Alphabetic Guide to Child Care - Accidents

Accidents

All children have accidents and injure themselves. Some do more frequently or more seriously than others. Parents should treat the ones that are minor and seek immediate medical attention for ones that are major. The parents’ response to an injury can greatly determine the child's response to it. Calm, responsible behavior will keep the child calmer, even in a serious accident.

For minor injuries such as cuts and bruises, treatment can be completed at home. Cuts and scrapes should be washed thoroughly with warm (not hot) water. A skin disinfectant can be applied, only if the cut is not deep. A bandage should be applied during the day to keep dirt out. The cut should be left uncovered when possible, though, to allow it to dry and heal. Once the cut or scrape has scabbed over, a bandage need not be used, unless the scab is damaged or tears off.

Sprains, unless very minor, are difficult to treat at home. It is not likely that a parent can determine the damage to muscle tissue. Sprains can be more painful than breaks and can inflict severe damage to ligaments and tendons. X rays are sometimes required to determine the damage done to the limb.

Minor sprains that show slight swelling or discoloration of the skin can be treated by applying ice to the injured area as soon as possible after the accident. Keep the limb elevated for ten to twenty minutes with the ice pack on the injured joint frequently through the first 24 hours. Have the child avoid using the limb during this time. If pain persists for more than 24 hours, consult your family physician.

Bruises are caused by bleeding under the surface of the skin with no cut to the surface of the skin. Black eyes are bruises under the eye tissue. Minor bruises can be treated with cold water or ice packs to the area hurt. (Eyes should receive only water packs, ice against the eye is not recommended.) As the bruise fades a purple or yellow tint to the skin will remain for a few days or so as the body removes the last of the dried blood from the bruised tissue. Bruises can take several days to fade and heal. If it takes longer, a doctor should be consulted.

Head injuries in children are also common. A sharp blow to the head, or a fall, can trigger vomiting in a child. This, in itself, is not a danger signal. Danger signals are:

1. • Both pupils in eyes not dilated equally.
2. • Eyes do not move together when following something.
3. • Child sleeps immediately, or is hard to waken during a nap. Any child should be awakened every three hours to check, for 24 hours after the accident.
4. • More than one episode of vomiting.
5. • Any sign of mental disorder—speech or movement difficulties, dazed focus or attention, or any type of non-response.
6. • Increasing headache.
7. • Blood or fluid from nose or ears. If any one of these symptoms appear, contact the local hospital emergency facilities immediately.

For more information, see Ch. 35, Medical Emergencies , and “The Emergency Room” in Ch. 20, Surgery .