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Emergency Center

 Conditions We Treat

Minor Problem Vs. A True Emergency

Many minor injuries can be handled at home. However, there are times when a trip to the hospital emergency room is needed. In general, take your child to an emergency room after an injury anytime you think the problem may need immediate attention, including if your child has:

  • Trouble breathing or shortness of breath
  • Bloody sputum (coughing up blood) 
  • Blue or purple color to lips, skin, or nail beds
  • Chest or stomach pain or pressure
  • Severe or persistent vomiting or diarrhea 
  • Sudden dizziness, weakness, or change in vision
  • Change in mental status (such as loss of consciousness, confusion, or trouble waking)
  • Seizures
  • Animal, snake, or human bites
  • Severe pain or loss of motion or sensation anywhere in the body
  • Severe bleeding or bleeding that does not stop after 5-10 minutes of direct pressure
  • Severe burns or burns of the face, hands, feet or genitals
  • Broken bones
  • Puncture wounds
  • Head, spinal cord, or eye injuries
  • Signs of an allergic reaction such as hives, swelling of the face, lips, eyes, or tongue, fainting, or with trouble breathing, swallowing, vomiting or wheezing
  • High fever (105 or higher)
    • Most febrile (fever-related) illnesses can and should be managed by your child’s doctor, and do not need to be emergently evaluated in your hospital emergency department

This is a partial list. There are other problems that may require emergency care. Contact your child's doctor for more information.

First-Aid Kit

Everyone should have a well-stocked first-aid kit at home, in the car, and in the workplace. You may also want to stock a portable kit (a box or small bag) that can be taken to the site of an emergency.

It is important to check your kit regularly to restock items that have been used, and to replace items that are out-of-date.

The contents of the kit vary depending upon the number of people it is designed to protect, as well as its intent for use. Recommended contents of a first-aid kit include the following:

  • Bulb syringe
  • Scissors
  • Thermometer (oral)
  • Tweezers
  • Bulb syringe
  • Scissors
  • Thermometer (oral)
  • Tweezers
  • Acetaminophen
  • Antacid
  • Antibiotic ointment
  • Antidiarrheal medication (for adults)
  • Antihistamine
  • Aspirin (for adults)
  • Antiseptic ointment
  • Calamine lotion
  • Decongestant (for teens/adults)
  • Hydrocortisone cream
  • Ibuprofen
  • Sugar or glucose solution
  • Alcohol (rubbing 70 percent)
  • Alcohol wipes
  • Blanket
  • Candles
  • Chemical ice packs or ice bag
  • Chemical hot packs or hot water bottle
  • Cotton swabs
  • Disposable gloves (non-Latex if you or a loved one has a Latex allergy)
  • Face mask for cardiopulmonary resuscitation (CPR)
  • First-aid book
  • Flashlight
  • Insect repellent
  • Insect sting swabs
  • Matches
  • Measuring/Dosing device (i.e., syringe or dosing cup)
  • Paper and pencil
  • Paper cups
  • Soap
  • Safety pins
  • Sunscreen
  • Tissues
  • Tongue blades

You can also use the following everyday items in the event of an emergency:

  • Disposable or cloth diapers for compresses, bandages, or padding for splints
  • Dish towels for bandages or slings
  • Umbrella, rolled magazine, or layered newspaper for use as a splint

In addition, it is helpful to carry the following items in your car:

  • A large blanket
  • Gallon-size bottle of water
  • Flashlight and extra batteries

If your child or other family member has special medical needs, be sure to carry extra medical supplies when you go on an outing or trip. Some of these items might include the following:

  • An allergy kit containing medications to be used by people allergic to insect stings or certain foods
  • Prescription medications (make sure they're stored properly and aren't expired), syringes, and special equipment or supplies
  • List of your or your child’s medical and surgical diagnoses and procedures, medications (including concentration, dose, and frequency) and physician phone numbers/contact information

Be sure any member of your family who has special needs wears a Medic Alert bracelet or necklace at all times. Applications are available in most pharmacies.

Conditions

An abrasion is a superficial scratch or wearing off of the skin, usually caused by a scrape or a "brush burn." Abrasions are usually minor injuries that can be treated at home. The skin may bleed at the time of the injury or on occasion over the next few days if rubbed or scratched.

