Would you have gone to A&E for this?

[yellowishgiraffe]

On Friday night my 12 month old DS was cruising around the coffee table, he lost his footing and fell forwards knocking his face against the table. It wasn't a particularity hard knock, the table in question has rounded edges and corners so pretty child friendly (or so I thought). He cried for a little bit, I calmed him down with his dummy and a cuddle. His face went red in the area where he knocked it, so I applied some ice to it for as long as I could get him to hold still, which wasn't long.

He did not seem to be in much pain after the initial shock. He did not throw up or show any signs of concussion.

The next morning he woke up with a bruise around his eye, but his eye wasn't swollen or red inside and he didn't seem bothered by it at all.

I have obviously been taking note of the bruising and it has been improving daily. I imagine by the weekend it will be just a faint shadow.

He has had an unrelated viral infection with fever which has been going on for a week. I took him to the GP about the fever and he was more concerned with his eye.

He is of the opinion that I should have taken him to A&E because he could have an orbital fracture. Honestly, that didn't even occur to me.

The white of his eye has stayed white, he's had no problem moving his eye or pain since the initial knock, as far as I can tell.

GP basically said that if I don't get injuries like this seen too it could be considered a non accidental injury and it could raise concerns, as anything on the face is considered a head injury.

He said if anything changes I should take him to A&E for an X-ray. I'm really shocked as I genuinely didn't think it was a big deal and now I'm not sure what to do. Do I take him to A&E for a 6 day old bruise and get an X-ray? Or just leave it?

I just feel terrible. We're we stupid not to take him for something like this?

Pic attached for reference...

I was just alarmed that the take home message of this thread seemed to be so skewed by wanting to reassure the OP.

I like MNs reassuring, supportive side but this GP was right.

• The dc should have been examined at the time
• The OP could have been vulnerable to an investigation as this is a particularly common non-accidental injury, which she may have been avoiding getting seen. (OP I realise you weren’t!)

And yes, unidentified poster and yes 111 is the place to ask. I’m not a GP but I am a medic, and even if you don’t believe that I posted the best practice information. I don’t understand why the response wasn’t “Oh I didn’t know that an injury so close to the eye was especially problematic” rather than empty reassurance.

@cantitbesimpler I have taken home the message that eye injuries should be investigated. If DS or any future siblings suffer a similar injury I will be taking them off to A&E.

Looking back on the GP appointment though, I don't understand why he didn't simply refer us to the local hospital for an X-ray. Surely if he was concerned about his eye that would have been the appropriate action, instead of telling me to "see it anything changes and go to A&E".

I'm not in the slightest concerned about anyone 'investigating' his injury. We have nothing to hide, toddlers fall and hurt themselves all the time.

The bruising has all but disappeared, so we got lucky this time and we are better educated about eye injuries for the future.

I think a lot of what goes on in GP land seems inexplicable though due to the complexity of the decisions, time pressures and lack of public confidence.

The GP would have assessed it there and then and decided an orbital fracture was unlikely because the symptoms and signs hadn't progressed after the initial bump. But he wasn't 100% sure, because you can't be without a scan, so if your son developed double vision etc then not to ignore it. What he was implying was that this kind of bump can suggest an orbital fracture but you were lucky.

Earlier in the course of the injury - when he bumped himself and when you could have taken him to A&E - you don't have a crystal ball to see he ended up ok.

I'm not having a go at you, but the GPs approach was exactly the right one - comment on injury, get the history, flag that not having it checked could have been a problem and safety-netted (ie asked you to come back if it progressed).

Take no chances if it involves hitting their head. My son at 18 months hit his head on a radiator at his dads. He only told me when i was in A&E at 3am because he had a seizure. Not knowing meant I was not looking for signs and if he had got him looked st they may of been able to prevent it or at least treat it straight away but no it was delayed because he said nothing. Have you never heard of these cases where an adult hits their head seems fine but is found dead? Head injuries are hard to spot and can have no symptoms.