Emergency First Aid for Babies and Toddlers

Wounds

When my oldest son first began toddling, I made sure to keep cleaning products and medications well out of his reach. But one day when he was 2 years old, he began vomiting mint-green foam -- and I realized that I'd forgotten all about one common product: toothpaste. The Poison Control Center soothed my frazzled nerves. As it turns out, a few mouthfuls of toothpaste aren't generally dangerous, though they can cause a major tummy ache.

When it comes to anything beyond a simple scrape, even veteran parents can be thrown for a loop. And the most safety-savvy moms might be surprised by new first-aid and CPR guidelines from the American Red Cross and American Heart Association. While a mother's kiss is certainly the best medicine, this guide will help you treat childhood injuries confidently.

Cuts and Animal Bites -- DO:

• Press gently on the wound with a piece of gauze or a clean cloth to control bleeding. Keep the cloth in place with a firmly wrapped elastic bandage.
• When the bleeding slows, rinse out the wound with clear running water until you see no dirt or foreign material in the wound, and cover with a bandage. If the wound is superficial, a dab of triple-antibiotic ointment, such as Neosporin, may help speed healing, says Greg Stockton, health and safety expert for the American Red Cross.
• Look for signs of infection over the next few days. Some redness is normal, but if it starts to look inflamed, is oozing pus, if the skin around it is streaked with red, or if your child complains that it's getting sorer, it could be infected and should be seen by a doctor, says Elizabeth Wertz, RN, of Pediatric Alliance, in Carnegie, Pennsylvania.
• Report animal bites to your doctor. Animal bites can be infectious, and the animal may need to be tested for rabies.
• Seek medical assistance for a puncture wound (like from a nail), if the cut is deep, if you can't get it to stop bleeding, if there's anything embedded in it that doesn't come out when you clean it, if the edges won't close together, or if you're concerned about scarring.

Cuts and Animal Bites -- DON'T:

• Remove gauze or other cloth when severe bleeding slows down -- taking it off could remove the scab underneath and cause the wound to start bleeding again, says Wertz. If the cloth soaks through, add another layer on top and add more pressure.
• Apply a tourniquet to control bleeding. Research shows that it's an ineffective device that can damage nerves and tissue.
• Use alcohol or peroxide on a cut. They can kill off healthy cells that are working to heal wounds.

Burns & Insect Stings

Burns -- DO:

• Run a burn under cool water to bring the temperature down, because skin can keep burning after it's removed from heat.
• Cover the burn with a dry, clean piece of gauze or bandage.
• Talk to your doctor about using a medication, such as acetaminophen or ibuprofen (e.g., infant or children's Tylenol or Advil), to relieve pain.
• Call your doctor if the burn covers an area larger than 2 inches across; is on the face, hands, feet, or genital area; or if you have any concerns or doubts about at-home treatment. "Even a sunburn can be serious if it covers enough of the body," says Mark A. Brandenburg, MD, author of Child Safe: A Practical Guide for Preventing Childhood Injuries (Crown).
• Seek immediate medical attention if the burn affects the mouth, nose, or airway. Check your child's face: If he looks flushed, his tongue or lips are swollen, he's coughing, his voice sounds hoarse or squeaky, or his eyelashes or nose hairs are singed, it could indicate that he's breathed in steam or smoke that burned his airway, which might cut off his air supply.

Burns -- DON'T:

• Put salve, butter, or Vaseline on the burn. It could introduce bacteria or seal in heat, says Wertz.
• Break blisters open. That could make them vulnerable to infection.
• Put ice on a burn. It can decrease blood flow to the skin and cause more damage.

Stings -- DO:

• Wrap ice in a cloth and apply it to the site of the sting to decrease swelling.
• Use calamine lotion to soothe itching. Talk to your child's doctor before using antihistamines or topical steroids, such as Benadryl or Cortaid.
• Head to the ER if your child develops welts or hives on her body.
• Call 911 if your child starts to cough or if his tongue or lips swell. (His airway might be tightening up.) Allergic reactions to stings can quickly become serious. "In the time it takes to put him in the car and drive to the hospital, he could stop breathing," says Wertz.

Stings -- DON'T:

• Try to pull on a stinger -- that could squeeze more poison into the skin. Instead, scrape a piece of cardboard or a credit card gently over the stinger to remove it. Research has shown that speed of removal matters more than the method, so if you can't get to a flat object quickly, use your fingernail to scrape the stinger away.

Poisoning, Head Injuries & Near Drowning

Poisoning -- DO:

• Call Poison Control at 800-222-1222 if your child is awake, alert, and you know what she's consumed. "Nine times out of 10 the poison control center will tell you that it's okay to stay home," says G. Randall Bond, MD, medical director of the Cincinnati Drug and Poison Information Center. Otherwise, you'll be told whether to go to the ER or call 911.
• Head to the ER if you don't know what your child took. Also, if she swallowed loose pills and you don't know what they're for, take any leftover medication with you to the hospital. Doctors may figure out what it is with software that analyzes the drug based on its attributes, such as color and size.
• Call 911 whenever your child is unconscious, convulsing, or having difficulty breathing.

Poisoning -- DON'T:

• Give your child syrup of ipecac or activated charcoal. In 2003, the American Academy of Pediatrics stopped recommending that parents stock syrup of ipecac in the home, and while activated charcoal is being researched as a possible substitute, it's not currently recommended.

Head Injuries -- DO:

• Apply an ice pack wrapped in a cloth to the bump.
• Call your doctor if your child won't stop crying, complains of neck or head pain, if she lost consciousness even for a few seconds, if her behavior seems "off," if she can't keep her balance, or if she is an infant -- babies can't tell you if they're in pain or don't feel well.
• Go to the ER if she vomits, has a seizure, is unusually hyperactive or sleepy, or if her pupils are unevenly dilated or don't seem to react to light.

Head Injuries -- DON'T:

• Move your child if she's unconscious or can't get up. If she has a spine injury, moving her can worsen it.

Near Drowning -- DO:

• Check for breathing, taking no longer than 10 seconds. If you don't feel or hear normal breathing -- not gasps or sporadic breaths -- start CPR immediately.

Near Drowning -- DON'T:

• Worry about removing water from the airway -- it won't obstruct the effectiveness of the CPR.

Meagan Francis, the mother of four sons, lives in Williamston, Michigan.

Originally published in American Baby magazine, June 2006.

All content here, including advice from doctors and other health professionals, should be considered as opinion only. Always seek the direct advice of your own doctor in connection with any questions or issues you may have regarding your own health or the health of others.