Published on July 05, 2016

When 'boo-boos' occur: What every parent should have in their medicine cabinet

Even when parents are taking precautions against heat and proper measures to prevent sunburns, kids are bound to end up with injuries and illnesses over the summer. Having the right items in the medicine cabinet could save you an unnecessary trip to the emergency room.

Even when parents are taking precautions against heat and proper measures to prevent sunburns, kids are bound to end up with injuries and illnesses over the summer. Having the right items in the medicine cabinet could save you an unnecessary trip to the emergency room.

By Mackenzie Clark, Lawrence Journal World reporter

Tuesday, June 21, 2016

Even when parents are taking precautions against heat and proper measures to prevent sunburns, kids are bound to end up with injuries and illnesses over the summer.

John Drees, safety educator and registered nurse with Lawrence Memorial Hospital said whether it’s falls at the pool, scrapes from playing around the dock at the lake or bee stings, those “boo-boos” are going to increase along with summer activity.

John Drees, RN, Safety Educator John Drees, RN 

“Being outside, we tend to engage more with the physical environment, and there's more possibility for injury,” he said.Lawrence Memorial Hospital, said whether it’s falls at the pool, scrapes from playing around the dock at the lake or bee stings, those “boo-boos” are going to increase along with summer activity.

Drees and Dr. Lee Norman, family practitioner by trade and chief medical officer at Kansas University Hospital, offered some practical tips for parents: what supplies to have where, and when to seek help.

What you need, and where

Parents will likely need different supplies on hand whether they’re at home or on-the-go — they’re not all interchangeable.

In the home:

Firstly, Norman said a thermometer is key — newer ones that read the temperature from the temporal artery in the forehead work well. If someone gets sick, one of the first things a medical professional will ask is whether they have a fever.

“I'm just amazed when I talk to parents, for example, how many times they don't have a thermometer,” he said.

Secondly, he said if a kid does have a fever and isn’t dehydrated, he would usually recommend lowering the fever with Tylenol — and he suggested keeping a dosage chart in the medicine cabinet along with a device to measure the right dose depending on the size of the child.

“Believe it or not we see people come to the emergency department because it may be a fever, they don’t know, and they don’t have any Tylenol at home,” he said. He also said multisymptom cold medications are “kind of handy.”

Next, he recommends a cream to take care of simple skin rashes, such as a hydrocortisone cream, and diaper rash cream for babies. He also suggests a topical antibiotic, such as Neosporin or bacitracin, to put on any skin injuries that could become infected.

Norman said the little blue suction bulbs come in handy for babies, as well.

“Sometimes babies get colds and they get fussy. Their nasal passages are blocked up,” he said. “It's easy to put a drop of saline in their nose and just suck the gunk out of their nose with a nasal aspirator.”

He also suggests keeping a pair of tweezers handy, particularly for splinters. A squirt bottle of eyewash can also be helpful in case of a splash of chemicals or anything getting in the eyes.

Drees and Norman agree pre-packaged first-aid kits — Drees cites Johnson & Johnson as one company that packages them — can be very helpful. Simple things such as wound dressings, antibiotic ointment, gauze pads, tape and bandages are good to have at home.

Along the same lines, Norman said, tongue depressors can be taped up and used as splints if a kiddo jams a finger.

Finally, even if kids won’t eat their vegetables, they could still help their health — Norman said a bag of frozen corn or peas will work as a makeshift ice pack. There are also gel ice packs available in stores. It’s best to get something that will bend to contour the area of a bump or bruise that’s starting to swell, Norman said, and to wrap those in a dish towel and alternate holding them on and off the wound for 20 minutes at a time.

All of the items listed here are available over the counter, Norman said.

In the car:

Drees said he was an EMT as a teenager, and in his experience the best first-aid items to keep with you in the car at all times are a couple of towels and a couple of Ziplock bags.

Most of the items in pre-prepared first-aid kits, such as antiseptic cream and bandages, won’t last through the extreme heat and cold that our cars are exposed to, Drees said. That means you won’t actually have what you need when you need it.

For minor injuries, he said he’s pretty comfortable with waiting it out — but towels don’t expire. There’s a reason emergency rooms keep 40-plus towels at the head of every bed, and their utilitarian value shouldn’t be underestimated.

“If it takes awhile to go get some Band-Aids that's not a problem,” he said. “But if you need a big towel for a tourniquet, or to stop major bleeding, or a big problem, you've got to have that on hand.”

For road trips, or circumstances in which the climate of the car will be fairly controlled, first aid kits are fine. They just shouldn’t be left there for extended periods of time.

Out and about:

In the great outdoors, some other items may be necessary. Norman said parents who are taking their kids backpacking or “out in the boonies” may want to have a more built-out first-aid kit in terms of bandages and splints, medical tape and so on.

It’s also good to be able to identify plants such as poison ivy and poison oak. Drees said that information is readily available on the internet, and people’s reactions to encountering it can vary greatly. He said some people may end up needing to go to the doctor, while others may not react at all.

Norman said if someone knows they’ve been exposed to it, they should take off their clothing and launder it immediately when they get home. The oily resin from the leaves can spread from person to person. A hot, soapy shower should eliminate it from the body, and a hydrocortisone cream for the skin and oral antihistamine should help with any itchy allergic reaction.

