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Head injuries fall into two categories: external (usually scalp) injuries and internal head injuries, which may involve the skull, the blood vessels within the skull, or the brain.
Fortunately, most childhood falls or blows to the head result in injury to the scalp only, which is usually more frightening than threatening. An internal head injury could have more serious implications because the skull serves as the protective helmet for the delicate brain.
External (Scalp) Injury
The scalp is rich with blood vessels, so even a minor cut to the scalp can bleed profusely. The "goose egg" or swelling that may appear on the scalp after a head blow results from the scalp's veins leaking fluid or blood into (and under) the scalp. It may take days or even weeks to disappear.
What to look for and what to do:
* Call your child's doctor if your child is an infant or has lost consciousness, even momentarily, or if your child of any age does any of the following:
o won't stop crying
o complains of head and neck pain
o becomes difficult to console
o isn't walking normally
* If your child is not an infant, has not lost consciousness, and is alert and behaving normally after the fall or blow:
o Apply an ice pack or instant cold pack to the injured area for 20 minutes. If you use ice, always wrap it in a washcloth or sock; ice applied directly to bare skin can cause frostbite damage.
o Observe your child carefully for the next 24 hours. If he or she shows any of the signs of internal injury (see below), call your child's doctor immediately.
o If the incident has occurred close to bedtime or naptime and your child falls asleep soon afterward, check him or her every few hours for twitching limbs or disturbances in color or breathing.
* If color and breathing are normal, and you observe or sense no other abnormalities, let your child sleep (unless your child's doctor has advised otherwise). There's no need to keep a child awake after a head injury.
* If color and/or breathing are abnormal, or if you aren't comfortable with your child's appearance (trust your instincts), arouse your child partially by sitting him or her up. Your child should fuss a bit and attempt to resettle. If he or she doesn't protest, try to awaken your child fully. If your child can't be awakened or shows any signs of internal injury (see below), call your child's doctor or an ambulance.
Suspected Internal Injury
The brain is cushioned by cerebrospinal fluid, but a severe blow to the head may knock the brain into the side of the skull or tear blood vessels. Any internal head injury - fractured skull, torn blood vessels, or damage to the brain itself - can be serious and possibly life threatening.
There are different levels of injury that require different levels of concern. It can be difficult to determine the level of injury, so it's always wise to discuss a head injury with your child's doctor. A clear indicator of a more serious injury is when your child loses consciousness or has signs of confusion.
What to look for and what to do:
Call an ambulance if your child shows any of the following symptoms:* unconsciousness * abnormal breathing * obvious serious wound or fracture * bleeding or clear fluid from the nose, ear, or mouth * disturbance of speech or vision * pupils of unequal size * weakness or paralysis * dizziness * neck pain or stiffness * seizure * vomiting more than two to three times * loss of bladder or bowel controlIf your child is unconscious:* Do not try to move him or her in case of neck or spine injury.
* Call for help.
* If you've been trained inCPR, follow the recommendations if they're appropriate.
* If your child is vomiting or has a seizure, turn him or her on the side while trying to keep the head and neck straight.
* If there's swelling, apply an ice pack or cold pack.
If your child is conscious:* Do your best to keep him or her calm and still.
* If there's bleeding, apply a sterile dressing (bandage).
* Do not attempt to cleanse the wound, which may aggravate bleeding and/or cause serious complications if the skull is fractured.
* Do not apply direct pressure to the wound if you suspect the skull is fractured.
* Do not remove any object that's stuck in the wound.
Concussions are also considered a type of internal head injury. A concussion is the temporary loss of normal brain function as a result of an injury. Repeated concussions can result in permanent injury to the brain. One of the most common reasons kids get concussions is through sports, so it's important to make sure they wear appropriate protective gear and don't continue to play if they've had a head injury. However, it's possible to get a concussion that's mild and just requires observation.
If your child sustains an injury to the head, watch for the following signs that indicate that he or she may have a concussion:
* seeing stars and feeling dazed, dizzy, or light-headed
* trouble remembering things, such as what happened directly before and after the injury occurred (this can happen even with mild concussions)
* nausea or vomiting
* headaches
* blurred vision and sensitivity to light
* slurred speech or saying things that don't make sense
* difficulty concentrating, thinking, or making decisions
* difficulty with coordination or balance (such as being unable to catch a ball or other easy tasks)
* feeling anxious or irritable for no apparent reason
* feeling overly tired
If you suspect a concussion, call your child's doctor for further instructions.
Preventing Head Injuries
It's impossible to prevent your child from ever being injured, but there are some things you can do to help keep blows to the head at bay. Make sure:
* your home is childproofed to prevent household accidents.
* your child always wears appropriate headgear and safety equipment when biking, in-line skating, skateboarding, snowboarding or skiing, and playing contact sports. (By wearing a bike helmet, for instance, your child can reduce the risk of getting a concussion by about 85%.)
* your child always uses a seat belt or child safety seat.
