Family Health Guide

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First Aid: Cuts, Scrapes and Wounds

If the wound is deep or bleeding profusely, take your child to the ER. Otherwise, here's how to treat all of the other countless cuts and scrapes that are a routine part of childhood:

Clean the area with water Set the temperature for whatever's comfortable for your child and remove any debris. Then flush the wound with more running water for at least 90 seconds -- not the 10 to 15 seconds most of us do -- to wash away bacteria. It's the pressure that's most important for zapping germs, but if there's no tap, use baby wipes or bottled water until you can get to a bathroom.

Wash gently with soap and water In a pinch, dishwashing liquid or baby-friendly liquid soaps will work.

Pat it dry with a clean cloth You could also use a clean diaper or paper towels. If the wound is still bleeding, apply pressure to the area for five minutes. You'll be tempted, but don't peek! Releasing it before the blood has had time to clot may make the cut bleed faster. If it's still bleeding, reapply pressure for another five minutes. (If the blood flow hasn't slowed after ten minutes, get medical help.)

Don't disinfect with rubbing alcohol, hydrogen peroxide, or iodine All three can sting or burn, and they're just not needed. Plus, alcohol dries the skin (which can slow healing) and hydrogen peroxide inhibits the growth of healthy cells. Soap and water are enough.

Apply an antibiotic cream Choose one that contains bacitracin for speedier healing (check the label) and put it on as soon as the cut is clean; reapply one to three times daily and each time you change the bandage.

Face facts A very small cut on the face will often heal easily and well, but the doctor should examine a larger one or anything close to the eye. You may also want to consider seeing a plastic surgeon for facial lacerations that may require stitches.

Don't allow a wound to air That just creates a scab, slowing the skin from healing and increasing the chances of infection and scarring. And, let's face it, kids tend to pick at scabs, making them dirty and opening them up. Exposure to the sun can also cause a scar to remain red longer and damage new skin cells during the healing process. The seal that a bandage provides -- allowing some oxygen to get in while keeping the area moist -- is the best environment for regenerating new skin. Keep the boo-boo covered until it's healed.

Check the wound daily A see-through, plastic bandage makes it easier to do this without having to put on a new one. Change the bandage only when it gets wet, dirty, or worn-out looking. If it's a cut on a foot or knee that keeps opening up, try a liquid bandage product  --  it works just like a regular one.

Ask about a tetanus shot Especially if it's a puncture wound (often caused by stepping on a sharp object, like a nail), which a child is more likely to get on his foot. This kind of cut makes it easier for tetanus, bacteria that can cause a debilitating disease, to get into the bloodstream. Kids 4 and under who've received all four shots of the combined diphtheria, tetanus, and acellular pertussis (DTaP) vaccine are protected. But if your child is over 4 years old and hasn't had the DTaP booster (between ages 4 and 6), or is 10 or older, his immunity could be waning. Check with his doctor to see whether his vaccination should be updated.