The screams of summer
Friday, May 23, 2008
Cuts, scrapes, bangs and bruises are an ordinary part of childhood. Usually they’ll heal quickly with a little first aid and a dose of TLC, but sometimes your doctor should get involved. Here’s a quick reminder on how to treat minor wounds at home and when to get medical attention.
The first thing to do for a wound is to take a quick look and see if it’s serious. Seek medical attention immediately if a wound won’t stop bleeding after you’ve applied pressure for several minutes, if the edges of the wound gape open (stitches may be needed), if there is debris (dirt or other yucky stuff) deep in the wound that you can’t get out, if the area around the wound is numb or if the wound is deep or the edges are jagged. If you can say no to all of those conditions, then you can begin immediate first aid at home.
First, remove any dirt or debris in the wound and wipe away any dead or hanging skin. Then apply gentle, firm pressure for several minutes with a clean cloth, paper towel or gauze to stop any bleeding. It can be very scary for a child to see his or her own blood, but bleeding helps to clean out a wound and will usually stop in a few minutes. Next, hold the wound under warm tap water or fill a bowl or the tub and use a cup to pour water over the wound several times. Use soap and a soft washcloth to clean the skin around the wound, but avoid the open area because the soap will irritate it. Remove any remaining debris with tweezers that have been wiped with alcohol to kill any germs.
Often children feel better when the wound is covered with a bandage (Band Aid) and that’s good because bandages help wounds stay clean while they heal. You can apply some antibiotic ointment to the area before putting on the bandage. Antibiotic creams and ointments are not necessary, but will help the wound heal faster and may reduce scarring. Change the bandage daily or if it gets wet. If your child absolutely does not want a Band Aid that’s also OK, but it may increase the risk of infection and may lengthen healing time. Covered or uncovered, the important thing is to keep the wound clean while it heals. Some wounds will form a scab, which is the body’s natural bandage. Leave the scab alone because the skin is healing underneath. When the wound is healed, the scab falls off.
A wound may be infected if it becomes more tender, red or swollen, if it drains thick, creamy fluid, if your child runs a temperature or if there are red streaks or blisters near the wound. Call your doctor and explain what you are seeing since antibiotics may be needed.
Every child is bound to get an injury now and then so be sure to have a complete first aid kit at home. Use a clear, plastic waterproof container to hold all the items. Inside of the container keep the name and number of your doctor and the local poison control center, a list of the medications, allergies and health conditions of each family member and a list of all of the contents of the kit.
The American College of Emergency Physicians and the American Red Cross recommend the following items:
- Acetaminophen (found in Tylenol) and ibuprofen for pain and fever
- Antihistamine (such as Benadryl)
- Injections such as epi-pen for severe allergic reactions, if needed
- Hydrocortisone cream for irritation from rashes
- Antibiotic ointment
- Thermometer (with petroleum jelly for rectal temps)
- Oral medication syringe
- Assorted bandages
- Elastic wraps to cover ankles, knees and elbows
- Gauze rolls and pads for larger cuts and scrapes
- Adhesive tape
- Sharp scissors with rounded tips
- Safety pins to fasten bandages
- Antiseptic wipes or gel
- Tweezers for removing debris and splinters
- Disposable instant-activating cold packs for injuries and burns
- Hydrogen peroxide to disinfect and clean wounds
- Latex-free gloves to reduce infection risk when cleaning wounds
- Calamine lotion to relieve itching and irritation from stings and poison ivy
- Aloe vera gel for burns, itching, dryness
- Activated charcoal (only give if advised by the poison control center)
Parents can feel comfortable dealing with minor injuries with confidence, buty remember to always trust your instincts. If you're feeling uncertain about what to do for any injury, call your doctor.
Dr. Lisa Thornton, a mother of three, is director of pediatric rehabilitation at Schwab Rehabilitation Hospital and LaRabida Children’s Hospital. She also is assistant professor of pediatrics at the University of Chicago. E-mail her at firstname.lastname@example.org.