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Family health

First aid tips

How to detect and treat common summer ailments

By Cathryn Tobin, MD. Author of "The Parent's Problem Solver"
First aid tips

Poison Ivy
What it looks like: Red, irritated skin with oozing blisters. Typically blisters appear in patches or form a straight line where the poison ivy brushed up against your child’s body.

Immediate action: Wash the area with dishwashing soap. What causes the itchy rash is urushiol, a colourless, odourless oil found in the sap of poison ivy, oak or sumac plants. It’s sticky stuff and could remain on clothes, so make sure you wash them before wearing again.

Ongoing care: A blistering rash will appear hours after urushiol has touched the skin. The oozing blisters do not contain the allergenic substance, so won’t cause further spreading. However, because urushiol can get trapped under the nails, scratching may expose new areas of skin to the oil. Left alone, poison ivy will usually disappear between 10 and 14 days.

In a mild case of poison ivy, cold compresses may give sufficient relief. An antihistamine (e.g. children’s Benadryl) and an over-the-counter topical cortisone (e.g. Cortate) will also help ease the discomfort. Aveeno Oatmeal Bath or calamine will help dry up oozing blisters.

Complications: A physician should assess your child if: the itching is severe; the rash covers more than 30 percent of her body; or it’s on her face. In these cases, oral corticosteroids available by prescription may be necessary.

Bee, wasp and hornet stings
What it looks like: A red, swollen area.

Immediate action: If a stinger is left in the skin, it should be removed quickly. This is best done by gently scraping it out with a blunt-edged object, such as a credit card. Apply ice to reduce pain and swelling.

Ongoing care: Keep the area clean with soap and water. An analgesic (e.g. Tylenol) may be used for pain, an antihistamine (e.g. Benadryl) for itchiness and swelling, and a cortisone cream for added relief. These medications are compatible, so you can treat any or all symptoms as needed.

Complications:
1. If a serious allergic reaction occurs, it will usually begin within minutes of a sting. If a child becomes pale, agitated or flushed, and has difficulty breathing, she should be taken by ambulance to the emergency room.
2. Hives is a skin reaction characterized by pale, raised areas surrounded by redness. They can be minor or severe. Children who develop hives following a bee sting should seek medical care.

Athlete’s foot
What it looks like: Looks and feels different from one person to the next. Some kids have red and itchy feet, while others may experience dry, peeling or cracked skin. There may be cracks or blisters between the toes. Although anyone can suffer from athlete’s foot, among kids it’s most common in preteen and teenage boys.

Immediate action: Generally easy to treat with over-the-counter antifungal creams.

Ongoing care: Fungal infections of the skin love dark, moist environments. Kids should avoid wearing sneakers for extended periods. For a child who experiences repeated bouts, send him to day camp with an extra pair of socks, or have him wear sandals as much as possible.

Complications: Some kids are prone to repeated outbreaks of athlete’s foot. If the infection or itchiness doesn’t settle within a few days of treatment, see your physician, as many rashes look just like athlete’s foot. In children under 10, check with your doctor to confirm the diagnosis, as athlete’s foot is rare in young children.
Mosquito bites
What it looks like: Red, itchy bumps.

Immediate action: As soon as you notice a bite, wash the area with soap and water. Calamine lotion will soothe itchiness, and an ice pack will reduce swelling. Discourage itching as best you can, as it leads to more itchiness and swelling. A topical hydrocortisone (e.g. Cortate) will relieve itchiness and may be used along with Benadryl. One trick — try rolling a liquid or solid antiperspirant over bites. If they’re still itchy, repeat after five minutes.

Ongoing care: The best way to prevent further mosquito bites is to wear an insect repellent. DEET is effective because it confuses the mosquito’s chemical receptors. Children under 12 should use only 10 0EET or less.

Complications: Because a bite breaks the skin, bacteria can enter and lead to infection. A significant area of swelling and redness, especially if pain is present, warrants a trip to the doctor’s office. If your child develops flu-like symptoms (fever, headache, muscle aches or swollen glands), see your physician, as West Nile virus, though rare, may need to be ruled out.

Slivers
What it looks like: A sliver of foreign material (wood, glass, metal) imbedded in the skin.

