When parents should worry about accidents
Donya Betancourt, Pediatrician, drdonya@hotmail.com
Bumps and bruises are a typical part of childhood, but when should a parent be alarmed by the sight of blood or large bumps on their child?
Anytime there is a fall or collision where there is evidence of blood or swelling, the best approach is to stay calm. This is often easier said than done, but it is necessary. First of all the child will probably be very upset and will need immediate calming. But it is impossible to relax a child relax if the parent is in hysterics, so the key to immediate care is to have everyone concerned stay calm.
If there is blood, locate where the blood is coming from, get a clean towel and compress the wound to speed the clotting process. If the cut is on a finger or leg have the child elevate the hand or limb. It is important to keep in mind that the head has numerous blood vessels and any small cut may bleed profusely.
After the child is calmed and the wound is compressed, it is time to clean the abrasion. Use clean water or saline solution to rinse the cut if it is still bleeding, keep the compress on until the wound is not bleeding or is bleeding very little.
After the wound has been cleaned apply an antibacterial ointment, wrap or cover the wound to keep it clean and keep it dry for at least 12 hours.
While cleaning the wound examine it for any foreign matter such as dirt, gravel, sand or glass. Glass is one of the most difficult foreign bodies to remove from a wound because it is transparent and even on close exam is often overlooked, consequently if the wound is caused by broken glass pay extra attention and request that your doctor reexamine the abrasion for any slivers that may have been missed.
Long cuts and deep cuts will often times require stitches, which will mean an immediate visit to the doctor. Keeping your child calm during the cleaning of the wound is probably the greatest challenge but it must be done. Far too often small scrapes and cuts become infected, requiring antibiotics and ongoing medical treatment simply because the initial cleaning was not done properly. Keep accurate medical records and keep your child's tetanus vaccine current.
Bumps, particularly to the head, will swell and look much worse than they are. The swelling is the result of small blood vessels being broken, which causes the discoloration and puffy appearance.
When a child falls and hurts an arm, leg or finger and no blood is present do a visual exam looking for the point of impact. Check for broken bones and dislocations by asking the child to move whatever limb is injured. If the child can move the finger by making a fist or lift the arm or leg without great pain or a popping sound, chances are that it is just a bump.
If the child has been hit on the head it is most important to observe the child for at least 10 minutes and do not let the child lie down. Put a cold compress on the bump and keep the child aware of what is happening. For severe head injuries the observation time may be overnight and these types of incidents should be considered very dangerous.
A big part of being a parent is watching our children grow up and along with that growth comes independence, which means our children will take more risks, play harder and have accidents that require our care. We all love our children and we all want them safe, but accidents happen and that is when parents and caretakers need to understand the importance of staying calm, having a well stacked medicine cabinet and the doctor's emergency phone number handy.