Falls and Accidental injury
Children are constantly exploring their environment and climbing in particular is crucial to their development. With this however, comes the inevitable falls as they learn to balance. Young children are unable to assess danger and they have limited perception of their environment and because their heads are larger than their bodies, this makes balancing more difficult and so they are more susceptible to falls and injuries (Tinsley, 2016).
According to NHS Choices (2016), around half a million children are taken to A&E each year with an injury sustained at home every year are younger than 5 and more injuries are reported in boys.
When children have minor injuries, they can be treated at home:
Simple first aid advice for cuts and bruises;
-stop the bleeding by applying pressure to the wound using dry absorbent material such as a bandage or handkerchief for several minutes.
-if the cut is the hand or arm, raise the affected limb above the child’s head to reduce the flow of blood.
-if it is on a lower limb the child can lie down to raise the limb to above the level of the heart.
- when the wound has stopped bleeding, it should be cleaned and covered with a dressing to stop it becoming infected.
-if the wound is painful, you can give your child paracetamol or ibuprofen.
If you feel that there is chance that the wound is at risk of infection, it is advisable to take them to the GP to be assessed. Examples may include that the wound may have been contaminated with dirt or bodily fluids, the wound is longer than 2 inches or perhaps it was caused by a human or animal bite. If in doubt, see your GP or practice nurse.
Signs of an infected wound may include;
-Any swelling, redness or increasing pain to the affected area.
-pus forming in or around the wound.
-child feeling generally unwell.
-A temperature of 38 degrees C or above.
-Swollen glands under the chin, neck, armpits or
Often and infected wound can be treated by a course of antibiotics. Also, it would be wise to check the child’s immunisation status as they may require a tetanus vaccination.
When to attend A&E.
Parents should attend A&E or a minor injuries unit in the following circumstances (NHS Choices 2016)
-if the wound does not stop bleeding even after applying pressure.
-if you suspect a foreign body in the wound eg: glass or other debris.
-if there is a loss of sensation near the wound or the child is having difficulty moving any body parts.
- if there is a large cut on the face as urgent treatment may prevent scarring.
*Any child under the age of 1 with a head injury should be seen in A&E.*
An ambulance should be called for falls if the child (NHS Choices 2016):
-Is struggling for breath ie they may be breathing fast, panting or becoming wheezy –sometimes you can see the muscles under their ribcage suck in when they breathe in.
-is unconscious or seems unaware of what is going on.
-has a cut that is gaping open or won’t stop bleeding.
-will not wake up
-has a fit for the first time, even if they recover from it.
-if there is bleeding from an artery.
-if parents suspect a child may have injured their neck or spine, the child should not be moved as unnecessary movement may cause paralysis.
Signs and symptoms of fractures
-the presence of pain and swelling
-the limb may be lying at a strange angle
-the child is refusing to walk or use the limb.
For pain relief, parents can uses paracetamol or Ibuprofen before they take the child to A&E and can use blankets or towels to support the affected limb.
Finger tip and crush injuries
Injuries to fingers are extremely common as children use their hands as a means of exploring their environment and as a result, can often get them caught in a car door or cupboard. The physiology of the hand and fingers is very complex and there are many sensory nerves and therefore if children have sustained a finger injury, I would advise that you get it seen at a local minor injuries unit or A&E.
Home safety advice for the Prevention of Falls and Injuries.
The following advice should be promoted to all parents (NHS Choices 2016);
-ensure babies cannot roll of changing surfaces and parents are advised never to leave a baby unattended on any raised surface.
-Parents are advised not to put a bouncing chair or baby chair on a table or work top as they can bounce off the edge. ( I have seen this often as a Health visitor!).
-Babies and toddlers should be strapped in their high chairs.
-Chairs and other climbing objects should be positioned away from windows and balconies to prevent children climbing up to the windows.
-Stair gates should be fitted at the top and bottom of the stairs for children younger than 2 yrs.
-ensure nothing is left on the floor that a toddler can easily trip over.
-Banisters should be checked to make sure there is no chance a child can crawl through the gaps.
-Balcony doors should be kept locked to prevent children from going onto balconies alone.
-Furniture and kitchen appliances that are at risk of being pulled over should be secured to the wall.
-Knives and sharp objects should be kept out of reach of children or you might want to consider a stairgate at the kitchen door to prevent them from entering the kitchen unaccompanied.
-Foam door guards can be bought as these prevent doors from fully closing and will protect against crush injuries.