If it gets much worse, though, Norman said to seek medical help.

“By the time we see some poison ivy that has gotten fairly widespread, blistered and crusting and oozing, that's not just a routine poison ivy anymore; that's probably got a staph superinfection on it and needs something more effective,” he said. “Or if they get it into their eyes; that’s a worrisome thing.”

Norman also said people should “aggressively sunscreen their kids,” using a cream and not a spray sunscreen. He also recommends insect repellant.

“Even before Zika virus appeared on the scene, insect repellant has always made sense,” he said. “There's lots of different kinds out there and they're all safe in kids as long as they're used accordingly.”

When boo-boos occur

Severity is in the eye of the beholder, Norman said.

Some injuries may need urgent care or a visit to the emergency room, but parents will have to make that determination. Here are some common ones:

• Cuts and scrapes: Generally it’s best to clean a cut or wound with warm, soapy water. Norman also suggested putting a kid in a bathtub of warm, soapy water to let the wound soak, and gently brushing it with a washcloth.

"A warm, moist washrag on it actually feels kind of good and cleans it at the same time, and you can get the kid's confidence when you do that,” Norman said.

A cut may need stitches if you can see down into it, or if you can see any other kinds of tissues in the wound, Norman said. Squirting of blood is also a pretty sure bet. Drees said you may also consider stitches if the cut is on part of the body that will move a lot and could be repeatedly opened

“If in doubt, you're probably going to fall on the side of going ahead and at least checking with your personal physician, or if you don't have that ability, going to the emergency room or urgent care, whatever it might be, but you may need to get that wound closed,” Drees said.

If a cut may need stitches, it’s best to go as soon as possible, particularly if it’s on the face, Norman said.

• Burns: First, get the burning substance off, Norman said. Run it under cold water right away to drop the temperature back to normal.

“No, you don't need to put butter on them. No, you don't need to put ice on them,” he said. “A cool compress works very well, and then if it's one that doesn't need to be seen by a doctor, then just put some antibacterial ointment on it, and just a loose gauze dressing over the top.”

He said with burns, doctors will look at the degree. A reddish burn with no blisters, such as a sunburn, is a first-degree burn; second-degree burns start to blister and will probably need to be seen by a medical provider.

Third-degree burns are “obviously charred, bad looking things and need to be seen right away. Those are emergency conditions,” Norman said.

• Stings and ticks: For most people, bee and wasp stings aren’t a huge deal, Norman said. He suggests using a toothpick to flick off the stinger if it’s left in the skin, rather than trying to pinch it with tweezers or your fingers because there could still be a venom sac in it.

Once the stinger is gone, put some ice on the site and wash it well. Ice will slow the spread of the venom, Norman said, and once again, hydrocortisone cream can come to the rescue. Benadryl can also help with itching, he said.

A very small percentage of people have allergic reactions to stings and their airways may start to close up. In this case, call for an ambulance immediately.

Ticks can be infected with several different kinds of viruses that they then pass along to their human hosts. Norman says to use needle-nose tweezers right at the skin and remove the tip. Don’t forget to wash your hands.

“I don’t like pinching the tick’s body because it’s more likely to squeeze the tick, and if it still has its proboscis into the skin, whatever is in the tick’s body as you pinch it will inject into your skin,” he said.

In a few days, if a person develops symptoms such as fever and aches, see a doctor right away because it could be a sign of a virus, but if treated rapidly, doxycyline could prevent serious illness.

• Bumps and bruises: Not a whole lot can be done, but an ice pack, as mentioned above, can help. Broken bones, on the other hand, are a different story.

Obvious fractures or bony deformities probably need to be seen by a doctor right away, Norman said.

“If you're not sure (if a bone is broken), then you probably need to seek medical attention, and a lot of times the physician or practitioner won't know either and will have to use an X-ray,” Drees said.

Clunks on the head can be cause for concern, as well. Norman said some signs of concussions are changing levels of consciousness, sleepiness, lack of alertness and changing behavior.

“The main thing is just to keep a close eye on the person,” he said, possibly even waking them up a couple of times throughout the night. “... We don't expect parents to be able to do sophisticated neurological exams, therefore the main thing you do is check and make sure they don't have changing levels of consciousness.”

If you do suspect a concussion, Norman said to seek medical care immediately.

Prevention and preparation

Drees said prevention is the most important piece of parents’ knowledge of first aid. Take advantage of this time when kids are young to instill lifelong good habits, such as always wearing helmets while riding a bike.

“When (kids are) out there experiencing life there is going to be injury,” he said. “What we're trying to do is minimize injuries so that it's minor and not life-changing. That's really the point of some of these prevention items.”

It’s still important to be prepared. First-aid classes are available through LMH, through the Red Cross, many fire departments, and even some online resources, such as the American Heart Association.

When disaster strikes, taking three deep breaths can help calm your nerves, Drees said. Also, knowledge gained in first-aid classes can help you react without responding to emotions of a situation — someone crying, screaming or bleeding can throw you off emotionally, he said.

“Everybody is different, every human being is different, so you don't know how you're going to react,” Drees said.

When 'boo-boos' occur: What every parent should have in their medicine cabinet

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