Summer vacation: Unintentional injuries among children

Child injuries can be unintentional or intentional, but more than 95% of them are unintentional. Unintentional injuries have become the focus of global public health because of the high disability and mortality rates resulting from them. The Outline for the Development of Children in China (2021-2030) lists the prevention and treatment of child injuries as one of the country’s main goals in this area.

How to deal with unintentional injuries of children
1.Drowning
Drowning is the leading cause of injury or death for children in China, with very high mortality and disability rates, which brings heavy burdens to the families and society.

In case of a drowning emergency, the drowning child should be removed from the water as soon as possible, call for help and dial emergency number "120"..
If a child is drowning in outdoor open waters like rivers and lakes, you should find someone with rescue ability to help, people who can’t swim should not enter the water for rescue.
Stick out branches, ropes, swimming rings or other floating objects to the drowning person at a safe place to help them float or pull them out of the water.
Children should know that when they find someone drowning, they should not enter the water impulsively, but call for help immediately.
After the drowning person is out of the water, do not try to drain water from his/her body. First, we should check the consciousness, spontaneous breathing and pulse of the person.
If the victim is conscious, breathing and has pulse, we can dry the body and wait for rescue.
If the victim is unconscious but has spontaneous breathing and pulse, we should clear the debris and sediment in his/her mouth and nose, and place him/her in a lateral position to prevent suffocation in case of vomiting. At the same time, dry the body and closely monitor breathing and pulse, and be ready to start cardiopulmonary resuscitation at any time.
If the victim is unconscious, and has no spontaneous breathing or pulse, the rescuer should immediately open the airway, clear the sediments in his/her mouth and nose, and start cardiopulmonary resuscitation.
NB: Most drowning victims may experience hypothermia, so we should remove their wet clothes, dry their body and keep them warm without affecting cardiopulmonary resuscitation.

2.Scalds
During the summer vacation, children normally wear light clothes, which makes it easier for them to be scalded by hot rice or boiled water.
Once a child is scalded, the caregiver should quickly remove the child from the heat source.
The caregiver should call the emergency number "120", then check the child's breathing and pulse. If necessary, start cardiopulmonary resuscitation as soon as possible. If the child is conscious, the 5-step treatment of "rinsing, removing, soaking, covering and sending" can be carried out.
Rinsing: After leaving the heat source, rinse the injured area immediately with tap water or clean water to cool down. Even if removed from the heat source, the temperature of the injured area is still high, and it needs to be cooled to reduce damage to deep tissues. Cold compresses with normal temperature water can be used to cool the parts that should not be rinsed.
Removing: After cooling down the injured area, the child’s clothes can be removed gently. If they are difficult to remove, scissors can be used. If clothes and skin stick together, do not pull them forcefully so as not to aggravate the damage to scalded skin, this can be treated after seeing a doctor.
Soaking: If the blister is not broken but the injured part is still painful, you can continue to soak it in cold water or compress it until the pain is relieved.
Covering: Cover the wound with gauze or clean cloth to avoid contamination.
Sending: Sufferers in serious cases should be sent to medical institutions as soon as possible.
NB: Don’t apply anything without therapeutic effect on the wound, such as soy sauce, vinegar, sesame oil, toothpaste or honey, so as not to affect the doctor's judgment of the wound or cause wound infection.
Don’t break the blisters by yourself. Try to keep the blistered skin complete, if the blisters are broken.

3.Poisoning and medicine misuse
Poisoning and medicine misuse is one of the most common unintentional injuries of children. In addition to children's accidental ingestion due to curiosity, it is not uncommon for children to suffer from acute poisoning due to their caregivers’ misreading of the medicine dosage or name.

In case of medicine misuse or overdose, the caregiver should be calm and figure out what medicine (poisons) the child has taken, how much he/she has taken and the time of taking them. Then the caregiver should take the child to a hospital, together with the remaining medicine, vomitus, medicine bottle and / or its packaging.

