Preschooler

Injury in a child - first aid and when is a visit to the Emergency Room necessary?


Children are very mobile by nature and it is practically impossible to protect them from minor accidents that may occur while playing in kindergarten, school or at home playground. Hence, it is worth knowing how to deal with wounds and abrasions and when to take a child to a doctor or an emergency room?

Types of wounds in children

Wounds due to the causes of their formation and characteristic features of appearance are divided into several types. Of these, children most often have:

  • abrasions - these are wounds that arise when the injury acts tangentially to the skin surface and damages the epidermis (they most often arise as a result of falls and affect the hands, elbows and knees). They are usually dirty and dirty, moderately bleeding, and are quite painful.
  • Cut wounds - arise from injury caused by a sharp object (e.g. a piece of glass). They are characterized by even edges and heavy bleeding (the intensity of bleeding depends largely on the depth of the wound).
  • Stab wounds - arise as a result of the action of a sharp object (for example a knife or rod) that sticks into the body. They are usually characterized by slight damage to the skin, but may be accompanied by invisible injuries to deeper tissues.
  • Lacerations - arise due to the action of sharp objects with uneven edges (the result of hooking on a protruding nail or knot). The wound itself is uneven and can bleed intensively.
  • Stab wounds - they are the result of biting by animals (usually dogs) and combine the features of cut, lacerated and stab wounds. As a rule, they are treated as infected wounds and require modified treatment.
    Of course, these are just examples of the types of wounds that occur most often in young patients.

When does a child's wound need to see a doctor?

Not every wound requires urgent contact with a doctor (mainly talking about abrasions and cuts that we can safely treat at home). But when is a visit to a medic necessary?

  • The wound is heavily contaminated or has features of infection.
  • The wound is a stung wound.
  • The wound bleeds profusely and its edges diverge strongly.
  • The wound is deep.
  • The wound is located within the face.

Wound in a child - first aid?

In case of minor mornings, cuts and abrasions should be washed under running water, and then sanitized with hydrogen peroxide or another disinfectant (for example, gentian). Then, protect the wound with a gauze pad or plastic dressing.

For wounds requiring medical contact they should be washed, secured with a dressing and see a medic.

In the case of intense bleeding wounds, the place of injury should be pressed very hard and secured with a thick layer of dressings (it is not advisable to put on compression bands by inexperienced persons).

Clean wounds, contaminated wounds and infected wounds, i.e. what treatment will be chosen by the doctor

When assessing the risk of infection, wounds are divided into three basic types, which is crucial when making decisions about their treatment. So we distinguish:

  • Wounds clean - arise almost exclusively during operations and procedures performed under sterile conditions. Some authors include fresh, uncontaminated cut wounds. Their treatment is based on the primary suturing of the wound and does not require the administration of antibiotics.
  • Contaminated wounds - most traumatic wounds are included. Their treatment consists of surgical cleansing and primary suturing. Similarly, clean wounds do not require antibiotics.
  • Infected wounds - all wounds accompanied by infection features (redness, swelling of the edges of the wound and filtration of purulent discharge). What's more, this includes bite wounds and all contaminated wounds if more than 8-12 hours have passed since the injury. Their treatment requires thorough surgical cleansing, administration of an antibiotic and placement of the so-called deferred suture (the wound is left open for a few days so as not to block the outflow of pus).

At this point it is worth noting that this division is used for wounds more extensive than abrasions and cuts that require medical intervention.

Prevention of tetanus and prevention of rabies

Tetanus prophylaxis is indicated when less than 10, but more than 5 years have passed since the last vaccination (in Poland the tetanus vaccination scheme is in force - 2 months of age - 3/4 months of age - 5/6 months of age - 5/6 months of age - 16/18 months of age - 6 years of age - 14 years of age - 19 years of age). It involves single administration of a booster dose of Td vaccine and further continuation of the basic schedule (tetanus and diphtheria vaccine - approved in children over six years of age).

When it comes to rabies prevention, it should be considered for all babies who have been bitten by animals (especially unknown, without current vaccination). It involves the start of vaccination in schedule 0-3-7-14-28 (vaccination should be discontinued when the animal turns out to be healthy after veterinary observation). For particularly deep wounds, rabies prophylaxis includes additional administration of specific immunoglobulin or serum.

In conclusion, wounds in children happen very often and are usually harmless and heal spontaneously without any complications. Nevertheless, you should always remember their exact decontamination, protection, and in some cases immediate contact with a doctor.

Bibliography:Surgery by Wojciech NoszczykPediatrics by Wanda Kawalec