School nurses play a crucial role in injury prevention and initial treatment when injuries occur at school. The role of school nurses includes being knowledgeable about the management of head injuries, including assessment and initial treatment. The school nurse must be familiar with the outcomes of a head injury and know when further evaluation is indicated. Developing a head injury protocol in the school setting is one strategy to make sure that all involved are able to consistently and effectively respond to a head injury and prevent a possible negative outcome. The combination of a protocol, nursing judgment, and best practices can ensure that all means are used to take care of children when a head injury is sustained. These strategies will help to increase the safety of children at school. A systematic approach to the management of these types of injuries is essential for preventing possible complications. (Contains 6 tables and 1 figure.)