Let the child drink more water if he/she has ingested non-corrosive medicine, but it is not recommended to induce vomiting, especially for infants and children with unclear consciousness or convulsions. For children who are conscious, caregivers can make them drink more water and try to induce vomiting within 1-2 hours of taking the medicine. If the child takes corrosive substances (such as toilet cleaner) by mistake, the caregiver should get medical attention immediately instead of inducing vomiting.

The caregiver should take the child to a doctor immediately if the child has gastrointestinal symptoms such as nausea, vomiting, abdominal pain and diarrhea, respiratory symptoms such as wheezing and cough, or nervous system symptoms such as unconsciousness, sleepiness, irritability and convulsions after taking medicines or poisons by mistake.

NB: If adolescents take an overdose at their own will, the caregiver should not blame them, but provide counseling for them or seek the help of a psychologist.

4.Scratches and cutting injuries
Stop the bleeding and clean the injured area. You should press the bleeding part with clean cloth or bandages for at least 10 minutes to stop the bleeding. Don't check the wound repeatedly during the process. The contaminated wound can be rinsed with clean water first. If there are sand and other pollutants inside the wound, clean the wound with soapy water after rinsing, and then wash it with clean water again and apply Iodophor for disinfection. After the wound is dry, apply antibacterial ointment. Cover the wound with sterile gauze to prevent infection, but it needs to be replaced every day to ensure that the dressing is dry and clean.

If the wound is deep and causes damage to the whole layer of skin, go to the hospital for medical help as soon as possible. In addition to debridement and suture, doctors will also decide whether to inject tetanus vaccine and / or immunoglobulin according to the vaccination record and wound conditions of the surferer.

In the process of wound recovery, it is necessary to pay attention to any signs of infection. If the wound is red and swollen, purulent or stinks, it indicates infection and should be treated immediately. It’s normal for a wound to have only a small amount of transparent or yellow fluid. Most cuts and abrasions heal spontaneously in 7 to 10 days.

5.Sprained ankle and fracture
When a child suffers from sprained ankle, the caregiver should follow the "RICE" principle (rest, ice, compression, elevation).
Rest: don’t move randomly, especially don’t let the injured ankle bear weight.
Ice: For the first 24 - 48 hours after the sprain, wrap an ice bag with towel and apply it to the injured part for 15-minute periods every 1 - 2 hours.
Compression: Wrap an elastic compression bandage around the ankle to help reduce swelling and support the ankle. Avoid winding it too tightly, so as not to block the blood supply to the feet.
Elevation: Lift the injured ankle to a level higher than the position of the heart. For example, cushion the feet with pillows or blankets in the lying position, and place the injured foot on a table or chair in the sitting position to reduce swelling.

The most common symptoms of fracture are pain and swelling. The pain is significantly aggravated and may be accompanied by deformities, bruises and even skin rupture when the injured area is pressed.

Spinal fracture will damage the spinal cord, leading to loss of sensation and movement, urinary retention and even respiratory dyspnea.

NB: If you believe that the cervical spine or other part of the spine is injured, do not move the child, and wait for correct treatment. If the child has to be moved, an axial movement must be performed, that is, the head, neck, and torso should be considered as one unit, and the child should be moved without changing the position of them

6.Animal bites
Stop the bleeding: The caregiver should use clean towels or clothes to compress the wound and stop the bleeding.

Rinse: Clean the wound within 3 hours after being bitten will help reduce infection and the risk of rabies. It is recommended to wash the wound with a large amount of soapy water and flowing water alternately for 15 minutes. Disinfect the wound with Iodophor after washing, and then seek medical help as soon as possible. Larger and deeper wounds, especially head and face wounds, should be treated as soon as possible.

Whether the child needs to be injected with tetanus toxoid or tetanus immunoglobulin after animal bites should be determined by a doctor, according to the vaccination record and wound conditions.