Transcription:
Basic Essentials: First Aid for Parents

Melanie Cole (Host):  Staying calm is not always so easy when your child gets hurt. But it’s important to know what to do and to whom you should turn. This is BayCare HealthChat. I’m Melanie Cole. And today, we’re discussing first aid 101 for parents. Joining me is Dr. Carolyn Marasco. She’s a Pediatrician with BayCare. Dr. Marasco, please tell us first about the importance of learning proper first aid for children, for parents, caregivers, even grandparents that might be watching our kiddos.

Carolyn L. Marasco, MD (Guest):  The main thing with first aid that parents need to know and grandparents is prevention. Prevention of injuries and things is the biggest thing that we can do for pediatrics. Again, no chocking foods under the age of three, proper car seats, proper positioning, proper booster seat sizes, vaccines. If one parent is CPR trained and parents are understanding the Heimlich maneuver that’s important. Safe sleep environment. Home safety. Poison control number available 1-800-222-1222. Having your outlets covered. Making sure TVs and dressers are tethered. Locks are high on the doors, smoke alarms are working, carbon monoxide alarms. If there’s a pool, make sure there’s an alarm fence, gate. Make sure your water heater is less than 120 degrees to prevent burning. Dental care, make sure they are brushing their teeth and that they are seeing the dentist. Not smoking around your child is very important. And again, make sure if you have to call 9-1-1, especially from a cell phone, make sure you tell them your location right away since they have a way to get back to you. And then obviously, bike helmets, street safety, things like that.

Host:  Wow, what a great list. So, important that we pay attention to all of those things you just mentioned and heed them and check over our houses for that. So, let’s talk about some of the things that children get into that we can’t always prevent. I’d like to start with scrapes, cuts, things like that. We never know as parents whether something requires stitches. Can you tell us when we should know that something might require a visit to the Urgent Care or the ER and whether we should be using gauze or bandage. Just give us a little first aid 101 on scrapes and cuts.

Dr. Marasco:  A scrape typically if it stops bleeding on its own, you just want to wash it with warm soapy water, and you can apply like Neosporin. If it seems deeper and it doesn’t stop after holding like gauze or tissue for, gauze is better than a tissue but for ten minutes and it doesn’t stop, you definitely need to take your child in to be seen. If it seems like it’s opened a good amount, then they should be seen for stitches most time you need to go to an Urgent Care or the Emergency Room. A lot of pediatricians aren’t doing stitches anymore, but you could always call your pediatrician for the information. Head injuries is one thing you need to keep calm. If there is a cut on the head, it does bleed a lot which can cause parents some anxiety. So, you need to be aware that a head injury will bleed more than a cut somewhere else.

And then if it’s a significant head injury where the child’s lost consciousness and they are vomiting then they should definitely be seen by their pediatrician. Nosebleeds again are another common injury with kids. The most important thing would be to make sure that you have the child leaned forward not back. If you have them lean back, they are going to swallow that blood and they are going to vomit. So, you want to hold pressure that’s constant at the bridge of the nose for about 15 to 20 minutes, and after 15 to 20 minutes of constant pressure then they probably need to go to the Emergency Room. You can do the old simple trip of applying sometimes ice to the back of the neck and sometimes that does help them stop bleeding.

Host:  Wow, that was excellent advice. I was going to ask you about nosebleeds and the fact that heads bleed. It is absolutely terrifying. So, now what about things like burns. It’s pretty common. Sometimes kids running around in the kitchen, parents are cooking. How do we know the severity of this burn? What do we do about that?

Dr. Marasco:  So, again, make sure your water heater is less than 120 degrees. Make sure the pot handle is facing not out so in case the child doesn’t hit it so prevention. But if a burn does occur, move them to a safe environment. If it’s because of a spilled pot of hot water, you want to immediately remove them from that water area. Don’t apply butter or Vaseline to the burns because that will actually trap heat and make it worse. You can submerge the area in some cool water. If it’s a mild burn and it’s not too much of a blister; you can apply aloe if it’s not open and again, small. Do not wrap the area especially like in an Ace bandage again because that will retain heat and make the burn worse. You want to push fluids. Drink a lot of water because again, it is injury to the skin, and they need that extra fluid.

If it is a large area, the rule of nines in kids, over 90% of their body, they definitely need to be seen. Or if it’s blistering you definitely would want to call your doctor or pediatrician and they may need to go to the Emergency Room depending on the severity. And then always make sure they check your child’s tetanus status because if it is a significant burn, they will need their tetanus updated.

Host:  Something that doesn’t seem quite as scary but could be, stings, bites. I think my parents used to put on baking soda that they mixed onto a bee sting as some sort of a paste or calamine. Are we still doing that? What do we do?

Dr. Marasco:  So, again, it depends on the sting. If it is like a mosquito bite, that works, the calamine, the baking soda, the aloe vera, the salt, lemon, actually minced garlic and onions works for mosquito bites and then like antihistamines if it’s really itchy like Zyrtec or Benadryl or just over the counter antihistamines. And then sometimes just cortisone over the counter helps. If it’s a bite such as a bee or a wasp that’s a little different. The bees have stingers, that need to be removed. The easiest way to remove that is actually to slide a credit card over the area and that removes the stinger. Sometimes tweezers. Ice, Motrin, antihistamines, again and it’s normal to have a localized reaction such as itching and swelling and redness and pain. And as long as it’s not effecting their breathing and it’s just a localized reaction, then you usually don’t have to be seen. But if there is obviously any concern; then you would want them to be seen right away.

