All children are sick or injure themselves from time to time, but should you treat it at home, or head straight to the ER? Khulekani Madlela finds out from the experts

Keeping children safe is every parent’s priority. And kids being kids, it’s all too common for them to injure themselves while playing, or to fall prey to germs as their immune system is not yet fully developed. On average the emergency department at Welcare Hospital, Dubai, sees approximately 330 paediatric patients a week.

“The majority of these cases are category 3 and 4, where the patients come in with a temperature higher than 39 degrees, or with severe vomiting, dehydration, burns, minor cuts and falls, severe asthma or wheezing,” says Dr Mohammad Abdul Rahman, specialist emergency physician. These cases obviously could not be treated at home and it’s common for doctors and medics to see parents panicking when their child becomes ill, especially if it comes on suddenly.

“High temperatures, cuts and convulsions can be frightening for parents. Usually when they come in a panicked state someone takes care of the parents while someone else takes care of the child. We reassure them that their child will be OK. I have also seen mothers who bring children scalded by hot coffee in, who feel guilty because they left the cup within the child’s reach.” But some basic first-aid knowledge can help you not only deal with the situation at hand, but also possibly save your child’s life in an emergency.

“Firstly, parents can treat simple injuries such as minor grazes, cuts or burns at home and save the time and stress associated with visiting an emergency room,” Dr Rahman says. “Secondly, a parent can save their child’s life by knowing what to do in a life-threatening situation, such as when a child is choking.”

Dr Rahman recounts the case of a child who had a febrile convulsion brought on by a high fever. “The parents acted immediately by undressing him, sponging him down and keeping him cool until they reached the hospital. Had they not cooled him down the outcome may have been very different,” he says.

On the other hand, there are some cases that can be dealt with at home if you know enough basic first aid and don’t require a visit to ER. “We see a lot of children who could have been treated by their parents at home, especially in the case of minor burns and cuts from falls that occur when children are exploring.” Dr Rahman adds that the Education Department at Welcare organises training sessions for parents and care-givers.

Below are five situations that happen to most children and advice on what to do at home to help and, also, when you should take your little one to the hospital.

High fever

A fever is one of the scariest symptoms for parents as it may indicate a serious infection, says Dr Ali Hasan, general surgeon, head of Emergency Department at Al Noor Hospital in Abu Dhabi. If the temperature is above 38 degrees Celsius, it means the child has a fever, but you don’t need to worry as long as the temperature is below 38.9 degrees.

Treat at home: Undress you child and give him/her a lukewarm bath or sponge bath as this will help lower the temperature. Use your wrist to check the temperature of the water to ensure that it isn’t too cold, as this could cause shock and shivering, or too hot – which may induce sweating and increase body temperature.

Give your child an acetaminophen (paracetamol) to relieve the symptoms, but make sure you give the correct dosage, as an acetaminophen overdose is serious and can cause liver damage and liver failure (the normal dossage is: Three months to one year, 60-120mg; 1-6 years, 120-250mg; 6-12 years, 250-500mg) Give at four to six-hour intervals for fever (the maximum is four doses in 24 hours). Avoid aspirin because of the risk of Reye syndrome, a rare but potentially fatal brain damage condition which has been associated with aspirin use by children.

Provide lots of fluids, including water, fruit juice and milk as long as they can tolerate it. Contrary to old wives’ tales, it isn’t a good idea to bundle you child up in blankets, as this could worsen the fever.

Seek medical help if: Your child’s temperature is above 39 degrees and if the fever remains high after more than two hours of home treatment, or your child shows any other symptoms such as lethargy, breathing problems, signs of dehydration, like a dry mouth and lack of tears, or a seizure. You should also rush your child to a doctor if they are younger than four months old, or if you detect a sunken soft spot on your child’s head.

Vomiting

Vomiting is one of the most common illnesses in children, and is usually a symptom of gastroenteritis. Also known as the stomach flu, this infection isn’t too much to worry about – the main thing to remember is to keep hydration levels up. You should start worrying if you can’t replace fluids your child has lost. For example, if your child can’t keep anything down and looks dehydrated, he may need to be taken to hospital where they’ll give him something to stop the vomiting and replenish fluids intravenously.

Treat at home with: Give your child water to rinse his mouth after vomiting to get rid of the sour taste. For younger children who aren’t able to rinse their mouths, give water to drink using a teaspoon.

Encourage older children to eat but give them simple, easy-to-digest food such as soup and yogurt, if they can tolerate it.

Keep them hydrated by giving them plenty of water, and if they cannot keep down anything, try a rehydration therapy such as ‘Dioraltye’ for children aged six and above to replace glucose and electrolytes in the body. In the case of a baby, check for signs of dehydration, which include a dip in the soft spot at the top of the head, dry tongue, restlessness and not passing urine frequently.

