Injuries in children: bruises, falls, fractures, abrasions, dislocations

This page is dedicated to providing first aid for trauma in children. The child can not grow without falls and bruises, so parents need to know what to do and how to help the child, when he fell and hurt himself, it is necessary to be able to correctly and quickly act in situations of getting abrasions on the skin, with dislocations, fractures, bleeding and even in casestraumatic amputation. From the adequately rendered pre-medical care to the child in many respects will depend on his further health and life.

Household injuries: first emergency child

Among the injuries in children in the first placee is home accidents.

In children under 3 years of age, almost a third of all accidents are burns( see page "Burns in children: what to do, treatment and first aid"), then there are injuries associated with falling to the floor, to the ground, from a height,bruises and wounds about various subjects. The child can fall from the highchair, from the stool, the crib. The child receives the heaviest injuries as a result of falling from a great height( from the window, from the balcony) and in road accidents.

Contusions

Contusions in infants up to 3-5 years are quite often, but due to the elasticity of tissues, expressed by subcutaneous fat and light weight, the case is most often treated without serious damage to soft tissues and bones.

The site of the bruise is usually swollen, there is a bruise, which in a few days changes color from violet to yellow-green and then disappears completely.

To reduce the edema of , it is recommended that a cold compress be applied to the site of the injury in the first 2-3 hours after the injury. Then apply a fixative bandage, ensuring the peace of the damaged part of the body or limb. The next day, you can apply thermal procedures that accelerate the resolution of the swelling and bruising: iodine mesh, warmer, warm bath, troxevasin and heparin ointment, and in the clinic - physiotherapy( UHF, electrophoresis, diathermy and , etc.).

Wounds

Wounds - soft tissue damage with violation of the integrity of the skin. According to the nature of the damaging agent, the wounds are cut, chopped, bruised, chopped, bitten, gunshot, and also superficial, deep and penetrating into any cavity( abdominal, thoracic, joint cavity).

The main signs of a wound: gaping of the skin, bleeding and pain.

First aid for is to stop bleeding and treat the wound surface with an antiseptic to prevent infection of soft tissues.

What to do if bleeding

For severe arterial bleeding , a tourniquet or a twist must be applied above the injury site in order to squeeze the affected vessel. It is necessary to note the time of application of the tourniquet and inform the doctor about it by means of an accompanying note.

Rules for applying a harness or twist

1. above the wound is applied a soft gasket made of cotton wool and gauze or from clothing;
2. immediately before applying the harness should give the limb an elevated position for 30 seconds to ensure the outflow of blood from it;
3. the harness is superimposed a few turns, with each subsequent covering the part of the previous one;
4. to the harness securely attach a note indicating the time of its imposition;
5. in no case is it allowed to apply a dressing over the harness. It should be clearly visible!
6. during long transportation of the injured person every hour, and in winter every 20-30 minutes the tourniquet should be weakened to restore blood circulation to the injured limb;
7. the limb with the applied harness must be securely fixed using a tire or improvised means.

If the tourniquet is applied correctly, the bleeding stops, the pulse is not probed, and the limb becomes pale and cold.

In the absence of the harness, prepare a twist in the form of a strip of durable fabric, place it above the wound and use a stick to tighten and secure it to the limbs.

Never use a fishing line, nylon thread, thin wire as a twist. Exerting excessive efforts, they can cut the soft tissue.

In case of unavenged bleeding, a pressure bandage is sufficient to stop the bleeding.

A 3% solution of hydrogen peroxide is used to treat the wound, and the contaminated skin around the wound can be washed with soap and water. Washing should be done carefully so that dirty water does not get into the wound. It is better to carry out this procedure with soaked in soapy water with napkins, observing the direction of movements from the wound to the periphery.

After that, the skin around the wound should be treated with iodine or green. Fill the wound with green, iodine, alcohol should not, so as not to damage the soft tissues. In addition, severe pain from such treatment will give the child additional suffering.

After treatment with , apply a sterile bandage and contact a trauma center where the doctor decides whether to place stitches and whether the baby needs to be injected with tetanus toxoid serum.

Abrasions

More often, children fall abrasions, especially knees and elbows when riding a bicycle and roller skates.

With abrasions, the upper layer of the skin is removed, bleeding occurs slightly, and with such trauma, the mother can cope on her own. With proper care on the site of abrasion quickly formed protective crust, which does not require further treatment.

The abrasion should be treated in the same way as the wound.

If the abrasion is dry, grease it with a grease and leave it without a bandage. In air, it will dry up faster and heal.

For extensive abrasions, , when a clear liquid oozes from the surface, apply a sterile bandage moistened with antiseptic solution( furacilin, chlorophyllipt, chlorhexidine) or with antibacterial ointment( erythromycin, tetracycline, levomecol, sintomycin emulsion).

The dressing should be applied neatly and tightly enough: it can slip off the wound with mobile restlessness, and you will not have time to blink an eye. But do not overdo it: too tight banding will cause blood circulation disorders, and even swelling below the located soft tissues. In order to better keep the bandage on the wound, use a flexible tubular bandage, properly sized.