First-aid for abrasions:

  • Calm your child and let him or her know you can help.
  • Wash your hands well.
  • Wash the scraped area well with soap and water, but do not scrub the wound. Remove any dirt particles from the area and let the water from the faucet run over it for several minutes. A dirty abrasion that is not well cleaned can cause scarring or lead to infection.
  • Apply an antibacterial ointment or cream.
  • Cover the area with an adhesive bandage or gauze pad if the area is on the hands or feet, or if it is likely to drain onto clothing. Change the dressing often.
  • Check the area each day and keep it clean and dry.
  • Avoid blowing on the abrasion, as this can cause germs to grow.

When should I call my child's doctor?

Specific treatment for skin wounds will be determined by your child's doctor. In general, call your child's doctor for abrasions that:

  • Are located close to the eye or on the face.
  • Are embedded with debris, such as dirt, stones, or gravel.
  • Show signs of infection, such as increased warmth, redness, swelling, or drainage.
  • Cover a large area of the body, such as the chest, back, or an entire limb.

Accidental poisonings can sometimes be treated in the home following the direction of a poison control center or your child's doctor.  At other times, emergency medical care may be necessary.

Patients can be seen by Texas Children's experts in Emergency Center.

Swallowed Poison

If you find your child with an open or empty container of a toxic substance, your child may have been poisoned. Stay calm and act quickly:

  • Get the poison away from the child.
  • If the substance is still in the child's mouth, make him or her spit it out or remove it with your fingers (keep this along with any other evidence of what the child has swallowed).
  • Do not make the child vomit.
  • Call your child's doctor or poison control center immediately for instructions ; do not follow instructions on packaging regarding poisoning as these are often outdated.

If your child has any of the following symptoms, call 911 right away:

  • Sore throat
  • Trouble breathing, noisy breathing
  • Drowsiness, irritability, or jumpiness
  • Nausea, vomiting, or stomach pain without fever
  • Lip or mouth burns or blisters
  • Lip swelling
  • Unusual drooling
  • Strange odors on your child's breath
  • Unusual stains on your child's clothing
  • Seizures or unconsciousness

Take or send the poison container with your child to help the doctor determine what was swallowed. If your child does not have these symptoms, call your local poison control center at 800-222-1222 or your child's doctor. They will need the following information in order to help you:

  • Your name and phone number
  • Your child's name, age, and weight
  • Any medical conditions your child may have
  • Any medications your child may be taking
  • The name of the substance your child swallowed. Read it from the container and spell it
  • The time your child swallowed the poison (or when you found your child), and the amount you think was swallowed.
  • Any symptoms your child may be having
  • If the substance was a prescription medication, give all the information on the label including the name of the drug:
    • If the name of the drug is not on the label, give the name and phone number of the pharmacy, and the date of the prescription.
    • What the pill looked like (if you can tell) and if it had any printed numbers or letters on it.
    • If your child swallowed another substance, such as a part of a plant, describe it as much as you can to help identify it.

Poison on the skin

If your child spills a chemical on his or her body, remove any contaminated clothes and rinse the skin well with lukewarm--not hot--water. If the area shows signs of being burned or irritated, continue rinsing for at least 15 minutes, no matter how much your child may protest. Then, call the poison center for further instructions. Do not use ointments, butter, toothpaste or grease on the area.

Poison in the eye(s)

Flush your child's eye by holding the eyelid open and pouring a small, steady stream of lukewarm--not hot--water into the inner corner near the nose. Allow the water to run across the eye to the outside corner to flush the area well. You may need help from another adult to hold your child while you rinse the eye; or wrap your child tightly in a towel and hold your child under one arm. Continue flushing the eye for 15 minutes, and call the poison center for further instructions. Do not use an eyecup, eye drops, or ointment unless the poison center instructs you to do so.

Poisonous fumes or gases

In the home, poisonous fumes can be emitted from the following sources:

  • A car running in a closed garage
  • Leaky gas vents
  • Wood, coal, or kerosene stoves that are not working properly
  • Mixing bleach and ammonia together, which makes chloramine gas
  • Strong fumes from other cleaners and solvents

If your child breathes in fumes or gases, get him or her into fresh air right away:

  • If your child is breathing without problem, call the poison center for further instructions.
  • If your child is having difficulty breathing, call 911 or your local emergency service (EMS).
  • If your child has stopped breathing, start CPR and do not stop until your child breathes on his or her own or someone else can take over. If you can, have someone call 911 right away. If you are alone, perform CPR for one minute and then call 911.