Seek medical help if: Your child continues to vomit frequently or has severe dehydration or fever.

Abdominal pain

Abdominal pain is among the most common cases treated at Al Noor Hospital’s emergency section, according to Dr Hasan. In most cases it is nothing serious, and the problem can easily be resolved at home.

Treat at home: Make sure that your child rests, and drinks a lot of fluids. Avoid soft drinks, however, as they can irritate the stomach lining or increase acid production. Give them soft foods, which are easy to digest, like potatoes, bananas, yogurt and apple sauce to eat, and avoid high-fat foods.

Don’t give them painkillers like aspirin or brufen on an empty stomach as these could cause stomach irritation. If your child hasn’t eaten give him brufen and half a glass of milk. You can also give your child Panadol to ease pain (see previous page for dosages of all medication which change according to age of your child.)

Seek medical help if: The pain persists or symptoms become more severe, or if the pain is localised (only concentrated in one area of the abdomen). Medical intervention is also recommended if the pain is accompanied by vomiting and diarrhoea or if the child cries when passing urine. Monitoring the child’s behaviour is also important; if he isn’t his usual self it’s an indication that something is wrong.

Lacerations and cuts

Your main focus if your child suffers minor cuts or lacerations is to calm him, Dr Hasan advises.

Treat at home: Apply gentle pressure using gauze or tissue over the wound – the bleeding should stop within about ten minutes. When it does, clean the wound under running water, then dry and apply an antibiotic cream. It’s advisable to cover the wound, bandaging firmly but not tightly. Change the bandage daily until the wound dries up and heals. You can also apply a plaster as long as the cut isn’t deep and bleeding.

Seek medical help if: The bleeding doesn’t stop and if the cut is big or deep. Maintain firm pressure on the wound and take your child to an emergency room immediately, as there could be an internal injury you don’t know about.

Minor burns

Children can, thanks to their curious minds, end up hurting themselves in their quest to see, touch and feel new things. The most common causes of burns are hot liquids like boiling water or soup, and candle flames. Burns can be classified into first, second, third and fourth degree burns, and if it doesn’t look too serious, burn injuries can be treated at home.

Treat at home: Your first priority is to get your child away from the source of the burn. Remove any clothes from the affected area and wash the wound with cool water and plain soap. After you have cleaned the skin, to cool the wound, you can put a cool cloth on it or soak his skin in cool water. Contrary to popular advice, don’t use ice or very cold water because it reduces body temperature and can induce hypothermia. After cleaning it apply an antibiotic cream. If the burn goes deeper than the top layer of skin, it increases the risk of infection. To prevent that, you can use either an aloe vera gel or cream, or an antibiotic cream. If the burn forms blisters, don’t pop them, and don’t allow your child to scratch the burn, as that can also lead to an infection. Keep the burnt part of your child’s body to a level above the heart, to slow down blood flow to the area, which helps ease pain. For instance, if they have burnt their foot, make them lie down and prop their foot up on pillows.

You can also give your child over-the-counter pain medicine, such as acetaminophen (sold as Tylenol) or ibuprofen (sold as Advil or Motrin), but check the appropriate dose for their age first.

Seek medical help if: Your child’s clothes stick to the burn, or if the burnt area involves the face. Cover the burn with a clean cloth or gauze, and rush to the nearest hospital.

Bumps to the head

According to Dr Rahman, in children head injuries usually are the result of falls or contact sports. Bumps caused by minor falls shouldn’t be a cause for concern, however those resulting from a fall from a height should always be looked at by medical personnel.

Treat at home: Put an ice pack on the bump. If your child is in pain give them a painkiller like Brufen or Panadol (always check the proper dosage on the packet).

Seek medical help if: If your child falls from a height or a heavy object falls on him or he starts vomiting or loses consciousness, rush him to hospital immediately. If he loses consciousness and you suspect his neck is injured as well, try not to move him. If a bump develops, seek medical attention.

What to keep in your medicine cabinet

First-aid kit:
1. First-aid manual
2. Sterile gauze pads of different sizes
3. Adhesive tape
4. Adhesive bandages in several sizes
5. Elastic bandage
6. Antiseptic wipes
7. Soap
8. Antibiotic ointment/cream
9. Emergency phone numbers
10. Thermometer
11. Several pairs of plastic non-latex gloves

Useful medicines:
1. Diazepam gel
2. Acetaminophen
3. Ibuprofen

Always seek medical help for:

1. Cuts that cause a lot of bleeding
2. Head injuries accompanied by vomiting and feeling drowsy or becoming unconscious
3. Swelling on legs and arms following a fall to check for fractures
4. High fever
5. Severe vomiting and diarrhoea