In pharmacies you will find a convenient dressing - coltex. Sterile napkin, impregnated with antiseptic, for a short time immersed in water and superimposed on the wound. Due to the sticky edges, it is tightly fixed, does not require replacement within 2-3 days and, most importantly, does not stick to the wound.

If the dressing is applied well, does not move away, remains dry and does not emit an unpleasant smell, which indicates the well-being of the wound, you can not touch it for 2-3 days.

When removing the bandage, be careful. Do not tear off the napkin, but thoroughly moisten with any antiseptic solution or boiled water, and only when it gets wet, separate from the wound.

When the abrasion on the joint is localized, its healing is prolonged, since the crust that forms is interfering with the movements, and the child rips it off. To soften the crust, make it elastic, apply bandages with oily contents for the night: sea buckthorn oil or rosehip oil, aerosol preparations "Olazol", "Levovinizol", "Iruksol", etc.

Dislocations

Dislocations as a result of injuries in childrenare rare. This is due to the high elasticity and strength of the ligament apparatus. Most of the dislocation of bones occurs in the elbow joint, which has a complex anatomical structure. The first place in frequency confidently retains subluxation( incomplete dislocation) of the radial head, which occurs exclusively in children under 5 years old and is called "dislocation from stretching". The name suggests the cause of the injury, a movement in which the child's arm, in the extended position, is stretched forward and upward. This happens when the mother raises the child from the floor, pulling her by the hand. Sometimes during a walk the mother keeps the slipped child from falling, pulling the handle, or during dressing, thrusts the child's handle into the narrow sleeve of the blouse. In some cases, a small crunch or a click is heard. Then the child cries out in pain, cries and stops moving his hand, holding it along the trunk, slightly bent at the elbow joint.

The mechanism of this trauma can be explained by the age features of the ligamentous and musculoskeletal apparatus of the child: muscle weakness, the thinness of the joint capsule, underdevelopment of the radial head - all these phenomena help to slip the head from its normal place.

Occasionally, this trauma is received by a very tiny 4-5-month-old baby when mom tries to put him in or out of the crib, pulling her by the handles. In such cases, it is rather difficult for a doctor to make a correct diagnosis for only troubled behavior. Well, if your mother tells you that the anxiety arose in a perfectly healthy baby after pulling the handle.

The subluxation is corrected by a traumatologist in a few seconds, after which the child immediately calms down and starts using the hand, as before - actively and painlessly.

Sometimes repeated subluxations occur on the same arm or on both hands in turn. The cause is the inherent weakness of the ligamentous-muscular apparatus of the hand.

In such cases, after correction, it is recommended that the dressing is applied for 7-10 days. A baby, prone to exploit, buy a walk for the "reins", which will save him from provoking, pulling the handle, movements.

The subluxation of the cervical vertebrae of is often observed in children after somersaulting on the floor, on the couch, jumps from height, accompanied by a sharp movement of the head. The child feels a strong pain in the cervical spine, which increases when trying to move his head. In this case, the forced position of the head is noted: a turn to the side and stiffness in the cervical spine. Most often it is a subluxation of the 1st cervical vertebra in relation to the 2nd.

Help: cervical collision and hospitalization. What is a cervical collar, you know perfectly well, have seen repeatedly in American fighters, how the policeman puts it on the neck of the victim in a car accident. Instead of the neck collar , you can use a folded towel several times. In a hospital, this subluxation is treated by stretching for 10-12 days, followed by wearing the fixing collar for 1-2 months.

fracture fractures in infants occur infrequently, although falls during mobile games are common. Again, this is explained by a lower body weight, elasticity of soft tissues with a well-expressed subcutaneous fat, which softens the fall. In addition, children's bones are more elastic and flexible, since they have less mineral substances, and the periosteum, on the contrary, has a greater thickness, forming around the bone a case protecting it in case of trauma.

Even if a fracture occurs, the periosteum keeps bone fragments in place, preventing displacement.

With a fracture, pain occurs immediately after the fall and the impossibility of movements in the injured limb. In the place of fracture, there may be swelling, deformity, shortening of the limb.

At the slightest suspicion of a fracture it is necessary to fix the damaged limb in order to avoid additional suffering of the baby. To do this, any means at hand: folded magazine, cardboard, plywood, ski poles. Correctly imposed fixing bandage will immediately ease the condition of the child, as the pain decreases or disappears. To fix at once two joints: above and below the fracture, and if it is a fracture of the hip, the tire should extend over the entire length of the limb: from the waist to the heel, so that all the joints of the leg remain unmoved: the hip, knee and ankle.

If a fracture occurred on the street , call for an ambulance and expect its arrival at the scene. Many adults, witnessing an accident, for the best of reasons take the child in his arms and take him home( to the next street, to the 5th floor without an elevator, by car to another district).And now imagine what kind of suffering a child with a hip fracture, who is born without preliminary anesthesia and immobilization in the apartment, and then in the opposite direction to the ambulance car( though, after the necessary measures have done) suffer.

