When I was about 8 months pregnant with my first child, I was sitting in traffic one day and witnessed something that sent a shiver of cold dread through me. A tween-aged boy was skateboarding on the sloped carport roof of a nearby bank (yes, the roof!). I looked down at my swollen belly and pleaded with the little person inside to please, please, please be a girl. A few weeks later, in my child’s first act of defiance, he turned out to be, well, a he. A boy who, now four, wants a skateboard so badly it sends him into contortions of begging every time he sees someone gliding along on one…

Whether or not your kid is a kamikaze in the making, there are times as parents when we’re going to be called on to be the first responder to some childhood mishap. Below is a guide for some of the more common ouchies you’re likely to encounter. Of course, this list is no substitute for taking a good CPR and First Aid course, which you can find in your area by calling your local hospital or chapter of the Red Cross. (If you took one when your child was a baby, take a refresher!) The Red Cross has recently updated many of its CPR recommendations.

Allergic reactions

Mild allergic reactions (itchiness, mild redness, stuffy or runny nose, watery eyes, red bumps) can be treated at home with an oral antihistamine.

Severe allergic reactions (significant swelling, difficulty swallowing or speaking, wheezing or difficulty breathing, abdominal pain, nausea, vomiting, dizziness or fainting) require immediate emergency medical attention. If you have an injectable epinephrine (an “epi-pen”), use it immediately as directed and call for emergency help.

Broken bones

If you or your child heard a snap (yikes!), or a grinding noise during the injury, and the injured area is swollen, bruised, tender or painful, and can’t bear weight, it’s possible your child has broken a bone. To treat, remove clothing from the injured area, apply a cold compress or ice pack wrapped in cloth, and place a splint on the injured part. For those of you who don’t remember the basics of splint-making from your scouting days, here’s a primer:

• Keep the limb in the position that you found it
• Place soft padding around the injured area
• Place something firm (like a board or rolled up newspaper) next to the injured part, making sure it’s long enough to go past the joints above and below the injury
• Keep the splint in place with first-aid tape (you’ve got that on hand, right?)

Finally, seek medical care and do not allow your child to eat in case he needs surgery to re-set the bone.

Burns

First-degree burns, caused by brief contact with heat can be treated at home with multiple kisses to the forehead and the following:

• Remove clothing from the burned areas, unless clothing is stuck to the skin
• Run cool (not cold) water over the burn until pain lessens
• Lightly apply a gauze bandage if it’s a small, first-degree burn (no blisters).
• Do not apply butter or any other thick cream to the burn, as this will hold in the heat and might make the burn worse.

Once the burn has been cooled, you can apply a light antibiotic ointment if infection is a concern.

More serious burns need immediate medical attention.

Cuts

Minor cuts and scrapes should be washed with soap and warm water, then soaked in soapy water for 10 minutes to ensure they are cleaned. “Bandaids are so overused!” cautions Rebecca Chase, PNP, a pediatric nurse practitioner in Wilmington Massachusetts. A cut only needs a bandaid if bleeding hasn’t stopped after the soaking, or if you need to keep the area clean in a dirty environment. Otherwise, fresh air will help the cut heal much faster.

For cuts longer than one inch, or if the edges are widely separated, stitches might be needed. No matter how good of a quilter you are, let a professional take over here. Apply pressure just above the wound to stop the bleeding and seek medical attention.

Falls

Minor falls resulting in bumps and bruises can be treated at home with TLC, cold packs, and acetaminophen (Tylenol). Watch your child closely for the next 24 hours, and if you see any of the following unusual symptoms, call your doctor:

• Crying or irritability that can’t be comforted away
• Your child is excessively sleepy or difficult to awaken
• Vomiting more than two or three times
• Complains of increasing pain, or pain in the neck or back
• Doesn’t walk normally
• Doesn’t seem to focus eyes normally
• Any other behavioral symptoms that don’t seem “right”

If your child may have seriously injured his head, neck or back, do not move him! Call for emergency medical help immediately. Likewise, if your child lost consciousness, even briefly, call 911 right away.

Nosebleeds

I was always taught to tip my head backwards when my nose would gush, and I can still feel the icky sensation of blood on the back of my throat. What a surprise and relief to learn that the best treatment for a nosebleed is to tip the head forwards and pinch the soft part of the nose just below the bone for at least 10 minutes.

Seek medical attention if the nose does not stop bleeding after two tries with this method, or if the child is dizzy, or if the nosebleed is a result of a blow to the head.

Poisoning

Pick yourself up off the floor and call poison control immediately if you think your child may have ingested anything that could be toxic. The national poison control hotline is 1-800-222-1222.

Splinters

Splinters are rarely cause for the level of alarm they generate in the child. The best way to handle a splinter is to wash the area with soap and warm water, then soak the splinter in warm water for 15 – 20 minutes. It should slip right out of the waterlogged skin. If it doesn’t, leave it alone! Most splinters will work themselves out within 24 hours. There is no need to try to pry them out with tweezers or worse, in the case of my husband who flies into DaddyMD-mode at the first sign of a splinter, donning a head-mounted flashlight, and digging for the offending barb with a sterilized safety pin. Sound familiar? No wonder our kids fly into a panic!

The only time you need to seek medical attention for a splinter is if it starts to look infected: red, swollen, painful to touch.

Stings / Insect bites

If the stinger is still visible, remove it by gently scraping the skin horizontally with the edge of a credit card. Wash the area with soap and water and apply an ice pack to relieve pain and swelling. If the area is itchy, you can apply a paste of baking soda and water, or calamine lotion (following package directions).

If your child was stung anywhere in the mouth, or if you see symptoms of a severe allergic reaction, or infection, seek immediate medical care.

Sunburn

Place the child in a cool (not cold bath) or apply cool compresses several times a day. Do not apply creams or lotions that may hold heat inside the skin. Offer the child extra fluids for the next 2 or 3 days and give ibuprofen or acetaminophen as directed if needed for pain. Make sure all sunburned areas are fully covered when outside until they are healed.

If the sunburn is severe, with blisters, extreme redness, or is accompanied by other signs of dehydration (fever, headache, confusion, faintness, extreme thirst, dry eyes and mouth), seek medical attention.

Online First Aid Resources

For more information, check out the First Aid Fact Sheets at kidshealth.org, or take a first aid quiz at keepkidshealthy.com.

– Karen McMillen

Karen is a freelance writer and filmmaker in the Boston-area, that is when she’s not hovering over her son hoping that she will never have to deal with any of the above situations. Send her a note karen@themommytimes.com

NOTE: This article is for informational purposes only and is not intended to be a substitute for professional medical advice.