A bruise is a collection of blood underneath the skin that is caused by trauma to an area of the body. The trauma causes tiny blood vessels, called capillaries, to break, and then blood leaks from the vessels into the surrounding tissue. Sometimes, enough bleeding occurs so that a lump also forms (this lump is called a hematoma).

First-aid for bruises

A bruise will usually heal on its own. Some general guidelines for treatment may include:

  • Calm your child and let him know that you can help.
  • A cold or ice pack for the first 24 hours after injury may help reduce swelling and discomfort. After one to two days, warm soaks or a warm bath may help the area feel better.
  • If the bruise or swelling is on the lips or in the mouth, offer your child an ice cube or ice pop to suck on.
  • Avoid putting more pressure on the bruised area or massaging it.
  • If the bruise involves a large area on an arm or leg, elevate the limb to help reduce swelling.

When should I call my child's doctor?

Specific treatment for bruises that require more than minor treatment at home will be determined by your child's doctor. In general, call your child's doctor if your child:

  • Bruises often or has recurring bruises without known trauma or cause
  • Has increased pain or swelling
  • Is unable to move a joint (such as the elbow, wrist, knee, or ankle)
  • May have broken a bone
  • Has injured or bruised an eye
  • Has injured or bruised the neck or is having difficulty breathing 

Children may get cuts and wounds to the face while playing, climbing, or during sports activities. Most of these injuries can be handled at home with simple first aid treatment.

First aid for superficial cuts and wounds:

  • Calm your child and let her know that you can help.
  • Wash your hands thoroughly with soap and water.
  • Apply pressure with a clean cloth or bandage for several minutes to stop the bleeding. Shield the eyes from any soap or antiseptics you may need to use on the wound.
  • Wash the injured area well with soap and water, but avoid scrubbing the wound vigorously. Remove any dirt particles from the area and let the water from the faucet run over it for several minutes. A dirty cut or scrape that is not thoroughly cleaned can lead to infection and scarring.
  • Pat excess water from the injured area and allow it to air dry. Do not scrub or dry vigorously as this may cause more bleeding.
  • Apply an antiseptic lotion or cream such as Neosporin™.
  • Cover the area with an adhesive bandage or gauze pad. Change the dressing daily, or more often if it becomes soiled.
  • Check the area each day and keep it clean and dry. If there is no risk of the injury becoming easily soiled, it does not need to be covered but can be left open to the air.
  • Bruises, blisters, or swollen areas caused by trauma may be treated by placing an ice or cold pack on the area every 1 to 2 hours for 10 to 15 minutes each time, for the first 24 hours. Do not put ice directly against the skin; instead, wrap the ice in a towel or sheet. 
  • Apply an emollient and sunscreen (sun protection factor, or SPF, of at least 15 or greater) daily on healed cuts and wounds to help prevent scarring.

When should I call my child's doctor?

Specific treatment for cuts and wounds of the face that require more than minor treatment at home will be determined by your child's doctor. In general, call your child's doctor for cuts and wounds of the face that are:

  • Still bleeding after 5 to 10 minutes of continuous, direct pressure. If the bleeding is profuse, hold pressure for 5 to 10 minutes without stopping to look at the cut. If the cloth becomes soaked with blood, put a new cloth on top of the old one; do not lift the original cloth. Keep in mind that facial and scalp injuries often bleed heavily, even under normal circumstances. Call the doctor if a wound or cut does not stop bleeding after 10 minutes or if bleeding recurs. 
  • On the eyelids or involve the eyes, nose or ear lobe.
  • Deep or longer than 1/2 inch.
  • Caused by a puncture wound, or a dirty or rusted object.
  • Embedded with debris or a foreign material, such as dirt, gravel, or glass.
  • Ragged or have separated edges.
  • Caused by an animal or human bite.
  • Associated with a broken or injured bone, or a head injury.
  • Showing signs of infection, such as increased warmth, redness, swelling, or drainage of pus.

Also call your child's doctor if:

  • Your child has not completed her childhood vaccinations, has not had a tetanus vaccination within the past 5 years, or if you are unsure about when your child's last tetanus shot was given.
  • You are concerned about the wound or have any questions.

