How to deal with a childhood emergency.

When your kid is screaming, blood is flowing and emotions are bubbling over, it can be hard to tell if a situation is a true childhood emergency, something that can be treated in your doctor’s office, or an issue you can handle at home once things calm down. How can you tell the difference?

Let your doctor help you decide, they can help over the phone, have you come into the office, or call A&E ahead of time to alert them that your child is on the way.
To make the decision easier here are some common child accidents and how to handle them.

Another kid bites your child and the skin is broken. Head to A&E?

No, but you should call your doctor right away. She may decide to send you there, depending on the location of the bite and how it looks. You should also wash the wound immediately and thoroughly with soap and warm water, then apply an antibiotic ointment and bandage.

Your child does a face-plant off the playground slide and knocks her tooth loose. Head to A&E?

No. Call the dentist instead. Assuming it’s a baby tooth that’s affected, the dentist is likely to pull it if it’s dangling. You don’t want your child to inhale a tooth that’s been knocked loose, but other than that, it’s usually more of a cosmetic issue. Another reason to call your dentist, if the tooth gets shoved into the gum, it might damage the developing adult tooth, and the dentist will need to treat that, too.

If a baby tooth is knocked completely clear of the mouth, there’s no need to save it. But if a bigger kid knocks out a permanent tooth, put it in a cup of milk and bring it and your child to the dentist immediately; he may be able to re-implant it.

Your 2-year-old topples out of the shopping trolley. The goose egg is huge and he’s hysterical. Head A&E?

Probably not—screaming is a perfectly healthy reaction. There are lots of blood vessels in the head and face, so the swelling can be dramatic. The exception: Any child under a year of age who experiences head trauma should always be checked out by a doctor because signs of injury are harder to detect in a young infant.

For kids older than 12 months, you can take a watch-and-wait approach. If your child is crying but can get up on his own and is moving about, he’s probably just fine. Keep an eye on him for the next few hours to make sure he doesn’t limp or favour one arm; vomit, especially after some time has passed; or become sleepy (and it’s not his usual nap time) or especially irritable. If you see any of these signs, call the doctor. And, of course, if your child is motionless or unconscious, or refuses to move after his fall, you should call an ambulance right away.

Your child gets hit in the eye with a projectile toy. Head to A&E?

Yes, if the eyeball is injured in any way. Look for bleeding, marked redness, impaired vision or an inability to move or open his eye. If the area around the eye (the brow bone or the lid) looks like it might need stitches, apply direct pressure to stop any bleeding and then call your doctor, who will likely advise you to go to A&E.

Otherwise, no trip to A&E is necessary, even if your child looks like Tommy Bowe after the Heineken Cup Final or is bleeding profusely. The way the eye is made, the bones around it take the force of most of the impact. The skin around the eye is very loose and can hold a lot more blood and fluid than other areas where the skin is tighter, so a small injury can look much worse than it is. Ice the area, if your child will let you, and don’t be surprised if the eye is swollen shut the next day. You can continue to offer him cold packs and an appropriate dose of a pain reliever if it’s still sore.

Your kid falls, bites her tongue and it’s bleeding buckets! Head to A&E?

Only if it’s still bleeding after 10 or 15 minutes of applying direct pressure. To do so, dampen a clean washcloth with cool water, seat your child on your lap then press the washcloth over the injured area of the tongue. Do your best to hold her still for as long as she’ll allow. The tongue is also stuffed with blood vessels, and so will bleed a lot, which may scare her (and you!).

If you do go to A&E, there’s not a lot the doctor will do, except help you calm your child and apply a cold washcloth.  Afterward, avoid feeding your child salty and acidic foods while the tongue is healing, and go heavy on the cold stuff. Lots of healing magical ice cream for a couple of days.

If you want to brush up on your First Aid skills join us at The elbowroom on Tuesday 24th March for our Paediatric First Aid Course.