Immediate action: If there are fine splinters on the surface of the skin, pat the area with packing tape and the splinters will adhere to the tape. For deeper splinters, remove with tweezers. Clean tweezers with an alcohol wipe before using.

Ongoing care: Keep the area clean with soap and water.

Complications: A physician should be consulted if the entire splinter can’t be removed, or there are signs of infection, redness or pain.

Sunburn
What it looks like: Painful reddened skin that may involve swelling and blisters.

Immediate action: Young kids burn faster than adults because their skin has greater water content. If your child has a burn, she should be taken out of the sun and given fluids. She’ll feel more comfortable if she remains in a cool room or a tepid bath. After the bath, apply a fragrance-free moisturizer to the burn to replenish moisture in the area. An anti-inflammatory (e.g. Advil) will alleviate discomfort and swelling. A topical hydrocortisone (e.g. Cortate) will also provide some relief.

Ongoing care: The burn area may peel and feel itchy, especially to kids with naturally fair skin. This area may be more sensitive to burning. Avoid pain-relief sprays or ointments, as these can irritate the skin.

Complications: If your child is under one and has a burn, you need to take him to the doctor. Plus, medical attention is needed for any burn that blisters, puckers, causes significant pain, or if a large area of the skin is burned, or a fever or chills are present.

Minor cuts and scrapes
What it looks like: Superficial abrasions to the skin.

Immediate action: Wash the area thoroughly with soap and water. Dry the abrasion and apply an antibiotic ointment (e.g. Polysporin). Cover loosely with a bandage.

CPR update
When finding an unconscious infant or child in water, check for signs of breathing, circulation, pulse, coughing or movement. If there are none, begin CPR.

For children aged 1 to 8
Place the child on his back on a firm, flat surface. Open the airway by tilting his head back, lifting his chin and checking for signs of breathing for no more than 10 seconds. Check for signs of circulation. If he’s not breathing, pinch his nose and make a tight seal around his mouth. Breathe 2 slow breaths; they should last 2 seconds. Pause between breaths. You should see his chest rise.

Check for circulation by placing two fingers on his neck. Look for movement and coughing. Check for 10 seconds. If there are still no signs of effective breathing, or circulation, perform CPR. Kneel over his chest, and place a hand on his forehead (to maintain the head-tilt position) and your other hand on the lower half of his sternum. Find the sternum by tucking your hand under his far armpit and sliding it over to his breastbone. With your elbows locked, press straight down to deliver compressions.

Each compression should push his sternum down 2.5 to 3.8 cm (1 to 1½ in.) and should proceed at a rate of about 100 per minute. Give 5 compres-sions (lasting 3 seconds) followed by 1 breath; repeat 4 times, then check for circulation. Continue CPR if no signs of circulation are present.

If signs of circulation are present: Check for breathing and continue rescue breathing if necessary. If he’s breathing, treat for potential shock by rolling him onto his side and keep him warm by covering him with a blanket, towel or clothing.

For infants under 1
Place the baby on her back on a firm surface. Open the airway by tilting her head back, lifting her chin and checking for signs of breathing for 10 seconds. If she’s not breathing, make a tight seal around her mouth and nose. Give 2 gentle puffs slowly, twice into the lungs. Breaths should last 2 seconds; pause between breaths. You should see her chest rise.

Check for baby’s pulse by raising her arm above her head and placing 1 or 2 of your fingers on the underside of her arm halfway between her elbow and shoulder. If there are still no signs of a pulse or circulation, perform CPR. Kneel over her chest and place 1 hand on her forehead to maintain the head-tilt position and use 2 fingers on the lower half of her sternum — about a finger’s 440 below an imaginary line drawn across the nipples — to apply compressions.

Each compression should push her sternum down 1.3 to 2.5 cm (½ to 1 in.) and should proceed at a rate of about 100 per minute. Give 5 compressions (lasting 3 seconds) followed by 1 breath, and repeat for about a minute, then check for circulation. Continue CPR if no signs of circulation are present.

If signs of circulation are present: Check for breathing and continue rescue breathing if necessary. If she’s breathing, treat for potential shock by rolling her onto her side with some support, and keep her warm by covering her with a blanket, towel or clothing.

This article was originally published on Jun 03, 2005

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