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June 17, 2010

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What are the different kinds of casts?

A cast, which keeps a bone from moving so it can heal, is essentially a big bandage that has two layers — a soft cotton layer that rests against the skin and a hard outer layer that prevents the broken bone from moving.

These days, casts are made of either:

  • plaster of paris: a heavy white powder that forms a thick paste that hardens quickly when mixed with water. Plaster of paris casts are heavier than fiberglass casts and don’t hold up as well in water.
  • synthetic (fiberglass) material: made out of fiberglass, a kind of moldable plastic, these casts come in many bright colors and are lighter and cooler. The covering (fiberglass) on synthetic casts is water-resistant, but the padding underneath is not. You can, however, get a waterproof liner. The doctor putting on your child’s cast will decide whether a fiberglass cast with a waterproof lining is appropriate.

How is a cast put on?

First, several layers of soft cotton are wrapped around the injured area. Next, the plaster or fiberglass outer layer is soaked in water. The doctor wraps the plaster or fiberglass around the soft first layer. The outer layer is wet but will dry to a hard, protective covering. Doctors sometimes make tiny cuts in the sides of a cast to allow room for swelling.

Can plaster of paris casts get wet?

Absolutely not! A wet cast may not hold the bone in place because the cast could start to dissolve in the water and could irritate the skin underneath it, possibly leading to infection. So your child shouldn’t swim and should use a plastic bag or special sleeve (available online or sometimes at pharmacies) to protect the cast from water. And instead of a shower, your child may need to take a sponge bath.

Can synthetic (fiberglass) casts get wet?

Although the fiberglass itself is waterproof, the padding inside a fiberglass cast is not. So it’s still important to try to keep a fiberglass cast from getting wet. If this is a problem, talk to the doctor about getting a waterproof liner. Fiberglass casts with waterproof liners let kids continue bathing or even go swimming during the healing process. Although the liner allows for evaporation of water and sweat, it’s still fragile. Also, only certain types of breaks can be treated with this type of cast. Your doctor will determine if the fracture may be safely treated with a waterproof cast.

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The common fall is more dangerous than it may seem. While the majority leave behind no more than a few bumps, bruises, or scratches others can be the injury behind a concussion, broken bone, seizure and other unpleasant situations.

When a person falls, the first thing to do is make sure there are no serious and obvious injuries- no broken bones, heavy bleeding, seizures, and that the person is conscious. If the fall was ‘bad’ do not allow them to move until you are sure no injuries have been done to their head, neck, back, or hips.

If there seems to be a serious injury, like any of the ones listed above and more, call 911 for aid. Also call if you see any of these signs

Unconsciousness- even if it is very brief (concussion)

Becomes very sleepy or is difficult to wake up (concussion)

Walking in an abnormal fashion- off balance, dizzy (concussion)

Difficulty breathing

No breathing -begin CPR

Clear fluid or bleeding coming from nose, ears or mouth.

Complains of intense or increasing pain

Vomiting

Deep or large wounds

Trouble focusing eyesight, distorted vision. (concussion)

Odd behavior or symptoms

Irritable and oddly moody, nonstop crying.

If the fall does not seem to be an emergency, but the child is young, keep watch over them closely for the next 24 or so hours, to make certain that no symptoms of injury or strange behavior develop. If you fear a concussion, due to a fall involving the head, even if there are no symptoms always go see a doctor.

Prevention

Preventing falls, especially with young children is tough, but it there are ways to minimize risks. With very young children or infants, always trap them securely into strollers, car seats, high chairs, and onto changing tables. Discourage children from playing on furniture or jumping on beds. Active children should be taught to wear helmets and other safety pads when biking, skating, skiing, and climbing.

*** Before administering any first aid to anyone outside your family, be aware of your rights and responsibilities: The Good Samaritan Law. ***

June 16, 2010

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Seizures

A seizure is a sudden “episode” caused by an electrical problem in the brain. With a seizure, a person has change in awareness, body movements, or sensation

Signs & Symptoms

There are many types of seizures. Common types are:

