The weather is getting super nice and even though we have to be physically distancing, kids can still play outside on their own or with other immediate family members they've been quarantining with. That means injuries to kids might be on the rise.
Across the country, people are understandably scared to come to the emergency room right now due to concerns about COVID-19. As an ER doctor, I definitely recommend that you avoid unnecessary exposure, but there are some circumstances where trying to treat your child at home may end up causing more harm than good.
Home first aid is recommended in most situations but not in all. Here are some common injuries that might require a trip to the emergency room:
1. Cuts or lacerations
Every parent's comfort level is different and many small lacerations can be easily managed at home. If the skin isn't separated, it may just be an abrasion you can clean at home.
However, if you observe that the skin is separated or gaping, see tissues hanging out of the cut or are unsure of the seriousness of the injury, it is best to get cuts and lacerations checked out by a doctor as soon as possible. There's no easy way for a doctor to know whether a cut needs sutures without seeing it in person.
Based on recommendations, lacerations are best closed within 12 hours of the injury to reduce the risk of infection. Some may be closed within 24 hours, depending on your doctor's evaluation. You would hate for your child to suffer a laceration at home and realize after two days that it's getting infected. Your best move is to have them seen earlier to avoid complications.
2. Bone injuries
Fractures in kids are frequently seen in nicer weather. Broken bones are very easy to notice in some kids, but some toddlers or teens with high pain tolerance might only gradually start limping or complaining of pain later on.
Obvious bone injuries need to be seen in the emergency room as soon as possible: Watch for severe pain, an inability to move the affected limb or any swelling or difference in appearance in the affected area. But if you observe small abnormalities in the bone or changes in how your child is walking, those should be checked out, too.
If your child sustains a burn or a severe sunburn and you aren't sure how bad it is, get it checked out. Blistering burns need to be cleaned out (debriding the top skin) and dressed to avoid infection. The longer a burn is left without evaluation and proper cleaning, the higher the risk of infection.
4. Head injury after a fall
All the outside tumbling may sometimes result in falls. If your child sustains a head injury in a fall, it's recommended that you call your regular physician to describe the head injury and how it happened. Most minor falls and head injuries need no intervention other than rest and pain control, but your doctor can help you decide if the impact is concerning enough that it should be evaluated by the doctor or in the emergency room.
If you observe that your child continues to complain or cry due to a headache (even after pain control and rest), is persistently vomiting or is acting differently, they need to be checked out in the ER as soon as possible.
5. Animal bites
Animal bites need proper skin care which may or may not include sutures, depending on the location and depth of the injury, and antibiotics to prevent infection caused by the bacteria from the mouth of the animal. Without this, a worsening infection is common.
Don't wait to get health care for common injuries, even during the pandemic.
It can be tough to know what needs to get checked out or not, and especially with coronavirus cases flooding ERs, you may be on the fence about how to get care when you need it.
If you're ever in doubt about what to do about an injury or condition, check in with your physician as soon as possible (many offices now have telehealth capabilities, making this kind of early check-in easier than ever). They can help direct you on where best to go. And if that's the ER, don't delay care.
Most hospitals and urgent care clinics are working hard to sanitize and disinfect areas to make it safe for your child to be seen. Kids older than 2 years of age should wear masks when they come into any health care setting, including urgent care or the ER. Since so many people who have COVID-19 don't have symptoms, wearing masks reduces the chances of transmitting the virus or getting infected by the virus if any other sick child arrives at the same time. Most ERs will give families and children masks if they do not have one at check-in.
When to call 911 right away.
Injuries that warrant an immediate call to 911 include—but are not limited to—an unconscious child, ongoing seizures after a head injury, fall from a height with concern of neck pain, serious burn or a burn involving significant areas of the face, multiple bone injuries from a fall or trauma, any abdominal or chest wound and any laceration with severe bleeding that can't be stopped with firm, steady pressure.