Another thing with bites is that the second or third day the inflammation is increasing so the swelling will also increase. So parents will get concerned that it seems a little more swollen, a little more itchy and red and that’s normal. And then you obviously want to watch for any infection because it is an open area where bacteria can go in, so you want to call if there is any fever, red streaking or vomiting.

Ticks will be a different category. There are deer and dog ticks depending on the area of the country you are in. And the common what we use for to determine the size sometimes the pencil point would be a deer tick, if it’s an eraser, it’s the size of a dog tick. And then make sure you remove it. You want to remove it with tweezers that attach closest to the skin and remove firmly upward so in case, we don’t want to engorge and then excreting that into the patient. And then obviously wash your hands with warm soapy water and rubbing alcohol.

Host:  So, that’s great advice. All of this is such usable advice. When it comes to our kids, they have aches, stomachaches, pains all the time sometimes it’s our teenagers, sometimes it’s hormonal or a certain time of the month, sometimes it could be stress. And with little kids, they get tummy aches all the time. Dr. Marasco, how do we know when a stomachache is something, we should concern ourselves with? Every parent thinks appendicitis right away. What do you want us to know about stomachaches?

Dr. Marasco:  The biggest cause of stomachache in kids most of the time is going to be constipation. So, the main thing is make sure they are drinking enough fluid, make sure that they’re – usually my rule is half their weight in ounces daily and if it’s really hot or sweaty, make sure they actually increase that. If the pain is waking them up at night, it they are having fevers, vomiting, diarrhea, it’s affecting their appetite, if there’s a family history of any GI issues, inflammatory bowel issues; those are more red flags and then they should be evaluated. If the pain becomes located in the right lower quadrant and they have no appetite, it’s not going away after Tylenol or Motrin after an hour, it’s just getting worse, they don’t want to walk and if they jump and they have severe pain in that right lower quadrant; then that’s a sign that they need to be evaluated for appendicitis.

Host:  And what about seizures? There’s febrile seizures, or epileptic seizures. Terrifying for parents. What do we do and how do we know?

Dr. Marasco:  So, again, the first thing with a seizure is remain calm and place them in a safe place on their left side. Make sure that their airway is clear, there is nothing in their mouth and call 9-1-1. You also want to look at the time if you can. Or start a timer because it will seem like it’s lasting forever when it lasts only seconds. So, it’s really important to know how long that seizure is. And it’s also important to remember that they will be sleepy after it and that’s a very normal component. So, any child who has a seizure even if it’s a young child with a fever; they need to be evaluated initially. So, febrile seizures usually are age six months to six years. They peak at age three. Usually there is a family history of them but the first one still should be evaluated.

Once they have the diagnosis of febrile seizures; then the parents can typically be less worried but again, you don’t want to overly aggressively worry about treating the fever all the time because if it’s going to happen, it’s going to happen no matter what you do. Sometimes when you give them the antipyretics, the acetaminophen and the ibuprofen, the fever comes down but then the fever spikes higher is typically when they have that seizure. So, you just have to be aware that they may still have the seizure even if you are treating them with the Tylenol and the Motrin. And then a child who has baseline seizure epilepsy, a fever, they can still have a seizure with a fever that’s not a febrile seizure. But that’s sometimes more concerning and we’re worrying about like an infection or something like that.

Host:  Wow so, before we wrap up, your best advice because there are so many we could go through, but certainly we don’t have enough time in this podcast but give us your best advice for parents about learning some first aid, about fevers, you just mentioned and when we worry. Just general first aid 101 Dr. Marasco, if you would.

Dr. Marasco:  So, a fever for a child over two months who has received their vaccines is going to be over 101. And a fever is your body’s normal way of fighting infection. So, try to remain calm and don’t be really upset about it. If the child is under two months and has a fever then like over 100.4 rectally, they need to be seen right away because of the risk of infection is greater. If the fever is getting high in a small, small child under three like 103 to 104; then they always should be evaluated. So, it depends on how the child looks. If a child has a 101 fever and is irritable, then they need to be seen right away. Again, you know your child as a parent, you need to be in tune with those – how they look and what’s normal for them.

If a child is 103 and the fever comes down and they are happy and playful, we’re less worried. But again, if the fever is prolonged over a few days or in flu season, you probably want to bring them in right away during influenza season because there are medications we can give, and the flu can hit little kids harder than adults. But again, the main thing is you need to respect the fever but even if the child does have influenza and we diagnose it; they will have fever for sometimes up to five to seven days. So, it’s again just a manifestation of the illness and it’s their body’s normal way of fighting infection.

My best advice would be you will be the expert of your child and you need to respect that, and you will know when things are wrong and when you should take your child in most of the time. But as pediatricians, we are always here for guidance and information and support.

Host:  Well you certainly are and thank you so much for all this great information for parents Dr. Marasco. And that concludes this episode of BayCare HealthChat. To learn more about BayCare’s Children’s Health Services please visit our website at www.baycare.org for more information and to get connected with one of our providers. Please remember to subscribe, rate and review this podcast and all the other BayCare podcasts. Share this show with your friends and other parents that you know that way we all learn together from the experts at BayCare. I’m Melanie Cole.