Thursday 9 August 2018

What to do when a child falls from height?



Before the concept of contraception or family planning came into action, people used to reproduce carelessly. The only population control mechanism was epidemics of small pox or cholera or natural calamities or hazards.  Married females were pregnant every alternate year.  A single support less mother surrounded by toddlers and one infant at the breast was the picture.  They never paid individual attention to each child. Those children grew up in the community playing, falling, and taking care of each other. And survival of the fittest was the rule.
But today times have changed. Mothers have decided on having only one or two children. So they are precious.  A small simple abrasion also panics her. And when the apple of their eye falls from height to sustain even a mild trauma to the head, her heart bleeds endlessly until the memory of the incident fades from her mind. Guilt creeps all over her for not being around her dearest piece of heart. She remembers the incident in her subconscious mind always to recount it whenever she finds anything unusual about her child’s behaviour.
So to calm the panic stricken mother, some information and knowledge about what to do and when to rush to the hospital, might help
What happens when a child falls from height?
Apart from injuries to limbs, most concerning one is the injury to head.  If a child sustains a head injury, following consequences occur-
1.      Crying – Don’t panic immediately as the child starts crying, allow the child to be active and to cry for some time.
2.      Swelling – look for the severity of the swelling.  Apply ice pack to the swollen area until it seems to decrease or for 20 to 30 minutes. Check if the swelling seems to decrease or increase. If it increases even after applying ice then take the child to the hospital/emergency without any delay.
3.      A laceration over swelling- Clean the wound of any dirt with running water. Pat dry, apply Betadine ointment and give pressure bandage. If the wound is big or if the bleeding is too profuse that it starts seeping the bandage, then rush to the emergency immediately.
Immediate signs of danger-
In case any of the following occurs either immediately after fall or anytime within 24 hours, then rush to the hospital without any delay.
1)      Vomiting
2)      Loss of consciousness
3)      Ear bleed
4)      Nasal bleed
5)      Seizures
If the child is having seizures, immediately turn the child on to left side and try to control the seizures by holding the limbs. They usually stop within seconds to a minute or in 2 minutes. Rush to emergency as fast as possible.
Not to miss symptoms within 24 hours of fall
1)      Fever – use a thermometer to check the temperature
2)      Neck rigidity- Try to move the child’s head on to the chest such that the chin of the child touches the chest with the mouth being closed.  If there is any difficulty, restriction or pain in doing this, then schedule an appointment with your pediatrician as soon as possible.
3)      Decrease in vision
4)      Decrease in hearing
5)      Decrease in movement or tone of any of the four limbs
6)      Any visible milestone regression
What will happen at the emergency or the hospital?
As soon as you reach the emergency, the emergency physician will examine the child thoroughly and send the child for a CT scan. You may be asked to make the child fall asleep or the doctor may prescribe a mild sedative for making the child fall asleep for a few minutes. If the CT scan appears normal, then you will be discharged with warning signs and some pain relieving medication. In case there is any abnormality in the scan, the child will be kept under observation for some time, and a neurosurgery opinion will be sought for. Further the prognosis will be explained to you by the treating doctor.
Prevention is always better than cure.
Safety precautions that can be taken
1)      For babies, use a stable strong and stout cot with railings to sleep in, when you are not around or else lay their bed on the floor itself with pillows surrounding the baby.
2)      Always be vigilant when toddlers are playing around in the park with other kids.
3)      Do not allow the kids to play on terrace or streets.
4)      When the child starts crawling or walking, adequately baby proof your house.
We all know about these safety measures and try our best to follow all of them, but mishaps still occur. Be little liberal to yourself. Guilt will creep in but we have to learn to forgive ourselves with time. And not letting the child to play with the fear of such mishaps is also not justified. It is their childhood and it will take its course as per their destiny. We have to accept that certain incidents are not under human control.

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