  • A Generalized Tonic Clonic Seizure. This is also called a grand mal seizure. A convulsion occurs with this type. Signs of a convulsion include:
  • Brief loss of consciousness. Falling down.
  • The arms and legs stiffen, jerk, and twitch.
  • This type usually lasts 1 to 2 minutes. When it ends, the person’s muscles relax. He or she may lose bladder control, be confused, have a headache, and fall asleep. This is the type most people think of with the word “seizure”.
  • An Absence Seizure. This is also called a petit mal seizure. A convulsion does not occur with this type. Signs of an absence seizure include:
  • Blank stares. It looks like the person is daydreaming or not paying attention.
  • Lip smacking. Repeated blinking, chewing or hand movements.
  • This type of seizure usually lasts only a few seconds, but can occur many times a day. When the seizure ends, the person is not confused, but is not aware that the seizure occurred.
  • Absence seizures are common in children and can result in learning problems.
  • A Fever (Febrile) Seizure. This type is brought on by a high fever in infants and small children. High fevers cause most seizures in children aged 6 months to 5 years. Signs are ones of a convulsion listed in the left column. Most febrile seizures last 1 to 2 minutes, but can last longer. Seeing a child have a febrile seizure causes alarm. In general, these seizures are harmless.
  • Causes

    Causes include epilepsy (a brain disorder), infections that cause a high fever, heat stroke, and electric shock. Head injury, stroke, and toxic substances can also cause a seizure. Sometimes the cause of a seizure is not known.

    Treatment

    Seizure disorders are treated with medication. Other medical treatments may be needed.

    June 13, 2010

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    Nosebleeds Overview

    Nosebleeds can be dramatic and frightening. Fortunately, most nosebleeds are not serious and usually can be managed at home, although sometimes medical intervention may be necessary. Nosebleeds (epistaxis) are categorized based on where they originate, and are described as either anterior (originating from the front of the nose) or posterior (originating from the back of the nose).

    • Anterior nosebleeds make up more than 90% of all nosebleeds. The bleeding usually originates from a blood vessel on the nasal septum. Anterior nosebleeds are usually easy to control, either by measures that can be performed at home or by a doctor.
    • Posterior nosebleeds are much less common than anterior nosebleeds. They tend to occur more often in elderly people. The bleeding usually originates from an artery in the back part of the nose. These nosebleeds are more complicated and usually require admission to the hospital and management by an otolaryngologist (an ear, nose, and throat specialist).

    One out of every seven people will develop a nosebleed at some time in their lives. Nosebleeds tend to occur more often during winter months and in dry, cold climates. They can occur at any age, but are most common in children aged 2-10 years and adults aged 50-80 years. For unknown reasons, nosebleeds most commonly occur in the morning hours.

    June 12, 2010

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    What is the best way to care for a cut or scrape?

    The first step in the care of cuts and scrapes is to stop the bleeding. Most wounds respond to gentle direct pressure with a clean cloth or bandage. Hold the pressure continuously for approximately 10-20 minutes. If this fails to stop the bleeding or if bleeding is rapid you should seek medical assistance.

    The next step is to thoroughly clean the wound with soap and water. Remove any foreign material, such as dirt or bits of grass, that might be in the wound and which can lead to infection. You may use tweezers (clean them with alcohol first) to remove foreign material from the wound edges, but do not dig into the wound as this may push bacteria deeper into the wound. You may also gently scrub the wound with a washcloth to remove dirt and debris. Hydrogen peroxide and providone-iodine (Betadine) products may be used to clean the wound initially, but may inhibit wound healing if used long-term.

    Cover the area with a bandage (such as gauze or a Band-Aid) to help prevent infection and dirt from getting in the wound. A first aid antibiotic ointment such as Bacitracin or Neosporin can be applied to help prevent infection and keep the wound moist.

    Continued care to the wound is also important. Three times a day, wash the area gently with soap and water, apply an antibiotic ointment and cover with a bandage. Also, change the bandage immediately if it gets dirty or wet.

    June 11, 2010

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    Need-to-Know Numbers

    During an emergency, it’s easy to become disoriented and upset, so you need to have all important phone numbers readily available ahead of time.

    Write each phone number clearly so that it will be easy for kids to read. Use a pen with dark-colored ink or type it on the computer because pencil or light-colored ink can be harder to read when you’re in a hurry or if lights are dim. If you choose to create your own phone list, make sure it includes these numbers:

    • emergency medical services: In most places this is 911, but your community may have its own number — check your telephone book if you’re unsure.
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    • poison control center: 1-800-567-8911. This toll-free number will put you in touch with the poison control center in your area.
    • hospital emergency room
    • fire department
    • police department
    • your child’s doctor
    • parents’ work
    • parents’ cell phone and/or pager
    • neighbors and/or relatives

    Your list should also include known allergies (especially to any medication), medical conditions, and insurance information for all members of the family.

    Because accidents can happen in any part of the home, make copies of the completed list and post one near every telephone in the house. Be sure to carry one with you, and keep one in the car as well. In addition, make sure that people who come to the house to watch your children (babysitters or relatives, for example) familiarize themselves with the list.

    June 10, 2010

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    Severe cuts and burns can cause your body to go into physiological shock. Fluid loss causes the body to reduce blood flow to the extremities in order to protect vital organ systems. Basically, your body starts shutting down – untreated shock can kill you.

