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Yesterday a 4 year old fell over when jumping on the hopscotch As she fell a staff member quickly managed to catch her as she fell against the plastic edge of our pod. She did not bang her head hard, no bruise or mark. The worrying thing was that the child lost consciousness for about 10 seconds. Her head fell back eyes rolled then she wet herself. 2 staff members sat with her. She was coherent and she could get up and walk after a few minutes. There were no jerky movements. Her parents were called immediately and her dad came to collect her in 5 minutes. Parents signed the accident book. All of incident was recorded in detail for the parents to use as evidence when talking to the staff at the hospital. I advised the parent to take her to A and E. Somehow I could tell that Dad was not going to take her anywhere. Mum arrived 10 minutes later but thinking that the child was probably at the hospital by now I also explained the situation to mum and she told me to stop worrying as she has done this before and they did not seek medical advice. I advised them that there was even more reason to check it out immediately. I asked mum to phone me as soon as the child had been seen by a doctor. Before we went home I phoned mum and she told me that they had phoned the NHS helpline and they said just to keep an eye on her. I just feel that a child who has lost consciousness should be examined by a doctor. I am going to phone the parents tomorrow but need to think what to say to them without going against any advice the helpline has given them.

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It's possible this was a reflex anoxic seizure rather than the child being knocked out. I've looked after a child who just went limp - no jerky movements.

 

http://www.patient.co.uk/doctor/Reflexic-Anoxic-Seizures.htm

 

Either way she should have been assessed unless she has had them diagnosed but the parents don't want to tell you for some reason.

 

There is only so much you can do. I would make detailed notes of all the conversations and maybe suggest they see their GP with her next week just for your peace of mind.

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We had a similar situation to this with a little boy over a year ago , he had several ' moments' that were very similar to a ' petit mal ' sorry old language or 'absences' , we advised mum to take to doctors which she did, fortunately he was ok and no longer has them. I would and I'm sure you have make sure all details of incident are recorded , it may be worth speaking to the HV too and a private chat with parents explaining that you are not making diagnosis but are concerned , emphasising that whilst she is in your care you need to know if there may be an underlying problem. Parents are probably scared and worried and it may be noticed by others and feel their child may not be seen as ' normal ' and it's their fault.

 

The stigma regarding epilepsy does seemed to have lessened over the years but never easy for a parent/ person to find out they have it. Remember not all types of epilepsy means jerky movements.

 

If you feel the concern is greater ie neglect then it may be worth looking at it again.

Edited by lashes2508
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I think definitely follow it up with parents. If there is something like epilepsy it could be hard for parents to talk about or maybe they have not even thought this may be the reason. I've come across parents who are scared to seek medical advice because they don't want to accused of abuse. Which I know is not logical but sometimes you just don't know what people think.

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Thank you for good advice everyone. Yes reflex anoxic seizure very interesting Upsy Daisy it could possibly be that but I am not a doctor. I do hope they follow my advice and get a medical opinion. I also wish that they had told me about the incident/s at home. The first thing that her dad did was look to at her pupils so he obviously knew what to look for.

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You can only advise that they consult a doctor.. but I would get parents to sign that they had been given this advice.. probably on the same accident sheet that the incident was recorded on.. so there is no way they can later claim that they were not told/ given any advice..

Over cautious , maybe, but had a circumstance where parents who ignored advice to take to see a doctor, later complained we had not told them.

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