Fun in the sun can also mean injuries, trips to ER
The summer solstice marks the official start of summer. It also kicks off the season of sunburns, bee stings, and bumps and scrapes from outdoor fun. How can parents know when it’s safe to treat a medical problem at home? When should they take their child to the emergency room?
Dr. Robert Dart, chief of emergency medicine at Quincy (Mass.) Medical Center, said parents should trust their judgment.
“If you have a concern, you’re better off bringing (kids) in and getting them checked than not,” he said.
“There are some straightforward (situations),” he said. “Any head injury associated with a loss of consciousness or a change in a child’s thinking. Any concern about a broken bone. Or if a kid’s getting listless and not acting themselves, that’s a sign for them to get checked.”
In addition to summer injuries, illnesses usually associated with the colder months make the rounds of neighborhoods and summer camps. Dart said the most common illnesses are gastrointestinal bugs and respiratory bugs, which usually respond to home treatment, with a few exceptions.
“If they just can’t hold any fluids, then they’ll get dehydrated and that’s a reason to check (in the emergency department),” he said. For a respiratory bug, “if they have a fever for more than a few days, or if they’re having difficulty breathing, or if their asthma is not controlled with the usual treatment, then bring them in.”
With so many children going to summer camps, the most important medical preparation a parent can do is to leave a good contact number for the camp staff.
“I think there’s nothing more difficult than if someone is trying to figure out if they should bring a child to the emergency department and they can’t get in touch,” Dart said.
As always, the best medicine is prevention. Be sure your children wear sunscreen and bike helmets; don’t allow them to swim alone. Teach kids to cover their mouths when they cough, and to wash their hands frequently when they’re sick. And Dart reminded families of one other key precaution:
“Don’t let the person with the GI bug prepare the food.”
First aid for families: How to handle medical emergencies:
- Remove the stinger as quickly as possible
- Wash the area with soap and water
- Apply an ice pack for a few minutes
Get medical help if:
- The sting is in the mouth
- A rash or swelling develops
- Your child is having difficulty breathing
- You observe swelling of the lips, tongue or face
- Your child is dizzy or faints
For small cuts and scrapes:
- Rinse the wound with water to remove dirt and debris.
- Wash with mild soap and water.
- Cover with a sterile adhesive bandage or sterile gauze and adhesive tape.
For large cuts:
- Wash wound with water.
- Cover entire wound with sterile gauze or a clean cloth.
- Apply steady, direct pressure with the palm of your hand for 5 minutes to stop bleeding.
Seek medical attention if:
- Bleeding doesn’t stop after 5 minutes of pressure.
- You’re unable to clean the wound thoroughly.
- The wound is on the child’s face or neck.
- The injury was caused by a bite, burn, electrical injury or puncture wound.
- If you have any doubt about whether stitches are needed.
- Do not move the child if the injury involves the child’s neck or back. Call 911 for emergency medical help.
- If a bone is protruding through the skin with severe bleeding, apply pressure on the bleeding area with a gauze pad or clean cloth. Do not wash the wound or try to push back the bone.
- Place cold packs or a bag of ice wrapped in cloth on the injured area.
- Keep child lying down until medical help arrives.
- If there is any doubt whether an injury is a sprain or a break, call your child’s doctor or take your child to the nearest hospital emergency department.
- For sprains, use the RICE treatment: Rest the injured part of the body; ice the sprain with ice packs or cold compresses; compress the area with an elastic bandage (such as an ACE bandage); elevate the injured part above the heart. Do not apply heat for at least 24 hours.
- Dry mouth few or no tears when crying
- Eyes that look sunken into the head
- Lack of urine for 6 hours in an infant or 12 hours in an older child
- Dry, cool skin
- Lethargy or irritability
- Fatigue or dizziness in an older child
- Allow child to drink as much as he or she wants. Plain water is best for the first hour or two; later, drinks containing sugar and electrolytes may be used. Child should rest in a cool, shaded environment. If dehydration is due to vomiting or diarrhea, child should drink an oral rehydration solution, available over-the-counter at pharmacies.
Seek medical attention if:
- There is no improvement with home treatment or the dehydration is worsening. Call your child’s doctor immediately or take your child to the nearest emergency department.
- Call the doctor if your child is an infant or loses consciousness, even briefly.
- Call the doctor if your child is inconsolable, complains of head and neck pain, or isn’t walking normally.
- If your child is not an infant and is alert and behaving normally: Apply ice or a cold pack to the injured area for 20 minutes Observe your child carefully for the next 24 hours. If you notice any signs of internal injury, call your doctor.
Call an ambulance if your child shows any of the following symptoms:
- 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
- Neck pain or stiffness
- Vomiting more than two or three times
- Loss of bladder or bowel control
An itchy or burning rash with small red bumps, blisters or streaks may be a result of exposure to poison ivy, oak or sumac. To treat:
- Wash skin and scrub under fingernails with soap and water.
- Use calamine lotion or an oral antihistamine to relieve itching.
- Place cool compresses on the child’s skin as needed.
- Wash all clothing recently worn by the child, as well as any items or pets that may have also come into contact with the plant.
- Call a doctor if the rash covers a large area or is on the genitals or face, if the rash is getting worse or the skin looks infected.
Seek emergency medical help if the child:
- Has a known severe allergy to poison ivy/oak/sumac; develops swelling in the face; complains or chest tightness or sounds hoarse; develops redness or swelling all over the body; becomes dizzy
Prevent sunburn by dressing your child in appropriate outdoor clothing, including a brimmed hat and sunglasses, and apply a sunscreen at least every two hours.
To treat sunburn, remove the child from the sun and place the child in a cool shower or bath. Offer extra fluids for the next few days, and make sure all sunburned areas are fully covered to protect the child from further sunburn.
Call the doctor if:
- The sunburn forms blisters
- There is facial swelling
- Your child develops fever or chills
- Your child has headache, confusion or a feeling of faintness
- Your child shows signs of dehydration or signs of infection on the skin
Heat cramps are brief, severe cramps that may occur during or after vigorous exercise in extreme heat. Treat with rest in a cool place and fluids to drink. Massaging the affected area may also help.
Heat exhaustion can happen when a person has not been drinking enough fluids. Symptoms may include fatigue, weakness, clammy skin, headache, nausea or vomiting, or rapid breathing. Bring your child indoors or into the shade; loosen or remove clothing; and encourage your child to eat and drink. Give the child a bath in cool water and call your child’s doctor for further advice.
Heatstroke is a life-threatening medical emergency. Call for medical help if your child has been outside in the heat exercising and shows any of the following symptoms: flushed, hot dry skin with no sweating; temperature of 105 degrees Fahrenheit or higher; severe, throbbing headache; weakness, dizziness, or confusion; sluggishness or fatigue; seizure; decreased responsiveness; loss of consciousness. While waiting for help, move the child indoors or into the shade; undress your child; and sponge or douse with cool water. Do not give fluids.
- Call your doctor, who may want you to save the tick after removal. Use tweezers to grasp the tick at its head or mouth, next to the skin. Pull firmly and steadily on the tick until it lets go. Swab the bite site with alcohol.
The Patriot Ledger