Bites, Stings, Cuts, & Burns

Accidents in childhood, including bites, stings, and cuts, constitute some of the more frequent medical problems beyond the age of infancy. Proper care and precautions will prevent a number of accidents and reduce the severity of others. Despite the best of care, however, some accidents occur. The following first aid measures are generally helpful when they do.

Animal Bites

Children should be taught to be wary of unfamiliar dogs or cats, and should not be left alone with any pet. If a child is bitten, scrub the bite area well with soap and water for a few minutes, and apply an antibiotic ointment. Notify the animal control authority, sheriff or police. Dogs and cats should be confined for 10 days of observation even if the rabies shots are up to date. Call the office for severe bites, deep cuts, or signs of infection.

Signs of wound infection include yellow fluid drainage, redness of surrounding skin, red streaks radiating from the wound, increasing pain, or significant fever.

Insect Stings & Ant Bites

The risk of bee stings can be reduced by avoiding areas where bees feed or congregate (fields with flowers, blooming trees, and bird baths). Children should be taught to recognize and avoid ant beds. If a child is stung, remove the stinger, if present, using a scraping motion with a plastic card or fingernail. Apply ice or cold compresses periodically for 8-10 hours to minimize the swelling. Benadryl will help relieve itching and swelling. The application of a teaspoon of moistened papain (Adolf’s Meat Tenderizer) for 15 minutes may neutralize some of the toxin, but will not aid ant bites. Most children will develop a local reaction of swelling, redness, and warmth. Stings on the hand or foot can cause swelling of the entire hand or foot. A sting near the eye may cause the eyelid to swell shut. Contact a physician if the child develops generalized rash, wheezing, hoarseness, facial or tongue swelling, faintness or for any signs of infection.

Signs of wound infection include yellow fluid drainage, redness of surrounding skin, red streaks radiating from the wound, increasing pain, or significant fever.

Cuts & Scrapes

Bleeding from an injury can usually be stopped within 10 minutes if direct pressure is applied to the wound. Cleanse the wound well with soap and water, apply an antibiotic ointment, and cover with a sterile dressing. If the cut is deep or the edges gape open, suturing may be needed for proper healing. Call the office if signs of infection occur. A tetanus booster is given within 72 hours for significant cuts, contaminated abrasions, puncture wounds, bites and burns. A booster dose is needed if a child had not completed a primary immunization series (2,4,6, and 18 month shots) or received a booster dose within the preceding five years. Call our office for any tetanus immunization questions.

Signs of wound infection include yellow fluid drainage, redness of surrounding skin, red streaks radiating from the wound, increasing pain, or significant fever.

Burns

Burns in childhood most commonly occur from touching curling irons, hot water, hot drinks, hot grease, and hot mufflers. The burn is usually first degree (reddened skin without blisters) or second degree (with blisters). Neither of these will typically leave a scar. Second-degree burns take up to 3 weeks to heal. A third-degree burn is deep, may leave areas of charred skin, and often requires a skin graft to properly heal. Immediately put the burned part of the body in cold water, or pour cold tap water over it for 10 minutes. If you are outside, the nearest garden hose should be used. This will lessen the depth of the burn and relieve pain. If the burned area is large, cover it loosely with a clean sheet or plastic wrap. The covering will keep the burn clean and reduce the pain. All second and third degree burns will require evaluation by a physician.

Daily Care of Burn Wounds:

  1. For pain, put cold wet cloths on the burned area and take acetaminophen every 4 hours or ibuprofen every 6 hours for at least 24 hours.
  2. Wash the area gently with liquid soap twice a day. If blisters are present, don’t open them – the outer skin protects the burn from infection. When the blisters break, gently clean the site daily, apply an antibiotic ointment (such as Bacitracin or Polysporin) and cover the burn site with a Band-Aid or sterile gauze dressing.
  3. After the blisters have broken, the dead skin needs to be timed away with fine scissors. This prevents infection from forming within the hidden pockets of the dead skin. The physician may ask to see the child every 2 or 3 days to perform this task of debridement.

CALL THE OFFICE IF:

  • A blister is larger than 2 inches across
  • The burn is on the face, hands, feet, or genitals
  • It was an electrical burn
  • It starts to look infected
  • You have any questions or concerns

Signs of wound infection include yellow fluid drainage, redness of surrounding skin, red streaks radiating from the wound, increasing pain, or significant fever.

Posted in: Pediatric Topics