Preventing facial injuries

The following are a few guidelines for preventing facial injuries in children:

  • Teach your child not to poke or place objects in the ears, nose, or mouth such as cotton swabs or pencils.
  • Teach your child not to walk or run while holding an object in his or her mouth.
  • Teach your child not to suck or chew on hard, sharp, or pointed objects.
  • Have your child wear appropriate protective eye, ear, or face guards for sports activities that could cause injury.

Children often get minor cuts, wounds, and lacerations to the mouth and lips while playing, climbing, or participating in sports activities. Most of these injuries can be handled at home with simple first-aid treatment. The gums, tongue, and lips have a rich blood supply, and when cuts occur, these areas may bleed excessively.

Patients can be seen by Texas Children's experts in Emergency Center.

First aid for superficial cuts and wounds

  • Calm your child and let him or her know you can help.
  • Apply pressure with a clean cloth or bandage for several minutes to stop bleeding.
  • Wash your hands well before examining your child.
  • If the wound is on the lips or OUTSIDE the mouth, wash it well with soap and water, but do not scrub the wound. Remove any dirt particles from the area and let the water from the faucet run over it for several minutes. A dirty cut or scrape that is not well cleaned can cause scarring:
    • Apply an antiseptic lotion or cream.
    • Give your child an ice pop or ice cube to suck on to help reduce bleeding and swelling.
    • Check the area each day and keep it clean and dry.
    • Avoid blowing on the wound, as this can cause germs to grow.
    • Use a sunscreen (sun protection factor, or SPF, at least 15 or greater) on healed cuts and wounds to help prevent scarring.
  • If the wound is inside the mouth, rinse the area well with cool water for several minutes. Remove any dirt particles from the area:
    • Give your child an ice pop or ice cube to suck on to help reduce bleeding and swelling.
    • Check the area each day and keep it clean.
    • REMEMBER: Cuts IN the mouth or on the tongue almost never need stitches.
  • Even small lacerations of the lips may cause a noticeable difference in the border or outline of the lips. These wounds may require stitches to keep the borders even and reduce the possibility of scars. Lacerations that occur in the corner of the mouth where the upper and lower lips come together have the potential for very severe bleeding. 
  • Bruises, blisters, or swelling on the lips caused by trauma may be treated by sucking on ice pops or ice cubes or by applying a cold pack to the area every one to two hours for 10 to 15 minutes for the first 24 hours.

When should I call my child's doctor?

Specific treatment for cuts and wounds of the mouth that require more than minor treatment at home will be determined by your child's doctor. In general, call your child's doctor for cuts and wounds of the mouth that are:

  • Bleeding and do not stop after five to10 minutes of direct pressure. If the bleeding is profuse, hold pressure for five to 10 minutes without stopping to look at the cut. If the cloth becomes soaked with blood, put a new cloth on top of the old one. Do not lift the original cloth. Keep in mind that facial wounds often bleed heavily, even under normal circumstances; call the doctor if a wound or cut does not stop bleeding after 10 minutes. 
  • Deep or longer than 1/2 inch
  • If the cut crosses the pink area of the lip and goes into the skin
  • Large cuts on the face
  • Caused by a puncture wound or dirty or rusty object
  • Embedded with debris, such as dirt, stones, or gravel
  • Ragged or have separated edges
  • Caused by an animal or human bite
  • Excessively painful or if you suspect a break in the bones of the face or jaw
  • Showing signs of infection, such as increased warmth, redness, swelling, or drainage

Also call your child's doctor if:

  • Your child has not had a tetanus vaccination within the past five years, or if you are unsure when your child's last tetanus shot was given.
  • You are concerned about the wound or have any questions.
  • Wounds on the face requiring stitches are best repaired in the first 12-24 hours. 

Preventing mouth injuries

The following are a few guidelines to use for preventing mouth injuries in children:

  • Teach your child never to walk or run while holding an object in his or her mouth.
  • Teach your child not to suck or chew on hard, sharp, or pointed objects, such as pencils.
  • Give your child wear a mouthguard for sports activities that could cause injury.

Children may get minor cuts, wounds, and lacerations to the outside part of the nose while playing, climbing, or participating in sports activities. Most of these injuries can be handled at home with simple first aid treatment.

Patients can be seen by Texas Children's experts in Emergency Center.