* your child takes it easy, especially after a concussion, and doesn't go back to rough play or playing sports until the injury has healed. (If your child reinjures the brain during the time it's still healing, it will take even more time to completely heal. Each time a person has a concussion, it does additional damage.)
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NOSEBLEEDSAlthough they can be scary, nosebleeds are rarely cause for alarm. Common in kids ages 3 to 10 years, nosebleeds often stop on their own and can be treated safely at home.
What to Do:
* Stay calm and reassure your child.
* Sit your child upright in a chair or in your lap and have your child tilt his or her head slightly forward.
* Gently pinch your child's nose (just below the bony ridge) with a tissue or clean washcloth.
* Keep pressure on your child's nose for about 10 minutes; if you stop too soon, bleeding may start again. It may also help to apply ice wrapped in a paper towel.
* Do not have your child lean back. This may cause blood to flow down the back of the throat, which tastes bad and may initiate gagging, coughing, or vomiting.
* Have your child to rest for a while after a nosebleed. Discourage blowing, picking, rubbing, and any rough play.
Call your child's doctor if your child:
* has frequent nosebleeds
* may have put something in his or her nose
* tends to bruise easily
* has heavy bleeding from minor wounds or bleeding from another place, such as the gums
* recently started taking new medicine
Seek emergency medical care or call your child's doctor if bleeding:
* is heavy, or is accompanied by dizziness or weakness
* is the result of a fall or blow to the head
* continues after two attempts of applying pressure for 10 minutes each
Preventing Future Nosebleeds
Most nosebleeds are caused by zealous blowing or picking, or a blow to the nose during rough play. In the wintertime, especially, if your child's bed is near a heater, the membranes inside the nose can become dried and itchy, causing your child to pick at his or her nose and further irritate the nasal tissue. Colds, other viruses, and allergies may also irritate the lining of the nose.
To help prevent your child from getting nosebleeds:
* Keep your child's nails short to prevent picking.
* Keep the inside of your child's nose moist with saline nasal spray or dab petroleum jelly gently around the opening of the nostrils.
* Humidify your child's room with a vaporizer (or humidifier) if the air in your home is dry. You can buy a cool mist or hot steam (also called warm mist) model. If you go with the hot steam kind, make sure to keep it out of your child's reach to avoid scalding. It's also important to keep vaporizers clean to prevent mildew.
* Make sure your child wears protective athletic equipment when participating in sports that could cause injury to the nose.
Even when taking proper precautions, your child may still get a bloody nose occasionally. But the next time your child gets a nosebleed, try not to panic. They're usually harmless and are almost always easy to stop.
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INSECT STINGS & BITES
The two greatest risks from most insect stings and bites are allergic reaction (which may occasionally be fatal) and infection (more likely and less serious).
What to Do:
Bee, Wasp, Hornet, and Yellow Jacket Stings
* A bee will leave behind a stinger attached to a venom sac. Try to remove it as quickly as possible. One way is to gently scrape it out with a blunt-edged object, such as a credit card or a dull knife.
* Wash the area carefully with soap and water. Do this two to three times a day until the skin is healed.
* Apply a cold pack, an ice pack wrapped in a cloth, or a cold, wet washcloth for a few minutes.
* Give acetaminophen for pain.
* For pain and itching, give an over-the-counter oral antihistamine, if your child's doctor says it's OK; follow dosage instructions for your child's age and weight. You could also apply a corticosteroid cream or calamine lotion to the sting area.
* A sting anywhere in the mouth warrants immediate medical attention. That's because stings in the mucous membranes of the mouth can quickly cause severe swelling that may block airways. You should seek medical care if you note a large skin rash, a large area of swelling around the sting site, or if swelling or pain persists for more than 72 hours. You should seek immediate medical care if you notice any of the following signs, which may indicate a serious or even potentially life-threatening allergic reaction:
o wheezing or difficulty breathing
o tightness in throat or chest
o swelling of the lips
o dizziness or fainting
o nausea or vomiting
Spider Bites
The black widow and the brown recluse (or violin) spider are found in warm climates.
* Wash the area carefully with soap and water. Do this two to three times a day until skin is healed.
* Apply cool compresses.
* Give acetaminophen for pain.
* To protect against infection, apply an antibiotic ointment and keep the child's hands washed.
* If you have any reason to suspect your child has been bitten by a black widow or brown recluse spider, apply ice to the bite site and head for the emergency room. Symptoms include:
o a deep blue or purple area around the bite, surrounded by a whitish ring and a large outer red ring
o body rash
o muscle spasms, tightness, and stiffness
o abdominal pain
o headache or fever
o general feeling of sickness
o lack of appetite
o joint pain
o nausea or vomiting
Check your children and pets for ticks carefully after you've been in or around a wooded area. Common types of ticks include dog ticks.
If you find a tick on your child:
* Call your child's doctor. The doctor may want you to save the tick after removal (you can put it in a jar of alcohol to kill it).
* Use tweezers to grasp the tick firmly at its head or mouth, next to your child's skin.