The victim is urgently transported to a traumatologist, where they will impose a plaster bandage on him. If, after helping the child go home, you will have to watch the limb condition in the cast so that does not miss the appearance of edema and compression of the soft tissues of

. The following signs will tell you about it:

1. the limb becomes swollen and red;
2. fingers turn pale, turn blue, become cold, grow numb;
3. aggravated the pain under the plaster bandage.

If any of these signs appear, you should contact a traumatologist again.

A child left in the hospital will be supervised by medical personnel who will not allow the development of complications.

Traumatic amputation

Mobility and curiosity of children, lack of caution often lead to the hitting of the limbs in the moving mechanisms, which results in the detachment of the body part. Most often amputation threatens fingers or feet, but, unfortunately, in our peacetime, explosives and objects become available "toys" for children, and in limbo acts limp detachment occurs equally often in children and adults. With complete amputation, the part of the body is completely separated from the trunk, while partial amputation is retained on the cutaneous or musculocutaneous flap.

At present, thanks to the success of microsurgery, has become possible to engraft an amputated limb, provided that the first aid is provided by and the victim is delivered to a specialized department in a timely manner.

should be acted quickly and clearly:

1. to stop bleeding, it is desirable to dispense with a tourniquet in order not to disturb the food in the tissues. This will play a positive role in engraftment of the amputated limb;
2. treat the wound, apply an aseptic bandage, immobilize the limb;
3. the severed part of the body wrapped in a sterile napkin and put in a clean cellophane bag, which, in turn, placed in another cellophane bag filled with snow, ice, cold water. In the cold, the amputated fragment can remain viable for half a day.

When transporting, take care of anti-shock measures: give anesthetic, water with hot and sweet tea, wrap up the affected child and deliver to the hospital as soon as possible.

If the amputation is incomplete, try to keep even the delicate connection of the affected limb with the trunk: fix it with a tire and sterile bandage, place it in a cellophane bag and keep it during transport in the cold.

The success of an operation to engraft an severed limb depends not only on the actions of rescuers, but also on the nature of the injury. It is clear that it is much easier to sew a brush cut with a circular saw having straight edges, rather than picking it up and engrafting the same brush that has been ground in an electric meat grinder.

New Year's injuries

To the most gracious and cheerful holiday - New Year - begin to prepare in advance. Christmas bazaars offer a huge selection of toys, garlands, shiny tinsel and potentially dangerous items designed for fireworks.

Firecrackers, crackers, "fire wheels", "flying saucers", "fire-breathing dragons" with carelessness lead to serious injuries, leaving not only traces on the body, but also memory for life.

Here at the counter teenagers, future patients of trauma doctors, desperate experimenters crowded. Belonging to the violent boyish race requires immediate action and testing of acquired items for damage. To begin with, a duel will take place on the clapper, aiming at the enemy's eye. If there were no casualties, go to the next stage: experiment with firecrackers.

"And what if we connect 3-4 firecrackers together and shoot at the same time?", "And what if firecrackers throw in the fire?", "Shchas ka-a-k babahnet!"

And babah, and how! As a result, it is necessary to sum up the burnt hands, injured eyes and torn fingers.

To prevent a happy holiday from turning into a disaster, warn children against risky experiments with explosive and inflammable materials, explain to them the consequences of careless and rash acts.

Do not buy explosive handicraft toys. They, of course, are cheaper, but will bring so much pain and sorrow that will not seem too small. Carefully read the instruction manual and follow its recommendations before using the factory pyrotechnics. If it is said that you should be at a distance of 20 meters from the fireworks, then stand there, admiring the festive salute. Remember that a certain time must pass from the moment of launching to the explosion, and do not rush yourself and do not let the child check "why does not it burn" if the result does not come right away.

And if the misfortune still happened, be able to provide first aid to the victim and know where to turn in such cases. In the explosion of flammable toys, flame burns, eye injuries and traumatic amputation of fingers are possible. How to help the child in such cases, we already said.

Video: Dr. Komarovsky

Household trauma: emergency care

This time, Dr. Komarovsky will not talk about ways of emergency care, but how to prevent household trauma. You will learn the basic rules and secrets of the safe life of children and adults, long established and used in other countries. Also, the doctor will personally show what the responsible parents should do to reduce the risk of injury in their own home and in the places where the child is.

Fracture: first aid to

How it is impossible to prevent rain, so can not be avoided and fracture. But you can prepare - take an umbrella, and in our case - provide the child with motor activity, intake of calcium and vitamin D. Also, Dr. Komarovsky will tell you about various immobility crooks and five rules that must be followed to help with trauma.(broadcast on 06/12/2014)

Bruising and sprain: first aid

What to do after getting a closed injury - a bruise? How to determine if you need to see a doctor? Dr. Komarovsky will remind you that houses should always have cooling bags or just ice, and also talk about the rules of first aid and various anxiety symptoms for tissue damage.

Source:

1. Related Videos.
2. «Pediatrics: A complete reference book for parents / L.Sh. Anikeeva ": Moscow: Publishing house" Exmo ".