First aid for superficial cuts and wounds:

  • Calm your child and let him or her know you can help.
  • Apply pressure with a clean cloth or bandage for several minutes to stop bleeding.
  • Wash your hands thoroughly.
  • Wash the cut area well with soap and water, but do not scrub the wound. Remove any dirt particles from the area and let the water from the faucet run over it for several minutes. A dirty cut or scrape that is not thoroughly cleaned can cause scarring.
  • Apply an antiseptic lotion or cream.
  • Cover the area with an adhesive bandage or gauze pad. Change the dressing often.
  • Check the area each day and keep it clean and dry.
  • Avoid blowing on the abrasion, as this can cause germs to grow.
  • A direct blow or blunt trauma to the nose that causes bruising and swelling can be treated by applying a cold or ice pack to the area every one to two hours for 10 to 15 minutes for the first 24 hours. Do not put ice directly against the skin. 
  • A wound, bruise, or hematoma (a collection of blood and fluid underneath the skin) that also involves the eye(s) should be evaluated by a doctor immediately.
  • Use a sunscreen (sun protection factor, or SPF, of at least 15 or greater) on healed cuts and wounds to help prevent scarring.

When should I call my child's doctor?

Specific treatment for cuts and wounds of the nose that require more than minor treatment at home will be determined by your child's doctor. In general, call your child's doctor for cuts and wounds of the nose that are:

  • Bleeding and do not stop after five to 10 minutes of direct pressure. If the bleeding is profuse, hold pressure for five to 10 minutes without stopping to look at the cut. If the cloth becomes soaked with blood, put a new cloth on top of the old one. Do not lift the original cloth. Keep in mind that facial wounds often bleed heavily, even under normal circumstances; call the doctor if a wound or cut does not stop bleeding after 10 minutes or if it recurs. 
  • Deep or longer than 1/2 inch, or there is a gap in the skin with fatty tissue seen.
  • Caused by a puncture wound, or dirty or rusty object.
  • Embedded with debris, such as dirt, stones, or gravel.
  • Ragged or have separated edges.
  • Caused by an animal or human bite.
  • Excessively painful or if you suspect a fracture, or head or bone injury.
  • Showing signs of infection, such as increased warmth, redness, swelling, or drainage.

Also call your child's doctor if:

  • Your child has not had a tetanus vaccination within the past five years, or if you are unsure when your child's last tetanus shot was given.
  • You are concerned about the wound or have any questions.

Preventing nose injuries

The following are a few guidelines to use to help prevent nose injuries in children:

  • Teach your child not to poke or place objects in the nose, such as cotton swabs or pencils, and not to pick.
  • Teach your child to wear protective face guards for sports activities that could cause injury.

Unintentional falls hurt more children ages 14 and under than any other accidental injuries. Parents play a major role in preventing falls in children. The best way to prevent an injury is to watch, listen and stay near your child at all times. Never leave your child alone while he/she is on a high surface.

The majority of falls occur at home. Depending on the child's age, there are many common causes of fall-related injuries. How serious an injury is from a fall depends on the height of the fall and the landing surface. Most serious or fatal falls involve head injuries.

Children most often fall from:

  • Baby walkers - these are unsteady and should not be used. Babies using them can easily tip over, fall out of them or fall down the stairs.  Stationary walkers, or seats that rotate but do not have wheels are safe alternatives for infants and toddlers. Playpens are safe, enclosed areas that offer great safety zones for children as they learn to sit, crawl and stand.
  • Furniture - always keep one hand on your young child while on a high surface like a changing table, chair, bed or couch. High chairs should be equipped with a safety belt or strap and children should be secured and supervised at all times. Do not put toys or items that may interest small children on top of the furniture.
  • Playground equipment - teach children proper playground safety. Always supervise your child on the playground. Surfaces below the equipment should be soft enough to absorb the fall. Recommended surfaces include wood chips, mulch, sand, pea gravel, rubber, and mats.
  • Shopping carts - young children should be seated and securely seat-belted or strapped in the front part of the basket. They should never ride or stand in the area where items are in the cart.
  • Stairs - properly installed safety gaits are very important. Anchor safety gates to the wall at the bottom and top of stairs. Do not use accordion-style or tension gates on stairs as children can become trapped and strangled in these types of gates. Teach your child to use the handrails when walking up or down the stairs. Remove all clutter from stairs.
  • Windows - all windows above the first floor should have locks and operable window guards. Window screens are not strong enough to keep your child safe from falling out of a window. Window guards prevent the window from opening more than four inches. They can be removed in the case of a fire.
  • Bathtubs - place slip resistant mats or stickers on the bottom surface of the bath tub or shower to prevent slipping. Never leave your child unsupervised near water.
  • Shoes - teach your child to keep their shoe laces tied at all times. Children should always wear footwear that fits properly and is slip-resistant and supportive such as tennis shoes.

