What to Expect the Toddler Years (241 page)

Learn to handle minor accidents calmly, which will help you keep your cool should a serious one ever occur. (Taking a couple of deep breaths before heading for an accident scene will help relax you.) Your manner and tone of voice (or those of another caregiver) will affect how your toddler responds to an injury. If you panic, your child is more likely to be upset or panicky and less likely to be able to cooperate. An unco-operative child is more difficult to treat.

To further relax and reassure, always try to divert your child’s attention from the injury by engaging at least three of the senses (stand where your child can
see
you, speak calmly so he or she can
hear
you, and
touch
a part of the body that doesn’t seem to be injured).

Following are the most common injuries, what you should know about them, how to treat (and not treat) them, and when to seek medical care for them. Types of injuries are listed alphabetically (abdominal injuries, bites, broken bones, etc.), with individual injuries numbered for easy cross-reference.

A gray bar has been added to the top of these pages, making the chapter easy to locate in an emergency.

1. Internal bleeding.
A blow to your toddler’s abdomen could result in internal damage. The signs of such injury would include: bruising or other discoloration of the abdomen; vomited or coughed-up blood that is dark or bright red and has the consistency of coffee grounds (this could also be a sign of the child’s having swallowed a caustic substance); blood (it may be dark or bright red) in the stool or urine; shock (cold, clammy, pale skin; weak, rapid pulse; chills; confusion; and, possibly, nausea, vomiting, and/or shallow breathing). Seek emergency medical assistance (
call 911
). If the child appears to be in shock, treat
immediately
(#48). Do not give food or drink.

2. Cuts or lacerations of the abdomen.
Treat as for other cuts (#51, #52). With a major laceration, intestines may protrude. Don’t try to put them back into the abdomen. Instead, cover them with a clean moistened washcloth or diaper and get emergency medical assistance immediately (
call 911
).

3. Animal bites.
Try to avoid moving the affected part. Call the doctor immediately. Then wash the wound gently with soap and water for 15 minutes. Do not apply antiseptic or anything else. Control bleeding (#51, #52, #53) as needed, and apply a sterile bandage. Try to restrain the animal for testing, but avoid getting bitten yourself. Dogs, cats, bats, skunks, and raccoons who bite may turn out to be rabid, especially if the attack was unprovoked. Low-risk dog bites do not usually require antibiotics, but it’s important to consult your child’s doctor for any animal bite.
Call the doctor immediately
if redness, swelling, and tenderness develop at the site of the bite.

Cat bites are prone to becoming infected because they tend to be puncture wounds that can’t be easily cleaned, and they may require antibiotics. Signs of infection include redness, tenderness, swelling, and tenderness or pain.

4. Human bites.
The human mouth contains a variety of infectious organisms. If your child is bitten by a sibling or another toddler, don’t worry unless the skin is broken. If it is, wash the bite with mild soap and lukewarm water for about 10 minutes, by running tap water over it if you can, or by pouring water from a pitcher or cup. Don’t rub the wound or apply any spray or ointment (antibiotic or otherwise); simply cover the bite with a sterile dressing and
call the doctor
. Use pressure to stem bleeding (#52), if necessary. Antibiotics may be prescribed to prevent infection.

5. Insect bites.
Treat insect stings or bites as follows:

Scrape off the honeybee’s stinger with the blunt edge of a knife or with your fingernail or the edge of a credit card. Don’t try to grasp the stinger with your nails or with a tweezer—this could squeeze more of the remaining venom into the wound.

To remove ticks, use blunt tweezers or fingertips protected by a tissue, paper towel, or rubber glove. Swab the area with alcohol, if possible. Grasp the bug as close to the child’s skin and to the
point of attachment as possible and pull upward, steadily and evenly. Don’t twist, jerk, squeeze, crush, or puncture the tick.
Don’t
use such home remedies as petroleum jelly, gasoline, or a hot match—they can make matters worse. Save the tick for medical examination if you suspect it’s a deer tick; otherwise squash it in a tissue and discard. A deer tick, which can carry Lyme disease (see page 848), is black and brown, pin-head size in the nymph stage and about
¹
/
₁₀
-inch in the adult stage; engorged with blood, it looks larger. Its bite leaves a red, round area that usually develops a clear “bull’s eye” center. Removing an infected tick quickly greatly reduces the risk of the victim developing Lyme disease. If you suspect a deer tick bite, call the doctor. Also call the doctor if the head of the tick remains embedded in the skin despite your efforts to remove it.

Wash the site of a minor bee, wasp, ant, spider, or tick bite with soap and water. Apply ice or cold compresses (page 836) if there appears to be swelling or pain. Follow with an application of bug-bite medication, or a paste of baking soda or meat tenderizer and water; a lido-caine spray or a mix of vinegar and salt may also relieve discomfort. If the bite is near an eye or on the eyelid, be careful not to get any medication in the eye.

Apply calamine lotion or another anti-itching medication to itchy bites, such as those caused by mosquitoes. If a child has several bites, a colloidal oatmeal bath may also be soothing (and distracting).

If there seems to be extreme pain, difficulty breathing, or fever after a spider or fire-ant bite, apply ice or cold compresses and
call 911
for emergency help
immediately
. Try to find the spider or ant and put it in a jar (avoid being bitten yourself) so that you can take it to the hospital with you. If you can’t find it, be ready to describe it so that the doctor can determine whether it was poisonous.

If you know (or even suspect) your child was bitten by a scorpion or a poisonous spider—a black widow, brown recluse spider, or tarantula, for example—get emergency treatment (
call 911
)
immediately,
even before symptoms appear.