My 10-year-old got hurt playing at a fri

Now I'll write the family-facing answer, the one-page clinic sheet, and the prompt record for validation.

Your 10-year-old, hurt at a friend's house — what to do tonight

If any of the red flags in box 1 below is true right now, call your local emergency services now and set off for the emergency department.

Why that comes first: with a child, a head or limb injury can be serious while he still says he feels fine, and some changes show up over hours rather than minutes. So the checks come before the advice. One thing to do in the next ten minutes: keep him still and resting, get a cold pack from the freezer wrapped in a thin towel, and write down the time of the injury.

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1. Right now — red flags that mean emergency care, not home care

Check this list before anything else tonight.

Head and brain

• Not quite himself: confused, drowsy, hard to wake, unusually irritable, slurred speech, one side of his body weak, a fit, or fainting
• Repeated vomiting, or a headache that keeps building
• Any knock to the head matters even if he never lost consciousness — and if he vomited after that earlier head bump and nobody checked it, that goes to the top of this list

Limb and joint

• Pain far worse than the injury looks, or a limb that is tight, rock-hard, or bent oddly
• Fingers or toes that are numb, tingling, blue, pale, grey, or cold
• He cannot walk, cannot put weight on the leg, or the joint will not move at all
• A pressure or tightness that builds through the evening

You do not have to be able to feel a pulse to know a limb is safe — a pulse can still be there while the limb is in trouble.

The whole child

• Bleeding that does not slow with firm pressure
• A deep cut, a gaping wound, a bite, a dirty wound, or anything that may still be in the wound
• A fall from height or a crash
• Pale, cold, clammy and confused after the fall

While you are calling and travelling

• Keep him still, sitting or lying with his head slightly raised
• If you are heading to hospital and he may need an operation, do not give food or drink
• For a bleeding wound on a limb, press firmly with a clean cloth and keep pressing; for a bleeding head wound, cover it loosely with a clean cloth and tell the dispatcher
• Send someone with him if anyone can come, and write down the time of the injury

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2. Which injuries still need a doctor, even if he says he feels fine

Book a same-day clinic or urgent-care visit today, and say "injury" when you book, if any of these is true:

• He cannot walk normally, or is still limping in the morning. A child who holds a limb still or refuses to use it needs to be seen — that is not something to sit on.
• The swelling is bigger than it was, or a joint looks hot, red and swollen, with or without a fever.
• Pain keeps increasing through the night, or is not settling with rest and a cold pack.
• Any head knock, even a small one with no symptoms.
• A cut that is deep, dirty, gaping, or an animal or human bite — these need cleaning and a check of his tetanus protection.

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3. Tonight at home, if nothing in box 1 applies

One adult stays with him. The other adult — the sibling or elder nearby — does the notes and the checks, so you can actually rest.

1. Rest the injured part and keep it still in the position you found it. Do not test it by moving it.
2. Cold pack wrapped in a thin towel: 15–20 minutes on, then off for at least as long. Never directly on the skin. Check the skin under the towel each time.
3. Support the limb so it does not hang down. If it is tight and swollen, keep it at heart level and do not wrap it tightly.
4. Take off rings, watches, tight shoes and tight clothing near the injury before the swelling builds.
5. Wounds: rinse with clean running water, cover with a clean dry cloth. No powders, no herbal paste, no oil, no toothpaste.
6. Write it down while it is fresh — time of the injury, what happened, whether he lost consciousness, vomited, had a fit, and whether he could walk straight away. Take photos with the time of day on them.
7. Pain relief: only what was prescribed for him, following the label or the prescriber's instruction. Nothing from another child or adult, nothing left over in the cupboard. If you are unsure, ask a pharmacist.
8. Do not let him sleep it off alone after a head knock. An adult watches him overnight.

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4. The re-check routine — screenshot this

Every 2 hours while he is awake tonight, then once in the morning, then again at 24 hours. Mark the edge of the swelling with a pen now, so later you compare instead of guess.

Write the time next to each check. One line per check is enough.

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5. If you already tried something — what is better tonight

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6. Do not do these

• Do not start, stop or change any medicine for him on your own, and do not use a child's medicine that was prescribed for a different child.
• Do not buy prescription medicine online, and do not try powders, herbal mixtures or "natural" remedies on an injury.
• Do not apply heat, a hot water bottle or a heat pad to a fresh injury.
• Do not massage the injury.
• Do not pull out a deep splinter or a tooth that might be broken — leave that to a clinician.
• Do not tell him to "walk it off" to see whether it hurts.

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7. When you leave for the door

• Any red flag in box 1 → call your local emergency number now and go to the emergency department.
• Anything in box 2 → a clinic or urgent care today, and tell them it is an injury; mention the head knock if there was one.
• Tell me which country and city you are in and I will pull the local emergency number and the nearest children's emergency department for you — I would rather look it up than guess a number that does not work where you are.

8. What to bring and what to say

Bring: your notes and the photos with their times, his medicines in their original boxes, the allergy list, and the immunisation booklet if there is a cut.

Say, in this order:

1. What happened, and exactly when.
2. Any loss of consciousness, vomiting, fit or confusion — including that earlier head bump with vomiting, and when it was.
3. Whether he could walk straight away, and whether he can walk now.
4. What you did at home, and what medicines he has had.
5. Allergies, regular medicines, existing conditions.

I also wrote a one-page clinic sheet you can print or open on your phone, with the same checklist and the notes fields to fill in: child-injury-clinic-sheet-2026-11-02-99f26a20.pdf

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9. What "going well" looks like in the next 24 hours

This is what to watch for, not a promise that it will be fine:

• He is himself again: talking normally, eating and drinking as usual, no vomiting, no drowsiness.
• The swelling is smaller, or no bigger than the mark you made, and the pain is the same or easier.
• He moves the limb more easily than before, and the limp is gone or clearly better.
• He sleeps through the night, and the adult watching him gets some sleep too.

If any of these goes the other way, or if you are simply not sure, that is the moment to get him seen — earlier rather than later.

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10. One message back, please

Tell me: is he completely himself right now with no vomiting and none of box 1, and which country and city are you in? Everything else is already in this message.

You sound exhausted. Checking the red-flag list once, then following the schedule, is enough for tonight — the rest is a timetable, not a vigil.

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This is home care and a decision tree, not a diagnosis, and it does not replace an examination by a clinician.

Source: rch-cpg https://www.rch.org.au/clinicalguide/guideline_index/Head_injury/
Source: rch-cpg https://www.rch.org.au/clinicalguide/guideline_index/Child_with_limp/
Source: merck-pro https://www.merckmanuals.com/professional/injuries-poisoning/traumatic-brain-injury-tbi/traumatic-brain-injury-tbi
Source: ilcor https://ilcor.org/uploads/PLS-2025-COSTR-Full-Chapter.pdf