Childrens Medical Office - of North Andover, P.C.

Scrapes & Abrasions

Wash thoroughly with soap and water and leave open to the air as much as possible so it will dry and a scab (nature's bandage) will form. Generally the only reason to cover such a wound would be to keep it clean while a child is outside playing. Acetaminophen or Ibuprofen in the same dose as for fever may be given for pain. Call for signs of infection (swelling, redness, draining pus).

Cuts & Lacerations

Immediate and direct pressure to the wound should be applied for 10 minutes to stop bleeding. Generally speaking, if a cut is deep and gapes open it may need stitches, while a cut with edges which lie together by themselves or which is very shallow will not. Cuts which lie entirely within the mouth are almost never stitched. If you think a cut needs stitches or you are in doubt - call to find out what to do. Do not go to an emergency room unless you are instructed to do so or there is very vigorous bleeding ("pumping" out) that will not stop with pressure. Cuts should be dressed with a bandage and some antibiotic ointment such as Neosporin or Bacitracin for several days - thereafter they should be left open to the air and kept dry. If your child is up to date on his routine childhood vaccinations he will not need a tetanus shot. If he is not up to date you should call and check.

Burns

Flush the area profusely with cold water for 5-10 minutes then cover the area with Saran wrap to cut off air and thus reduce pain. NEVER apply any kind of grease or medication. Any burn on the palm, face, or which crosses over a joint should be checked by the doctor. Any burn larger than the size of the child's palm in total area should be checked also. Any burn in which tissues turn white or gray and seem to have lost blood flow or with extensive blistering should be seen as well. Otherwise, after 8-12 hours the covering can be removed and Acetaminophen or Ibuprofen given for pain.

Bruises & Sprains

Ice and elevation will retard swelling, but may not be worthwhile for the younger child who becomes too upset by these measures. Direct and continuous pressure, such as may be applied by an ace bandage and some padding, also retards swelling. In most cases swelling in the soft tissues surrounding the injury is the MAIN SOURCE OF PAIN - so all these measure to reduce it are important. Fractures (broken bones) are usually marked by some combination of exquisite tenderness, bruising, loss of motion, and deformity. If you suspect a fracture call.

Nursemaid's Elbow

This is a very common injury in children age 6m to 4y and is classically caused by pulling a child hard by the hand or forearm although it can happen in a fall or even a minor bump as well. The child will suddenly stop moving that arm and cry only if you try to move or go near it. There will be no swelling, redness, or other outward signs of trauma. A bone has been dislocated (popped out of it's socket) in the elbow and will need to be reduced (popped back in) by the pediatrician. While not an emergency, it's best taken care of within 6-8 hours.