20060426article about first aid

First Aid for Your Baby's Accidents

Preparing for Accidents

Every year, nearly a quarter of all children suffer an injury that's severe enough to require medical attention and even bed rest. Worse, accidents are the leading cause of death in children ages 1 to 21.
Accidents invariably happen, no matter how careful you try to be, so it pays to be prepared. Here's a primer on treating baby's boo-boos -- big and small.

Cuts and Scrapes

Beginning walkers take a lot of tumbles and get cuts and scrapes. Fortunately, most are minor and can be treated at home.

Home Care
Wash your own hands with soap and water first. Use lukewarm water to wash away any blood and grime on the surface of the wound. Clean the cut with mild soap and water, too. Then gently pat the area with a sterile gauze pad to dry. If bleeding hasn't stopped, apply firm pressure for up to five minutes.
Apply antibacterial ointment, such as Neosporin or Bacitracin, to prevent infection, and then cover the wound with a bandage until it heals, says Loraine Stern, MD, a clinical professor of pediatrics at the University of California at Los Angeles. Keeping the wound covered, rather than allowing a hard scab to form, keeps the area moist, which helps the cut heal faster and with less scarring. Replace the bandage daily and look for signs of infection such as redness or pus.

Call the Doctor If...
The cut is ragged, deep, or longer than an inch; embedded with gravel or dirt; or caused by a puncture wound, rusty object, or animal or human bite. Also call if heavy bleeding continues after at least five minutes of direct pressure.

Tip
Apply sunscreen of at least SPF 30 daily to a healed wound. The new skin that forms over a cut is more sensitive to sunlight and should be protected.


Burns and Scalds
A hot iron, a steaming cup of coffee -- these are among the many things you never used to worry about in your life B.C. (before child). But now that you've got a curious crawler or new walker in the house, you need to prepare for a potential burn emergency.

Home Care
Only first-degree burns should be treated at home, says Jessica Cooper Foltin, MD, director of the Pediatric Emergency and Transport Program at NYU Medical Center. A first-degree burn affects the outer layer of skin, causing redness but no blistering.
To treat, run cool water over the area for several minutes, which will lower the skin temperature. Avoid icy-cold water, which will feel uncomfortable and may even decrease the flow of blood to the skin, says Dr. Foltin. Apply an aloe vera cream to ease pain, and cover the area with a damp gauze pad. Don't apply ice, butter, or other home remedies, which can actually increase the size of the burn.

Call the Doctor If...
Your child has blistering burns (they're second-degree burns, which affect the outer and underlying layer of skin); the burn covers a large area but is not blistered; or the burn is on the face, hands, feet, or genitals.

Call 911 If...
Your child is not breathing, has suffered a serious burn such as an electrical burn, has a blistering burn over a large area, or needs immediate medical attention.

Tip
Never place hot food or drinks near the edge of a counter or table or on a tablecloth because kids can yank on it. Keep your water heater set at or below 120 degrees F. to prevent scalding. Don't leave hot irons or hair appliances unattended or within reach of little hands.


Insect Bites
Mosquitoes, bees, and other insects seem to love young skin. While annoying and sometimes painful, most bites are harmless, says Sajjad Yacoob, MD, attending physician at Childrens Hospital Los Angeles. Still, you need to be on the alert for allergic reactions and infection.

Home Care
If your child is scratching her mosquito bite, try applying a cool compress or rubbing an ice cube on the bite for several seconds. You can also alleviate itching with calamine lotion or a paste made of three teaspoons baking soda and one teaspoon water. For persistent or severe itching, ask your pediatrician if it's okay to use a topical anesthetic cream such as Itch-X or a 1-percent hydrocortisone cream. Also, cut or file down your child's fingernails so that any scratching will be less likely to break the skin and cause an infection.
A bee leaves behind a nasty calling card -- a stinger attached to a venom sac. Don't try to pull it out with your fingers or the stinger will release more poison. Use a clean fingernail, credit card, or the edge of a very dull knife to scrape the stinger out. Wash the area with soap and water and apply a wet washcloth or cold pack for several minutes. Then apply a paste of baking soda and water.
To relieve the pain and itching from a sting, can ask your doctor about using an over-the-counter antihistamine such as liquid Benadryl. One caution: To avoid an overdose, never give your child an oral antihistamine at the same time as a topical one.
The bite of an infected tick can cause Lyme disease, a bacterial infection that usually first appears as a red bull's-eye rash and triggers fatigue, aching joints, and other symptoms if left untreated. If you live in a rural or forested area or take a family camping trip, you'll need to inspect everyone from head to toe for ticks when you come indoors. Be sure to wash all clothes too.
To remove a tick, use tweezers and grab it as close to the skin as possible. Pull back slowly, being careful not to squeeze, which may cause you to lose some of the tick in the skin. If you live in an area where tick diseases are common, save the tick in a small bottle of rubbing alcohol and call your doctor for advice.

