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Monday, June 15, 2009

Basic First Aid for Anxious Parents (part 1): Cuts and scrapes

I've just remembered all the times when anxious parents brought their kids in to the emergency department with simple problems that they could have solved by themselves at home. Children are far more resilient than we give them credit for, and they heal better too.

Inquisitive children are bound to have an accident or two whilst they are starting to explore their world. So here are a few things a parent should do BEFORE taking their kid to see a doctor.

Step One: Take control
You need to have a good look at your child's wounds but you also need to take control over the situation first. This means creating an atmosphere where you can adequately manage your child. Here's how to take control:

1. Keep calm
Just take a few deep breaths and say "oh dear, let me have a look" or "come and give me a cuddle" in your most normal and reasonable voice. No shrieking, please! Your child needs you to be calm. If you are frantic, then your child will know there is a reason to panic and will freak out beyond the point of reason. That is, they will make a greater fuss over their situation - which means it will be more difficult for you to access their pain levels.

2. Comfort your child.
Never mind if he or she is covered in mud and gore. Give your child a close cuddle whilst you think of what to do next. Do not bounce or rock your child or fuss over them with words - this might overstimulate them and they are already feeling very emotional. Quickly bring them to a quiet place and allow them to hold you. Try giving them a drink of water to break the crying cycle. Chances are, if your kid is crying from shock rather than pain, a good cuddle will settle them down.

3. Observe
If you are calm and your child is easily comforted (that is, they stop crying after less than 10 minutes), then you can start treating the wound and you probably will not have to bring them to hospital.
If you are calm and your child is quiet after taking more than 10 minutes to calm down but is still whimpering and looking sad, then it is worth giving some painkillers before treating the wound- baby paracetamol or baby ibuprofen should be ok.
If you are calm and your child is still screaming hysterically at the top of their lungs after 15 minutes of quiet cuddling and shows no signs of backing down, then go and find a doctor.

Step 2: Treat the wound
1. Wash the wound under running water - don't use soap or scrub the wound with your fingers because you will only grind the dirt into the wound. Just rinse.

2. Apply direct pressure to bleeding areas using a thick layer of gauze or a clean dry cloth for at least 5 minutes. Don't use tissue paper if you can help it, because the tissue paper fibres will stick. Apply firm pressure (you will know it's firm because the tips of your fingers will turn white) and resist the temptation to check if the wound is still bleeding until after 5 minutes are up. If you keep checking the wound every half minute instead of applying direct pressure, it will not stop bleeding. Try cuddling your child or getting your child to sit in your lap and look at a toy or book, so that they are sufficiently distracted to keep still.

Please note:

- If your child is trying to jump off your lap and run away to play, chances are they aren't really badly hurt - so you probably don't have to try to do anything at all. Don't even bother applying a bandaid in this case. They'll be fine.

- If, after 5 minutes of direct pressure, the wound is still oozing fresh blood and showing no signs of stopping, then take the child to a doctor.

- If, after less than 1 minute of direct pressure, the gauze or dry cloth is totally soaked and dripping, continue to apply direct pressure and quickly change or add another layer of dressing, then take the child to a doctor. On the way to the doctor, lie your child down and try to elevate the bleeding area above the level of the child's heart whilst applying direct pressure to the wound.

3. Consider antiseptic treatment - as long as you are confident that your child is not allergic to it, you can consider painting weak antiseptic lotion over the wound such as iodine or gentian violet or whatever treatment makes you feel like you're doing something useful. Or you can just leave the wound open to air and just make sure it is kept clean and dry.

4. Consider dressing - if you are uncomfortable leaving the wound open to air, you can apply a clean dressing to it. Gauze held in place with surgical tape will do the trick, but if your child tend to pick at things like this, use a sticky band-aid.

Step 3: If you cannot fix it, find someone who can

1. If you are not confident to treat your child yourself or you are freaking out, then please get help from someone nearby.

2. If your child has cut themselves with something that is clearly filthy (eg. a rusty nail), then they might need a tetanus shot. Go to your GP or local clinic.

3. If there are objects lodged within the wound, do NOT try to remove them yourself! You might cause more damage. Bring them to the emergency department.

4. Watch for signs of infection - if it looks infected in the coming days, go and see a doctor.


Anonymous Hamster said...

Thanks for the tips. :) Will be very useful...

1:29 pm  
Blogger Tym said...

An excellent series for adults too!

Btw my mom was a nurse and was always cool and collected when I presented her with a gaping wound from falling off my bicycle or something. Which made me wonder why she didn't fuss over it more. :) She usually dispatched me to clean and dress it myself. O the humanity.

12:24 pm  

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