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Pullman & Associates - Panda Pediatrics
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    The staff of Panda Pediatrics, located in Washington, D.C.

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    Bumps/Scrapes/Other Injuries
    Common Illnesses
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Falls and Head Injuries

2/3/2019

 
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Sooner or later, every child will fall and strike his or her head. Falls are especially common when your child is learning to walk. Most head injuries simply result in a scalp injury. Big bumps can occur with minor injuries because the blood supply to the scalp is so plentiful. For the same reason, small cuts on the scalp or face can bleed profusely.

Home Care Steps:

1) If there is a scrape, wash it off with soap and water.
2) Apply pressure with a clean cloth for 10 minutes to stop any bleeding.
3) For swelling, apply ice for 20 minutes. (Frozen vegetables such as peas work well or keep a wet sponge in a zippered bag in the freezer).
​

For more serious head injuries, look for the following symptoms:
  • Did your child cry immediately? Crying is a normal response and indicates that he has not lost consciousness.
  • Is he sleepy? After a fall it is common to be sleepy and you should encourage your child to lie down and rest until all symptoms are gone. Just observe him closely and awaken him every 15 minutes for the first hour and every 30 minutes for the second hour. Awaken your child twice during the night. Arouse him until he is walking and talking normally. Do this for two nights.
  • Did your child lose consciousness? If he becomes unconscious, but regains consciousness within a few seconds, bring him to the office for evaluation. If he remains unconscious for more than 1 minute, call 911.
  • Did your child vomit? If he vomits only 1 to 2 times and otherwise appears normal, give him only clear fluids until he has gone 2 hours without vomiting. If he vomits two or more times, bring him to the office for evaluation.
  • Does he have persistent pain or headache? If so, bring him to the office for evaluation. Don’t give any pain medicine.
  • Does he have abnormal body movements? If so, bring him to the office for evaluation.
  • Are his pupils unusually small, large, or unequal? If so, bring him to the office for evaluation.

​Call our office immediately if:
  • The pain or headache becomes severe.
  • Vomiting occurs two or more times.
  • Vision becomes blurred or doubled.
  • Your child becomes difficult to awaken or acts confused.
  • Walking or talking becomes difficult.
  • Your child’s neurological condition worsens in any other way
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Bruises

2/3/2019

 
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A bump or bruise may cause damage to superficial blood vessels, resulting in a black and blue mark. Since the skin is not broken, there is no risk of infection. Bruises usually follow injury caused by blunt objects.

Unexplained bruises may indicate a bleeding tendency. However, unexplained bruises overlying the shins are usually not a sign of a bleeding tendency. Children often bump this area and then forget about it.

Home Care Steps:
1) Apply ice to the bruised area for 20-30 minutes.
2) No other treatment should be necessary.

Optional: Give acetaminophen (Tylenol) or Ibuprofen (Motrin) for pain relief. Avoid aspirin. Bruises usually resolve in about 2 weeks. During this time, the color will change from blue to green to yellow.

Note: If a blood blister is present do not open it due to increased risk of infection. It will dry up and peel off in 1-2 weeks.

Call our office immediately if:
  • Bruises are unexplained and several in number.
  • Bruises are noted in upper extremities or on chest.
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Puncture Wounds

2/3/2019

 
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These wounds occur when the skin has been completely punctured by an object that is narrow and sharp, such as a nail. Since puncture wounds usually seal over quickly, there is a greater chance of wound infection.

Home Care Steps:
1) Soak the wound in warm water and soap for 15 minutes.
2) Scrub the wound with a washcloth to remove any debris.
3) Cut off any flaps of loose skin that cover the wound and interfere with drainage or removing debris. 4) Apply an antibiotic ointment and a bandaid to reduce the risk of infection.
5) Re-soak the area and reapply antibiotic ointment every 12 hours for 2 days.
6) Give acetaminophen (Tylenol) or Ibuprofen (Motrin) for pain relief.

Call our office immediately if:
  • Your child has been bitten by a human or animal.
  • Dirt in the wound remains after you have soaked the wound.
  • The tip of the object could have broken off in the wound.
  • The wound looks infected (yellow pus, spreading redness, red streaks).
  • Your child has never had a tetanus shot.
Call our office during regular hours if:
  • Your child hasn’t had a tetanus booster in more than 5 years.
  • Pain, redness, or swelling increases after 48 hours.
  • You have other questions or concerns.
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Scrapes and Abrasions

2/3/2019

 
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An abrasion is an area of superficial skin that has been scraped off during a fall, such as a skinned knee. Wash the wound for at least 5 minutes with warm water and soap. The area will probably need to be gently scrubbed several times to get out all the dirt. You may have to remove some dirt particles with a pair of tweezers. Pieces of loose skin may be cut off with clean scissors. Apply an antibiotic ointment and cover the scrape with a bandaid or gauze dressing. Cleanse the area once a day with warm water and then reapply the ointment and dressing until the scrape is healed. Give acetaminophen (Tylenol) or Ibuprofen (Motrin) for pain relief.
​

Call our office immediately if:                             
  • There is dirt or grime in the wound that you can’t get out.
  • Skin loss involves a very large area.
  • The wound looks infected (yellowish or foul smelling discharge, foul odor, spreading redness or streaking).
Call our office during regular hours if:
  • Your child hasn’t had a tetanus booster in more than 10 years.
  • The wound doesn’t heal by 2 weeks.
  • You have other questions or concerns.
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Burns

2/3/2019

 
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Be careful with pots, warm air humidifiers, cooking on the stove, hot cups of coffee and soup on the table, matches, fireplaces and of course electrical outlets. Be aware that exposed surfaces of ovens and radiators are sometimes hot enough to cause burns.

First-degree burns are mild and result in redness, slight swelling, and pain. Sunburns are usually first-degree burns. Second-degree burns cause blistering and more intense swelling and pain. Third-degree burns are serious and life threatening, causing charring and destruction of all the skin layers.

Usually you can treat a first-degree burn yourself by soaking the burned area in cool water for 10 minutes. Keep it clean, dry and free from sun exposure until it heals. Second-degree burns require our attention, particularly if they occur on the face, hands or feet. First, soak the burned area in cold water. When you bring your child to the office, cover the burn with sterile gauze or a clean cloth (not absorbent cotton). Try not to pop the blisters. Give acetaminophen (Tylenol) or ibuprofen (Motrin) for pain relief.

Third-degree (full-thickness) burns require emergency treatment at the nearest hospital. Call 911 immediately. [HOW DO YOU KNOW IF IT'S 1st/2nd/3rd DEGREE?]

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Washington, DC 20037

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