    Symptoms of shock

    • restlessness/irritability
    • altered consciousness (dizziness, feeling faint, nausea)
    • pale, clammy, moist skin
    • rapid breathing
    • rapid pulse

    Treating shock

    • Call 911. Shock is a serious condition requiring immediate medical treatment. It can kill.
    • Have the victim lie down
    • Control external bleeding
    • Keep victim comfortable to reduce the stress on body systems
    • Help maintain body temperature; if victim seems cold, cover him/her with a blanket
    • Reassure victim
    • Unless head, neck, or back injuries or broken bones are suspected, elevate victim’s legs about 12 inches
    • Don’t raise victim’s head
    • Give victim no food or drink, even though s/he is likely to be thirsty

    June 9, 2010

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    Minor Burns and Scalds

    Minor burns and scalds are usually the result of domestic accidents.  Prompt first aid will generally enable them to heal naturally and well, but the advice of a medical practitioner should be sought if there is doubt as to the severity of the injury.

    Treatment of Minor Burns and Scalds

    DO NOT use adhesive dressings.

    DO NOT break blisters, or interfere with the injured area.

    DO NOT apply lotions, ointments, creams, or fats to the injured area.

    • Cool the injured part with copious amounts of cold water for about 10 minutes to stop the burning and relieve the pain.  If water is unavailable, any cold, harmless liquid such as milk or canned drinks will suffice.
    • Gently remove any jewellery, watches, or constricting clothing from the injured area before it starts to swell.
    • Cover the injury with a sterile dressing, or any clean, non-fluffy material to protect from infection.  A clean plastic bag or kitchen film may be used.

    June 8, 2010

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    Near-drowning is when a person is in danger of drowning. Each year, almost 8,000 people die from drowning. Seventy percent of all near-drowning victims recover; 25% die, and 5% have brain damage.

    A toddler can drown in as little as 2 inches of water in a bathtub, sink, etc. Toilet bowls are unsafe, too, if a small child falls into one head-first.

    Signs & Symptoms

  • A person is in the water with signs of distress. He or she can’t stay above water, swims unevenly, signals for help, etc.
  • Blue lips or ears. The skin is cold and pale.
  • Bloated abdomen. Vomiting. Choking.
  • Confusion. Lethargy.
  • The person does not respond or can’t breathe.
  • Causes

  • Not being able to swim. Being in water too deep and too rough for one’s ability to swim.
  • Water sport and other accidents. Not following water safety rules. Not wearing a life preserver, etc. Unsupervised swimming.
  • Falling through ice while fishing, skating, etc.
  • Injury or problems that occur while swimming, boating, etc. Examples are leg or stomach cramps, fatigue, and alcohol or drug use. A heart attack, stroke, seizure, and a marine animal bite or sting may have occurred.
  • Treatment

    Immediate medical care is needed for near-drowning.

    June 7, 2010

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    Under normal conditions, we all lose some body water every day in our sweat, tears, urine, and stool. Water also evaporates from our skin and leaves the body as vapor when we breathe. We usually replace this body fluid and the salts it contains with the water and salts in our regular diet.

    Sometimes, however, kids lose abnormally large amounts of water and salts through fever (more water evaporates from the body when body temperature is increased), diarrheavomiting, or long periods of exercise with excessive sweating. Some illnesses might also prevent them from taking fluids by mouth. If they’re unable to adequately replace the fluid that’s been lost, kids can become dehydrated.

    Recognizing Dehydration

    If your child has fever, diarrhea, or vomiting, or is sweating a lot on a hot day or during intense physical activity, you should watch for signs of dehydration, which can include:

    • dry or sticky mouth
    • few or no tears when crying
    • eyes that look sunken into the head
    • soft spot (fontanelle) on top of baby’s head that looks sunken
    • lack of urine or wet diapers for 6 to 8 hours in an infant (or only a very small amount of dark yellow urine)
    • lack of urine for 12 hours in an older child (or only a very small amount of dark yellow urine)
    • dry, cool skin
    • lethargy or irritability
    • fatigue or dizziness in an older child

    Preventing Dehydration

    The best way to prevent dehydration is to make sure kids get plenty of fluids when they’re sick or physically active — they should consume more fluids than they lose (from vomiting, diarrhea, or sweating).

    How you keep a child adequately hydrated can depend on the circumstances. For example, a child with a sore throat may become dehydrated due to difficulty drinking or eating. Easing the pain with acetaminophen or ibuprofen may help, while cold drinks or popsicles can soothe a burning throat while also supplying fluids.

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