Call the Doctor If...
An insect bite gets unusually large, becomes very painful, or appears to be infected.

Call 911 If...
Your child has an allergic reaction. In rare cases, anaphylaxis can occur, a potentially life-threatening condition with symptoms that affect more than one part of the body, such as throat swelling and hives.
Remember when a mosquito bite was just an itchy annoyance? Nowadays parents in many parts of the country worry about West Nile virus, which is transmitted by infected mosquitoes. Less than 1 percent of people who become infected with West Nile get seriously ill. But that's little comfort for parents when mosquito bites start popping up like chickenpox in summer months.
To minimize bites: Keep children indoors at dawn and dusk; dress them in long-sleeve shirts and pants (weather permitting); and for kids 1 year and older, use an insect repellent with 10 percent or less DEET. Spray on clothing only, not on skin.


Head Bumps
You may never forget the first time your child falls and bumps his head. But be brave: There may be many "goose eggs" in your child's future. The trick is learning which ones merit hugs and kisses and which call for professional help.

Home Care
If your toddler falls and hits his head, examine him for other injuries, says Dr. Yacoob, and watch for changes in behavior. If he cries but stays alert, he's probably okay. Apply a cold compress to minimize swelling.
Call the Doctor If...
Your child vomits; loses consciousness briefly; doesn't want to play; seems more tired, irritable, or quiet than usual; suffers headaches; or seems generally "out of it," Dr. Yacoob says. He may have a concussion. If there's a divot in the skin of his skull, your child could have a fracture. Also call the doctor if your baby falls from a height of three feet or more -- such as off a changing table; or if your child falls while being propelled, such as off a moving swing.

Call 911 If...
Your child loses consciousness or has seizures.


Splinters
Removing a splinter from a squirming baby or toddler can challenge even the most seasoned parent. It helps to have two adults for the job -- one to remove the splinter and the other to distract an unhappy child.

Home Care
Wash the skin around the splinter with soapy water. Clean a pair of fine-tipped tweezers with rubbing alcohol, then slowly pull the splinter out. Apply an antibacterial ointment and cover the area with a bandage if it's likely to get dirty. If the splinter isn't easy to remove, leave it alone for a couple of hours and see if it works its way toward the surface. Never dig at the skin or you risk causing an infection.

Call the Doctor If...
You can't remove a splinter safely.

Tip
For really soft splinters, like the ones from certain prickly plants, try using adhesive or duct tape to pull them out.


Choking
Babies are always putting things in their mouth. While mouthing is a natural part of learning and exploring, it puts them at serious risk of choking. Hard or gummy round foods are also dangerous.

Home Care
If your child appears to be choking but has a strong cry or a forceful cough (signs of little or no blockage), encourage him to cough, which may dislodge the object. Otherwise, begin first aid if your child can't breathe, cough, or cry; makes high-pitched noises while breathing in; is blue in the face; or loses consciousness. Follow these steps for babies 12 months and younger. (For older children the technique is different. Call 911 for instructions.)
CDATA[Lay the baby facedown along your forearm, with her head lower than her chest. Support the head with your hand around the jaw and under the chest, using your thigh for support. Give up to five quick back blows between the infant's shoulder blades, using the heel of your free hand.
If the child is still choking, turn her faceup. Use your thigh or lap for support. Support her head, which should be lower than her chest. Place two fingers on the middle of her sternum (breastbone) just below the nipples and give five quick downward thrusts. If the baby is still choking, repeat back blows and chest thrusts. Have someone call 911.
If the baby loses consciousness, give infant CPR for a minute (call 911 for instructions). If you can see the object blocking the airway, try to remove it.

Tip
Any adult or teenager caring for children should take a basic course in first aid and CPR, says Ellen Kempf, MD, a medical director at Akron Children's Hospital in Ohio. To find a class, contact your local chapter of the American Red Cross or American Heart Association.


Accidental Poisoning
Little ones tend to think everything is ingestible. It's up to you to keep potential poisons out of reach.

Home Care
If you think your child has ingested a poisonous substance, contact the Poison Control Center immediately at 800-222-1222. Among other information, they will ask for your child's age, weight, and if the child has vomited. They will tell you whether or not you need to go to the emergency room. Don't make your child vomit unless instructed to do so.

Tip
Throw out the syrup of ipecac. This vomit-inducing medicine is no longer recommended by the American Academy of Pediatrics because it's been proven ineffective in poisoning cases.