ice pack versus wet paper towel

[mrsmuscles1978]

Does anyone know the real procedure for a bump on the head. My 5 yr old has just been discharged from a 24 hour stay in hospital as he developed extremely alarming symptoms after a bang to the head at school? Turns out even though it was a very nasty bang there was no visible mark in the area of impact so no cold compress was applied. Surely this was the most important thing to do when there is no sign of injury to a known impact site? Also when a mark is visible a wet paper towel is used as a cold compress. Is this really deemed to be of any benefit in reducing swelling and further brain complications?

We would hand out an ice pack to pretty much anyone who comes along with any kind of bump.

Although don't you have to be careful putting anything very cold directly on the head?

A wet paper towel is a cure-all in primary schools. I always think its a Peter Kay joke of the future

From the children's first aid course I attended, the "magic" wet paper towel was advocated for use when there wasn't any real injury, but as a distraction technique for the child, to make them believe it had been "treated".

Sounds like the first aider may have misjudged it this time.

I was given a wet paper towel and sent on my way when I feel on my arm - shouted at in PE for dropping the relay baton turns out my arm was broken in 3 places! That was 18 years ago, a bit worrying that it's still going on.

As a first Aider working with 16-19year olds, if they come with a bump on the head, I chat to them, give a covered ice pack to bring out bump/bruising, get their history whilst looking for signs of concussion (confusion/slurring words/pupil dilation) If they've vomited or been unconscious for a time after the initial accident then I ring parents and recommend a trip to the GP if it is more serious that a visit to A&E. I find our first aid is much more comprehensive at sixth form than my DDs (5) school.

Alarm bells ring with me when there is no visible swelling after a bump to the head. Last time I saw this in our playground the child had a fractured skull!!

IME some school staff are very poorly trained regarding head injuries.
The key thing is to observe the child closely, document exactly what happened, icepack and inform the parent if the bump was hard, or as a result of a fall.

My DC and my DN both suffered serious head injuries and concussion - one at school, the other at nursery. Both were bad enough that parents should have been informed immediately. In both cases staff ignored obvious signs of concussion.

My DC was off school for months as a result of head injury (at school). The school lied, denied and put my DC's life at risk.

A friend teaches at a secondary school in a different borough. If a child has a head injury they are treated immediately by the first aider, then an email goes out to all staff to be alert and watch out for signs of concussion for the next few days - even if initially the child is sent home. This is what should happen.

Actually - I think if an injury at school results in hospital admission, the LA has to be informed.

We put an ice pack on any head bump/injury that comes to us during first Aid at play time/lunchtime. Ice pack applied, note home, bump sticker on jumper. Teacher don't always mention it to a parent though unless it looks nasty or the child is still upset, or for other specific reasons. We only phone home if it is a nasty looking bump or a child is very upset/in pain, etc.

Wet paper towel is often used as a distraction technique when there s no visible mark - though we tend to use it on other parts of the body rather than heads.

I guess it is hard to say without knowing what happens. We do have a lot of children coming in at playtime saying they have bumped/banged their head. Often there is no visible sign at all, and more often than not the child is not upset and what has happened isn't very clear. We do generally treat them all the same regardless but when you have half a dozen children or more coming in during a 10 minute slot asking for an icepack it can be somewhat busy (finding ice packs, finding notes, filling in accident book, filling in bump slips, applying plasters, etc) and I am sure things get missed or overlooked, through judging it wrong at times.

Surely a cold compress will only help if there is any brusing and swelling. If the injury is within the head, a cold compress will have no effect. We were advised on our last first aid course not to use ice packs on children's heads, just to keep compress packs in the fridge.

We were told by our paramedic/first aid trainer that under no circumstances should wet paper towels be used on any kind of injury. If there is any kind of open wound/graze/scratch, the fibres in the paper towel can enter the wound, and become embedded in the tissue, causing scarring.

We also just use cold compress packs, rather than ice packs.

My DDs school seems to be really good at dealing with bumps to the head. As soon as it happens, a cold compress is applied. The child then gets a sticker that says 'I bumped my head' so all staff are aware, and parents are called to warn them it has happened incase a further call is needed later in the day. They then have a sheet that is signed by a member if staff every hour until the go home.

This to me seems to cover all bases. Maybe pick out some of the things people mention on this thread and take them to the school and suggest ways they can improve their system?

An ice pack will reduce pain and possibly the size of the bump but nothing else. It certainly will have no effect on a brain injury. The size of the bump doesn't matter beyond the brief cosmetic effect. A wet paper towel does nothing at all... drives me nuts as now when the children hurt themselves at home they go rushing to get a horrid bit of wet tissue to put on it.
The important thing is the symptoms following a head injury- vomiting 3 or more times, loss of consciousness, confusion or amnesia, being unsteady or abnormally drowsy, fits, severe headache. The school should let you know they have had a head injury so the child can be observed for these symptoms and signs when they get home. If any of the symptoms occur the child should be taken for an immediate medical assessment.