First aid for common childhood injuries and accidents

Updated: Sep 18

(The same article is also available in Nepali and Hindi)

Children are always running around, exploring the world, making them highly prone to accidents, injuries and poisonings. Most parents experience at least minor cuts/burns in their children. It is imperative that everyone is well aware of effective first aid skills and also to avoid common mistakes. They also should know when the condition is serious enough to mandate taking to the hospital. This article has two parts, the first part deals with common childhood injuries. The second part is on childhood medical emergencies and poisonings.



What to do always?

1. Stay calm - Seeing a child having any emergency is frightening to anyone, more so to the parents. However, remaining calm is essential to be able to carry out effective first aid while preventing further injury.

2. Check the scene- Do not run, approach the site of accident injury slowly while checking the scene carefully. Example, in case of vehicle accident, checking if the ignition is on and switching it off is the first and most important thing to do to prevent further injury

3. Protect yourself first- although it may sound selfish, you are needed to carry out the first aid. Carrying one sick child to the hospital itself is challenging, if one more person is hurt, it becomes a burden to others.

4. Ask for help. If no one is around, must ask help through a phone.

Cuts

What to do?

If bleeding, elevate the limb above the level of the heart and apply continuous pressure for at least 15 mins. Use clean cloth if available.. Wash with running water and soap once bleeding stops (warm water in winter). Apply antiseptic solution

What not to do?

1. If a foreign body like stick, nails are embedded. do not attempt to remove them.

2. Do not apply home remedies like cow dung, leaves, turmeric, butter. These may cause a secondary infection.

3. If the child is fully immunized for age and received at least one dose of TT in the last 10 years, no need to administer fresh dose of TT. TT is needed only once in 10 years, unlike every 6 months (Which is a popular belief). Administering TT more frequently than needed may lead to allergic reactions. TT is for preventing tetanus, it does not for prevent wound infection. This is prevented by thorough wash and antiseptic solution.

When to take to the hospital?

1. If a foreign body is embedded.

2. If bleeding does not stop

3. The wound is large/gaping

4. Pain is severe

5. If TT is needed

6. Cuts in face

7. If you see deep tissues, ligaments, or bone

Bring the child as soon as possible to the hospital if any of the above is there


Burns

What to do?

1. Wash with cold water

2. Cover the wound with clean cloth/ bandage


What not to do?

1. Do not use ice, it obstructs blood supply to the burnt area and prevents healing

2. Do not apply an antiseptic solution

3. Do not apply home remedies

When to take to the hospital?

1. Pain is severe

2. If TT is needed

3. Burns in face

4. If burn occurs in a smoke filled in a closed environment.

5. Size of the burn is larger than of the child’s palm


Nosebleed

Often it occurs spontaneously in children, sometimes can occur after injury also


What to do?

Make the child sit, preferably on a chair, slightly bending forward and pinch the soft part of the nose for at least 15 mins

What not to do?

1. Don’t make the child lie down/bend backward (commonly done mistake). This causes blood to go towards throat undetected.

2. Don’t pinch the hard part of the nose. Bleeding occurs from the blood vessels in the inner surface of the soft part of the nose. Pinching of the soft part is only effective

3. Don’t stuff leaves, tissue or cotton into his/her nose

When to take to the hospital?

1. If the child has fallen and the nose looks abnormal shape

2. Recurrent episodes of bleeding

3. Current or previous history of bleeding from other sites (may be shown to outpatient, not emergency)

Head injury/bump

If only a slight swelling is there and the child is otherwise playful, active, applying ice is enough. Bring the child immediately to the hospital (emergency department) if any of the following signs are there

1. Severe headache

2. Vomiting

3. Passing out (even briefly)

4. Excessively sleepy

5. Not able to recognize parents

6. Fits

7. Bleeding through ear, nose or mouth

8. Not moving any of the limb well (as compared to the opposite limb)

9. Neck injury


Dog (and other mammal) bites

What to do?

Wash under running tap water for at least 10 mins. (this is the most important step). May apply an antiseptic solution.

What not to do?

1. Do not try to bleed the wound to remove the rabies virus.

2. Do not delay vaccination..

When to take to the hospital?

All the dog bites (and bites of other animals), need to be vaccinated with 5 doses of human rabies vaccine.. If it is lick on a already present wound or a scratch without bleeding only vaccination is enough. If bleeding occurred due to the bite, anti-rabies immunoglobulin is also needed. The doses of vaccine are given at 0, 3, 7, 14, 28 days. Vaccinate the child even if because the dog is a “pet” or is fully vaccinated. Rabies, if occurs is a serious disease with a 100% death rate. If the child has already received a full course of the vaccine, due to the previous bite, only three doses of vaccine are enough. And no immunoglobulin is needed. In dog bite TT is needed as in any other cuts.

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