn't leave until doctors were sure he was ok. It was terrifying. I wouldn't take any chances with a fall like that.

Yes, good points.