Minor injuries are very common in childhood. Providing a safe environment and adult supervision is vital to avoid serious harm, but no parent can completely prevent their child having a few bumps and scrapes along the way. Having said that, how we respond to accidents and what treatment we provide can make a huge difference to our children’s suffering and time taken to heal. This month, Dr. Steve Cockeram, Chief Medical Officer for the local emergency service Falck, takes a look at some common injuries and how to deal with them most effectively.

Wounds

• Wounds come in all shapes and sizes, but the basic principles of treatment are:
• If it is bleeding use a clean cloth to put firm pressure on the wound for 10-15 minutes. This will stop most bleeding. If it doesn’t then take the child to hospital. If it is squirting out, call an ambulance and use firm pressure.
• If you cannot see the deepest part of the wound or it is gaping open then it may need exploring and stitches.
• If there is dirt in it, wash it out as soon as possible using lots of tap water. Remember, “The solution to pollution is dilution”. Normal bar soap will help to clear any stubborn dirt. 
• If you cannot get all the dirt out, then seek medical attention.
• Cover the wound with a non-adherent, sterile dressing.
• Do not use cotton wool to clean a wound as the fibres tend to get stuck in it.
• Avoid putting undiluted antiseptic solutions in a wound. Actually, scientific studies do not support the use of antiseptics to clean wounds because although they kill germs, they also kill healing cells.
• For dirty wounds, a tetanus booster is very likely to be needed. However, your child will not need a tetanus booster if the wound is minor and clean and they have had all their childhood vaccinations including tetanus within the last 10 years.
• Animal and human bites, however minor, must be assessed by a medical professional. Serious infections like rabies, hepatitis B and tetanus may be transmitted and wound infections commonly need antibiotics.

Nosebleeds

Whilst most nosebleeds in children are caused by exploring fingers and stop spontaneously, occasionally they can be quite dramatic producing large amounts of blood. With the right technique they can be controlled easily.

• Tip the child’s head forward, so that blood does not drip down the back of their throat
• Pinch the soft part of their nostrils together and hold for 10-15 minutes (this feels like a long time when you are holding a child’s nose!)
• Tell the child to spit out any blood in their mouth, not swallow it.
• Once the bleeding stops they should be instructed not to blow their nose as this will start the bleeding again
• If these measures fail then you should seek medical attention

Bumps and bruises

Bumps on knees, shins, elbows and heads are all very common. Sometimes you can find a bruise without your child remembering how they got it. Any bruise in an unusual place or that is not at all tender to touch should be shown to a doctor. Otherwise, just apply an icepack for 10 minutes at a time, repeating every half hour until the pain and swelling are better.

Bumps on the head can be a concern. If your child has any loss of consciousness, vomits more than once, sleeps for more than one hour when they would normally be awake, or has a large swelling on their head then seek medical attention immediately.

Stings

Stings by insects do not usually cause significant illness, but can cause terrible itching and occasionally serious allergic reactions. To minimise the amount of venom that is injected, do not try to pull the stinger out, scrape it off the skin using the edge of a card or blunt knife. Immediately wash the area with soap and water and apply ice if there is swelling or pain. Antihistamine creams work really fast, but unfortunately are not available in Sri Lanka, so an oral dose from the pharmacy may be needed to reduce the itching. If your child has any facial swelling, faint feeling or difficulty breathing seek medical attention immediately.

Sprains and fractures

Twisting an ankle or wrist is the main cause of sprains. The ligaments supporting the joint are stretched too much and become swollen and painful. Remember the acronym RICE: Rest, Ice, Compression (bandage) and Elevation (keep it up when resting to reduce swelling). If the injured limb is very swollen, your child is in significant pain or will not use the affected area, then seek medical attention. A severe sprain and a fracture can look very similar, so get an expert opinion.

Burns and scalds

Burns and scalds cause pain and can be disfiguring. The correct home first aid can be the difference between permanent scarring and complete recovery. Cool the affected area immediately by running under the tap or shower for at least 20 minutes. Never, under any circumstances, apply ice, toothpaste, butter or any creams. These will all make the burn worse. Burns on the face, hands, feet or genitals should always be treated by a medical professional. Small burns on other areas can be treated at home with cooling and a non-adherent, sterile dressing. Small blisters should not be burst as they will go down by themselves and may become infected when burst. Seek medical attention for large blisters.

Eye injuries

Dust or sand in an eye is extremely painful and can scratch the sensitive lens or cornea. Rinse your child’s eye with clean, tap water to flush the offending article out. An accidental finger poke in the eye (usually father’s eye by child’s finger!) will cause similar symptoms and can be treated in the same way. If your child’s eye remains painful or they cannot open it, then take them straight to hospital.

Fainting

Fainting or a faintish feeling happens when the blood pressure drops suddenly. This is typically caused by emotion (fear, sight of blood, etc), over-heating or dehydration. Lie your child down and lift their feet about six inches off the ground. Most children will become fully consciousness within a few seconds with this treatment. If they remain unconscious, then turn them onto their side, tilt their head back and call an ambulance.

comments powered by Disqus

Stopping a virtual time-bomb in the brain

Battling the deadly sting for 54 years

Let’s see,are you happy?

Children’s toys dirtier than your toilet seat!

Staying positive in the face of adversity

Pack in the energy as they head to school

Pet hazards: Infections you could pick up