MEDARVA: Stuff Happens

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And when it does, here’s what you can do.

By Lisa Chestnut, MD
Henrico Monthly
September 2014

As parents, we are often (daily) amazed at what our children can do ... and equally amazed at the things that we do not believe that they can do. A lot of these things require medical evaluation, so here is a little advice.

First of all, we must remember to keep calm, seek a common-sense approach to dealing with a sometimes difficult situation, and remember that our children learn how to react to stress from how we as parents react to stressful situations. So if the parents remain calm, often the children are much easier to manage when they have done something that requires medical intervention.

He swallowed what?

One of the biggest fears that parents of young children have is that they are going to swallow something that they are not supposed to and choke on it.

This is the reasoning behind a lot of the toys that are marked “not age appropriate for children under 3,” as there may be small objects that may lodge in a child’s airway. As a parent, you know that they still find things to put in their mouths.

If you are presented with a child who swallowed or is choking on a small object, the first thing to decide is, “Are they having trouble breathing?” If the answer to this is yes, then call 911. If not, but you think that there is an ingestion, then you should seek medical attention. The biggest concern is that the swallowed object is stuck in the airway or the upper esophagus; often X-rays can help in the evaluation of a child in this situation. Frequently swallowed objects include coins, buttons, batteries, small toys and other objects on your floor or in drawers accessible to young explorers. 

He put what? Where?

As parents, we often encourage our children to be imaginative and explore the world around them. As children, they often explore their bodies by putting things where they shouldn’t be. 

Unfortunately this is a common occurrence. Curious toddlers find pearls, beads, popcorn kernels and green peas the perfect size to put in their ears and noses. Unless these are visible by you as a parent and easily removable, a medical evaluation is required to evaluate for damage to eardrums and for removal in a safe and monitored environment. 

The biggest complication from not having these removed is infection behind or around the foreign body. Again, if your child has put something in his nose or mouth and is having trouble breathing, call 911; otherwise, an evaluation at an urgent care center specializing in pediatrics is recommended. If you are unsure what to do, call your pediatrician. 

He did what? To what? 

As children are encouraged to be physically active and explorative, they often find interesting ways to injure themselves; as parents, we are often not sure how to manage some of these injuries.

Certainly if there is a head injury with a change in mental status, neck injury, uncontrollable bleeding, deformity of extremity or penetrating wounds, 911 should be called.

For most other childhood injuries, parents should assess the situation and decide whether the child can be seen at an urgent care center for pediatrics or if the child requires a visit to an emergency room. 

KidMed can manage lacerations, puncture wounds, splinters, fractures (even angulated ones), abrasions, eye injuries, strains/sprains, foreign bodies as well as all common illnesses.

What can you do at home? 

If there is swelling at an injury site, you can wrap the site with an elasticized cloth bandage or stabilize with a pillow or other household item that makes your child more comfortable prior to evaluation. 

If there is minor bleeding, apply pressure with a clean bandage to control it prior to evaluation. If you are presented with a tooth or a broken tooth related to an injury, place the tooth in a cup of milk, call your dentist and seek evaluation.

In summary, kids will be kids but hopefully you now have a better idea of what to do as the parent. Encourage physical activity in your children, and KidMed will help manage the injuries suffered from all the fun. ■

Lisa Chestnut, MD, FAAP, is a board-certified pediatrician and co-founder of KidMed, an after-hours pediatric urgent care center that provides acute care to infants and children, ages newborn to 21. KidMed has three locations: South Side, the West End and Mechanicsville.