• Posted November 21, 2024

Kids' Injuries in Sports and at Home: When Is It Right to Seek Medical Attention?

A sprain on the soccer field. A tumble to the floor at home.

Kids get injured, but as a parent, when's the right time to bring them to a doctor or ER?

Pediatric sports medicine and orthopedic physician Dr. Bianca Edison, of Children's Hospital Los Angeles, offers up guidance for worried moms and dads.

First of all, she said, don't assume that childhood injuries are seldom severe: Edison pointed to U.S. Centers for Disease Control and Prevention statistics, showing that nearly half (45%) of playground injuries involve fractures, dislocations, concussions and other harms serious enough to need urgent medical attention.

She broke down child injuries into four types: head injuries, mouth/tooth injuries, fractures and eye injuries.

Head injuries

A knock to the noggin isn't an uncommon event for rambunctious kids. But certain symptoms may signal that more than a hug is needed to help your child.

“They include severe crankiness above and beyond what the child normally displays, multiple vomiting episodes, slurred speech, different pupil sizes and a sudden change in the way the child walks,” according to Edison. “These symptoms are of significant concern and need immediate medical attention.”

There are certain metrics that can also help, especially when it comes to head injuries linked to falls. If the child is less than 2 years old and falls more than 3 feet, or is over age 2 and falls more than 5 feet, a trip to the emergency room is in order, the Los Angeles physician said.

Certainly, if you feel any dent or depression on your's child's head, take them to immediate medical care, Edison added. That could point to a skull fracture.

Any bruising in or around the eyes is another red flag, as is blood draining from the nose or ears.

Once you're at the hospital, a CT scan may be required if any of these symptoms or events are involved:

• Loss of consciousness

• Agitation

• Extreme sleepiness or significantly slowed response

• Severe, worsening headache

• A car crash that ejected the child from the vehicle, or a bicycle accident in which the child was not wearing a helmet

• Multiple vomiting episodes or any seizure-type activity

“These symptoms or situations indicate or may produce increased pressure in the brain, swelling of the brain or actual bleeding in the brain,” Edison explained.

Eye injuries

There are clear warning signs that emergency care is needed whenever a child's eye is injured:

• nosebleeds that happen alongside a black eye or bleeding within the whites of the eye

• head injuries that result in black eyes

• a fracture or depression in the orbital bones surrounding the eye

• sudden and/or persistent vision issues, including double vision, blurriness or difficulty moving the eyes

“Ask the child to follow your finger,” Edison instructed. “If one eye follows it and the other eye stays straight, or if there’s pain with the movement of one of the eyes, there may be more significant trauma to the injured eye, or there might be an infection brewing within it.”

Injuries to the mouth or teeth

Very young children who are still mastering walking can sometime tumble and damage the mouth or teeth.

If that means a child loses a primary ("baby") tooth, that's typically not an emergency, Edison said, although having the child see a dentist over the next 24 hours is warranted.

For older children, however, any injury to a permanent tooth is a dental emergency, she said. If the child loses a tooth, be sure to retrieve it, wash it with saline or warm water, being sure to hold the tooth by its crown, not its root.

After the tooth is properly rinsed, you can actually re-implant it yourself, making sure you have correctly positioned in your child's mouth, Edison said. Hold the tooth in place with a moist napkin or paper towel.

“You should do this within five to 20 minutes of the tooth falling out so the roots of the tooth don’t  die,” she added. An adult should always hold the tooth in place with a moist napkin or paper towel.

Don't let your child do this themselves, because they may not hold the tooth still, or the tooth could loosen away from the jaw and pose a choking hazard.

If re-implanting the tooth is tough, or there are multiple missing teeth, seek out emergency dental care.

“All missing teeth should be accounted for,” Edison said, “and follow up with your child’s dentist to ensure there’s not an underlying injury.”

Fractures

Skateboarding, football, climbing trees: Kids find many different way to fracture a bone.

But the most common cause of fractures is a simple tumble from a bed, changing table or sofa by a baby or toddler, Edison noted.

“All it takes is the right angle and the right force to the bone for a fracture to occur,” she said. For infants and toddlers, the most common fracture sites are the elbow, wrist, collar bone, lower leg and finger.

Fractures typically show key characteristics, such as immediate swelling at the site of the injury, deformity and reluctance by your child to use the injured body part. They might keep the fractured arm close to their body, for example, or "favor" a leg or foot and not put weight on it.

Any fracture requires a doctor's immediate attention.

Look for one of these "5 Ps," each of which warrant taking a child to the ER:

• Pain (extreme discomfort and sensitivity)

• Pallor (unhealthy pale appearance to the skin)

• Pulse (weak or not detectable)

• Parasthesia (numbness or tingling)

• Paralysis (inability to move the injured body part)

Make sure your child is taken to a facility with scanning technologies such as X-rays.

Knowing the above tips can help moms and dads react quickly and effectively when injuries occur.

“Kids are active and curious and injuries will occur, no matter how many safety precautions are put in place,” Edison said in a hospital news release. “That’s why it’s important to know what to do when something happens.”

SOURCE: Children's Hospital Los Angeles, news release, Nov. 4, 2024