By Dr. Tanya Remer Altmann
Summertime means picnics in the park, sporting events, beach parties and unfortunately childhood injuries. Luckily most are minor and can be treated at home. But how do you know when something is more serious and requires medical attention? These are the five most common calls I get from parents during the summer months.
1. My son slipped while running in the yard and hit his head. What should I do? Do I need to take him to the Emergency Room?
Head injuries are common and most minor falls do not result in serious injury. Keep a close eye on your child after the head bump. If he lost consciousness after the fall, you should go to the doctor immediately. If he got right up and continued playing, you can just observe him closely. Check his scalp. Is there a bump? If he’ll let you (good luck), apply ice to help soothe the pain and decrease the swelling.
If your child begins to complain of a severe headache, develops vomiting, has trouble seeing, talking or walking, call your pediatrician or take him to the Emergency Room right away.
2. My daughter fell, scraped her knee and cut her chin. Can I treat this at home? How do I know if she needs stitches?
Minor cuts and scrapes are par for the course when running outside. It’s usually the initial trauma or site of blood that brings her running to you in tears. First, apply pressure with a clean cloth to stop bleeding. Next, use soap and lots and lots of water to clean the wound. If she won’t let you wash out her cut, try soaking her (and the boo-boo) in the bathtub. Finally, apply an antibiotic ointment and a band-aid. Cute band-aids keep the area clean and seem to calm down an injured child.
If the cut is deep, has jagged edges, the skin is gapping open or it doesn’t stop bleeding in 10 minutes it should be evaluated as it might require stitches. Also, call your pediatrician if there are any signs of infection such as redness, oozing, pain or swelling.
3. Every summer my son gets insect bites that swell and itch horribly. How can I prevent them and what can I do to treat them?
Bugs love feasting on summer nights and some kids seem to be sweeter targets. It’s impossible to completely protect your child, but keeping him covered with light clothing will help. Don’t use scented soaps, perfumes or hair spray since they invite insects to taste. Wash the mosquito or bug bite and apply an over the counter lotion for itching. For a wasp or bee sting (ouch!), apply a cold cloth to reduce the pain and swelling. If the stinger is visible, remove it by gently scraping it off horizontally with a credit card or pull it out with a pair of tweezers. Most parents don’t realize that bee stings and mosquito bites often swell more two or three days later.
Call for medical help immediately if your child has any wheezing or difficulty breathing, extreme swelling, spreading redness on the skin, becomes weak or unconscious or has hives or severe itching all over.
4. My son is very active and often twists his ankle or falls and hurts his elbow. How do I know if he has a broken bone or if it’s just a sprain or strain?
You often can’t tell if a bone is broken without an x-ray, but many summer injuries are just sprains (a stretch or tear of a ligament) or strains (twist, pull or tear of a muscle or tendon) and can be treated at home. With both you may see immediate swelling and pain. The best initial treatment is always ice (if he’ll let you) and immobilization (also can be tough with a little one). Unless there is an obvious deformity or your child is in extreme pain, I usually recommend observation for a few hours at home. If he gets back up to play then most likely it’s only a minor sprain or strain that will heal on its own. A good treatment plan to remember for injuries is RICE: rest, ice, compression and elevation.
If you see an obvious deformity, your child is in a lot of pain, they can’t stand on the injured ankle or can’t use the injured arm, call your pediatrician.
5. During the summer my children live in the pool. I use sunscreen, but they sometimes get a sun burn. What should I do?
The best treatment for burns is prevention. If possible, stay in the shade and avoid sun exposure during peak hours. Keep your children covered up with light clothing when you can. And don’t forget hats and sunglasses too! Apply sunscreen 30 minutes prior to going outside (even on cloudy days), use an SPF 30 or greater and reapply every two hours and after swimming or sweating. Keep infants under 6 months of age out of direct sunlight.
When your child does get a burn, get them out of the sun right away and apply a cool compress to the affected area. Aloe Vera gel may help soothe the burn and over the counter pain medication (eg. Tylenol, Motrin) as directed can help decrease pain and inflammation. Make sure your child stays hydrated by drinking plenty of water for the next few days. Keep the affected area covered to avoid future sun exposure.
Call your pediatrician if the burn covers a large area of your child’s body, she is in extreme discomfort or blisters appear. In addition, if there is any swelling, oozing, she gets fever, chills, signs of dehydration (increased thirst, dry mouth or eyes), confusion, headache or feels faint seek medical attention.