Fractured Skull- When to Return to Daycare

[MomBoss]

3yo dcb fractured his skull at home from falling off a chair. They kept him overnight at hospital to make sure therr wasnt any internal bleeding (there was none) but he was acting himself and they say it will heal on its own, just obviously need to watch him closely. When should i allow him back to daycare? Im thinking he should stay home at least 3 days..

[CountryRoads]

Oh my gosh! I don't know how long I would require him to stay home, but I would be so paranoid.

What if he fell at daycare? Bonked heads with another kids? It's hard to keep a 3 year old confined to one spot.

Yikes. I would feel most comfortable if he stayed home until it was healed - although, that might be unrealistic because I have no clue how long that would take.

[Unregistered]

When he is cleared to actively participate in outdoor play?

[Cat Herder]

From my experience he should have been released on a concussion noise and stress-reduction plan. :confused: We even had to keep low lighting for a couple of weeks.

It is to prevent increased intercranial pressure until the skull heals. Swelling and a soft skull is bad ju-ju. Sneezing, blowing of noses and lifting are also no-no's.

Is it posible is was not an actual fracture, just a small compression?

I'd ask for a doctors note and a copy of the discharge instructions.

[MomBoss]

They said it would take a couple weeks to heal. They didnt mention when he would be coming back...but i want to tell them when Im comfortable. I just dont know what is realistic and what is safe.

[DaveA]

From my experience he should have been released on a concussion noise and stress-reduction plan. :confused: We even had to keep low lighting for a couple of weeks.

It is to prevent increased intercranial pressure until the skull heals. Swelling and a soft skull is bad ju-ju.

Is it posible is was not an actual fracture, just a small compression?

I'd ask for a doctors note and a copy of the discharge instructions.

Before I even thought about when they could return I would want to know exactly what I was dealing with.

[MomBoss]

From my experience he should have been released on a concussion noise and stress-reduction plan. :confused: We even had to keep low lighting for a couple of weeks.

It is to prevent increased intercranial pressure until the skull heals. Swelling and a soft skull is bad ju-ju.

Is it posible is was not an actual fracture, just a small compression?

I'd ask for a doctors note and a copy of the discharge instructions.

The dad told me a “fractured skull and a concussion im sure” Which tells me a concussion was not verified. They also didnt tell me any other info or how bad it really is. Fractured could be 1cm long or 5in long..
i was going to ask what the doctor suggested and then tell them “im going to reach out to my childcare resources” and see what they say. Im worried he will be back tomorrow otherwise.

[Snowmom]

Here's my biggest concern:

If you are licensed and god forbid, something happened to him in care, licensing would need to investigate even though there's a pre-existing condition that may factor into the equation. Your license may be suspended while this happens (worst case scenario). If you take him back before the injury has been cleared as healed, you need to be willing to take that risk.

[MomBoss]

Here's my biggest concern:

If you are licensed and god forbid, something happened to him in care, licensing would need to investigate even though there's a pre-existing condition that may factor into the equation. Your license may be suspended while this happens (worst case scenario). If you take him back before the injury has been cleared as healed, you need to be willing to take that risk.

This!

[MomBoss]

Im texting dcd and he said the Dr said to stay home 1 or 2 days. They think the drs are being overly cautious and that their child is fine.
They said they did a ct scan, the dr didnt say how big it was and that the ct scan was “non displaced” what does that mean?

[boy_mom]

Im texting dcd and he said the Dr said to stay home 1 or 2 days. They think the drs are being overly cautious and that their child is fine.
They said they did a ct scan, the dr didnt say how big it was and that the ct scan was “non displaced” what does that mean?

Ummm I feel.like the parent should have wayyyy more information available for you, as well as for themselves!

I would ask for a dr note with more information in order to make a decision on what you can and can not care for, as well as a timeline for when he can return to care.

I would tell parent doctors note with diagnosis and instructions for care are required before even talking about coming back to daycare.

[MomBoss]

Ummm I feel.like the parent should have wayyyy more information available for you, as well as for themselves!

I would ask for a dr note with more information in order to make a decision on what you can and can not care for, as well as a timeline for when he can return to care.

I would tell parent doctors note with diagnosis and instructions for care are required before even talking about coming back to daycare.

I asked to see discharge/aftercare papers. Hopefully the papers will have more info for me

[rosieteddy]

Even if Dr ok's return ,I would not allow for this week.A full 7 days from accident and I would insist on a return visit to Dr.I would insist on an all clear for inside and outside activities.

[Annalee]

My own son had a concussion from a collision playing basketball in sixth grade. While he was allowed to attend school after a couple days, he wasn't allowed to do any PE or ball playing for 14 days per the school athletics protocol. The pediatrician had to clear him at the end of the 14 days. Ped said the first hit is not the bad one, but the second hit is the one that causes the most damage not allowing the original hit to heal first.

As for daycare, it would be hard because the child needs to be reasonably able to participate. I would go with whatever i felt comfortable with. Never had this happen to me within the child care setting....just the school issues.

[Cat Herder]

Im texting dcd and he said the Dr said to stay home 1 or 2 days. They think the drs are being overly cautious and that their child is fine.
They said they did a ct scan, the dr didnt say how big it was and that the ct scan was “non displaced” what does that mean?

That is actually good. Little kids skulls are not fused and are better pliable so it isn't quite the same as a teen (like when my 14yo did it in a bicycle accident) or adult.

Here is the case studies pdf. Linear nondisplaced skull fractures in children: who should be observed or admitted? https://thejns.org/doi/pdf/10.3171/2015.4.PEDS1545


"In conclusion, 23-hour observation or hospitalization
for many children with NDSFs is costly and not always necessary. As demonstrated in this study and previously
published reports, the likelihood of missing a delayed
hemorrhage or other life-threatening complication in patients with isolated NDSFs is extremely low.7,9,14 Based
upon the findings in this review, we plan to attempt to find
ways to minimize hospital transfers and admissions for
isolated NDSFs, and we hypothesize that doing so would
be worthwhile at other centers as well."