Bruises Treatments from the School of Hard Knocks
BRUISES Treatments from the School of Hard Knocks
I was almost afraid to take my three-year-old in for his regular checkup,'' says a mother of an active preschooler. ''He had so many bruises up and down his shins, he looked like we had beaten him.''
For kids, bruises are an occupational hazard. Children run, jump, climb, skate, bike . . . and fall, crash, slam and bump. Jeffrey Fogel, M.D., a pediatrician in Fort Washington, Pennsylvania, and staff physician at Chestnut Hill Hospital in Philadelphia, says that bruises are so normal that if he sees a young childwithout bruises on his legs, he wonders if the parents are being overprotective.
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| When to See the Doctor Some bruises require at least an evaluation by a physician before you begin any home remedies. And in very rare instances, bruises that appear spontaneously indicate serious diseases such as leukemia. Seek professional help if: * The eye or head is bruised. * The blow is to the side of the head above the ear, an area at high risk for fracturing. * Your child has trouble walking, talking or seeing, becomes drowsy or unresponsive or has one pupil that is larger than the other after receiving a bruising blow. * Swelling occurs at a joint, particularly an elbow. * Bruising occurs in abnormal places, such as the back, the calves or the backs of the arms. * A minor blow results in a large bruise. * A blunt or hard object, such as a bicycle handlebar, has struck your child's abdomen with significant force. * A fever accompanies the bruising. * Bruising appears with no apparent cause. |
Most bruises require no medical attention and can be treated successfully at home with these simple techniques.
Ice the injured area. ''If the skin is intact, apply ice for five minutes at least,'' says Grace Caputo, M.D., associate chief of the Division of Emergency Medicine at Children's Hospital and assistant professor of pediatrics at Harvard Medical School, both in Boston. You should never, however, apply ice directly to the skin.
If the skin is torn, cleanse the skin first, apply a clean covering and then apply ice to the covered skin. Wrap ice in a clean dish towel or washcloth or use an ice-pack. Ice the area continuously when the bruise first occurs, to minimize swelling. ''Most children will tolerate only about 20 minutes of this,'' says Dr. Caputo. Reapply the ice until the swelling subsides.
Or apply cool compresses. If the injury seems minor and your child rebels at the freezing sensation of the ice, then use a cool compress instead, says Dr. Fogel. Just wring out a washcloth in cold tap water and place it on the injured area. If your child resists even that, don't push. It's not worth the trouble.
Elevate a limb. If a bruised arm or leg is swelling after applying ice, elevate the arm or leg with pillows, says Dr. Caputo. ''This will minimize the swelling,'' she explains.
Switch to heat. After 24 to 48 hours, it's time to reach for warm compresses rather than ice or cold cloths. ''Cold constricts blood vessels, which helps the bleeding stop quicker,'' explains Dr. Fogel. ''After the blood vessel heals over, you want the bruise to go away. Heat dilates the blood vessels, encouraging blood flow, and the bruise gets better faster.''
Wring out a washcloth in warm water and apply for five to ten minutes two or three times a day. Keep this up for two to three days or until the bruise begins to disappear. Explain to your child that the color change of the bruise--from red to purple to greenish-yellow--is the result of the bruise healing.
Kiss it and make it better. ''I don't say that flippantly,'' says Joseph Hagan, M.D., clinical assistant professor of pediatrics at the University of Vermont College of Medicine in Burlington and a pediatrician in South Burlington. ''A little sympathy and reassurance can help. Some bruises, even if they don't look bad, can really hurt.''
Give a pain reliever. If a child is complaining of pain, you can give an appropriate dose of children's acetaminophen, says Dr. Caputo. (Check the package directions for the correct dosage for your child's age and weight. If your child is under age two, consult a physician.) ''But in the case of bruises to the head and stomach, you don't want to give kids pain medications until you've seen the doctor,'' she cautions.