* Pull firmly and steadily on the tick until it lets go, then swab the bite site with alcohol.
* Don't use petroleum jelly or a lit match to kill and remove a tick.
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BLEEDING
Most small cuts don't present any danger to your child. But bleeding from large cuts may require immediate medical treatment. Depending on the type of wound and its location, there can be damage to tendons and nerves.
What to Do:
For Minor Bleeding From a Small Cut or Abrasion (Scrape):
* Rinse the wound thoroughly with water to clean out dirt and debris.
* Then wash the wound with a mild soap and rinse thoroughly. (For minor wounds, it isn't necessary to use an antiseptic solution to prevent infection, and some can cause allergic skin reactions.)
* Cover the wound with a sterile adhesive bandage or sterile gauze and adhesive tape.
* Examine the wound daily. If the bandage gets wet, remove it and apply a new one. After the wound forms a scab, a bandage is no longer necessary.
* Call your child's doctor if the wound is red, swollen, tender, warm, or draining pus.
For Bleeding From a Large Cut or Laceration:
* Wash the wound thoroughly with water. This will allow you to see the wound clearly and assess its size.
* Place a piece of sterile gauze or a clean cloth over the entire wound. If available, use clean latex or rubber gloves to protect yourself from exposure to possible infection from the blood of a child who isn't your own. If you can, raise the bleeding body part above the level of your child's heart. Do not apply a tourniquet.
* Using the palm of your hand on the gauze or cloth, apply steady, direct pressure to the wound for 5 minutes. (During the 5 minutes, do not stop to check the wound or remove blood clots that may form on the gauze.)
* If blood soaks through the gauze, do not remove it. Apply another gauze pad on top and continue applying pressure.
* Call your child's doctor or seek immediate medical attention for all large cuts or lacerations, or if:
o you're unable to stop the bleeding after 5 minutes of pressure, or if the wound begins bleeding again (continue applying pressure until help arrives)
o you're unable to clean out dirt and debris thoroughly, or there' s something else stuck in the wound
o the wound is on your child's face or neck
o the injury was caused by an animal or human bite, burn, electrical injury, or puncture wound (e.g., a nail)
o the cut is more than half an inch long or appears to be deep - large or deep wounds can result in nerve or tendon damage
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BROKEN BONES, SPRAINS & STRAINS
A broken (fractured) bone requires emergency care. Suspect a possible broken bone if your child heard or felt a bone snap, if your child has difficulty moving the injured part, or if the injured part moves in an unnatural way or is very painful to the touch.
A sprain occurs when the ligaments, which hold bones together, are overstretched and partially torn. Simply overstretching any part of the musculature is called a strain. Sprains and strains generally cause swelling and pain, and there may be bruises around the injured area. Most sprains, after proper medical evaluation, can be treated at home.
What to Do:
For a Suspected Broken Bone:
* If the injury involves your child's neck or back, do not move him unless the child is in imminent danger. Movement can cause serious nerve damage. Phone for emergency medical help. If your child must be moved, the neck and back must be completely immobilized first. Keeping your child's head, neck, and back in alignment, move the child as a unit.
* If your child has an open break (bone protrudes through the skin) and there is severe bleeding, apply pressure on the bleeding area with a gauze pad or a clean piece of clothing or other material. Do not wash the wound or try to push back any part of the bone that may be sticking out.
* If your child must be moved, apply splints around the injured limb to prevent further injury. Leave the limb in the position you find it. The splints should be applied in that position. Splints can be made by using boards, brooms, a stack of newspapers, cardboard, or anything firm, and can be padded with pillows, shirts, towels, or anything soft. Splints must be long enough to extend beyond the joints above and below the fracture.
* Place cold packs or a bag of ice wrapped in cloth on the injured area.
* Keep your child lying down until medical help arrives.
For a Suspected Sprain or Strain:
* If the injury involves your child's neck or back, do not move him unless the child is in imminent danger. Movement can cause serious nerve damage. Phone for emergency medical help. If your child must be moved, the neck and back must be completely immobilized first. Keeping the head, neck, and back in alignment, move your child as a unit.
* It may be difficult to tell the difference between a sprain and a break. If there is any doubt whatsoever, phone your child's doctor or take your child to the nearest hospital emergency department. An X-ray can determine whether a bone is broken.
* First aid for sprains and strains includes rest, ice, compression, and elevation (known as RICE).
o Rest the injured part of the body.
o Apply ice packs or cold compresses for up to 10 or 15 minutes at a time every few hours for the first 2 days to prevent swelling.
o Wearing an elastic compression bandage (such as an ACE bandage) for at least 2 days will reduce swelling.
o Keep the injured part elevated above the level of the heart as much as possible to reduce swelling.
* Do not apply heat in any form for at least 24 hours. Heat increases swelling and pain.
* Your child's doctor may recommend an over-the-counter pain reliever such as acetaminophen or ibuprofen.
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i hope this is useful in "hopefully I'll never practice but thank goodness I know some knowledge."