You can help prevent certain types of falls at home by taking the proper safety steps and always supervising young children.  

Patients can be seen by Texas Children's experts in Emergency Center.

Insects that sting, such as bees, wasps and fire ants, do not usually carry disease, but their stings can cause pain and irritation (most common) as well as death in individuals who are severely allergic to them (rare).

Yellow jackets cause the most allergic reactions in the U.S.

Fire ants, usually found in southern states, can sting multiple times, and the sites are more likely to become infected.

Symptoms

The following are the most common symptoms of insect stings. However, each child may experience symptoms differently.

Local skin reactions at the site or surrounding the sting can include pain, swelling, redness, itching, warmth, a small amount of bleeding or draining, and hives. 

Generalized symptoms that indicate a more serious and possibly life-threatening allergic reaction, including the following:

  • Coughing with shortness of breath or wheezing
  • Hoarseness
  • Tickling or tightness in the throat or chest
  • Abdominal cramps, nausea, vomiting or diarrhea
  • Dizziness or fainting
  • Swelling of the hands, feet, face, mouth, eyelids or ears, especially when it is far from the site of the sting

Treatment

Even large local reactions with the symptoms listed above are expected and usually do not lead to generalized reactions. However, they can be life-threatening if the sting occurs in the mouth, nose, or throat area; this is due to swelling that can block the airway.

Call 911 or your local emergency medical service and seek emergency care immediately if your child is stung in the mouth, nose, or throat area, or for any signs of a systemic or generalized reaction.

How to treat local skin reactions:

  • Calm your child and let him or her know that you can help.
  • Do not try to pull the stinger out, as this may release more venom. Instead, try toremove it by gently scraping across the site with a blunt-edged object, such as a credit card or dull knife
  • Wash the area thoroughly with soap and water.
  • Apply a cold or ice pack wrapped in a cloth to help reduce swelling and pain (10 minutes on and 10 minutes off for 30 to 60 minutes).
  • If the sting occurs on an arm or leg, elevate the limb to help reduce swelling.

To help reduce the itching and discomfort, consider the following:

  • Apply a paste of baking soda and water or a wet tea bag and leave it on for 15 to 20 minutes.
  • Use an over-the-counter product made to use on insect stings.
  • Apply an antihistamine cream, corticosteroid cream or calamine lotion.
  • Give acetaminophen for pain. Be sure to follow dosage instructions carefully for your child.
  • Give an over-the-counter antihistamine, if approved by your child's health care provider. Be sure to follow dosage instructions carefully for your child.

Observe your child closely for the next hour for any signs of a generalized reaction (see symptoms listed above) that would warrant emergency medical treatment.

Prevention of insect stings

Some general guidelines to help reduce the chance of insect stings while outdoors include:

  • Avoid perfumes, hairsprays, and other scented products.
  • Do not let your child walk or play outside barefoot.
  • Spray your child's clothing with insect repellent made for children.
  • Make sure your child avoids locations of hives, nests and ant mounds. Have them removed by professionals.
  • Teach your child that if an insect comes near to stay calm and to back away slowly.

Some additional preventive measures for children who have a known or suspected allergy to stings include the following:

  • Carry a bee sting kit (including an EpiPen) at all times and make sure your child knows how to use it. These products are available by prescription.
  • Make sure your child wears long-sleeve shirts, long pants and shoes when playing outdoors.
  • See an allergist for allergy testing and treatment.

Insects may fly or crawl into the ear and become trapped when a child is playing outdoors, or even indoors. Sometimes, the insect dies after entering the ear; other times, it may remain alive and attempts to work its way back out of the ear. In either case, the insect can cause fear and discomfort for a child and the insect should be removed immediately.

First-aid for insects in the ear:

  • First, try to calm your child and let him or her know you can help.
  • Do not attempt to remove the insect by poking it with a cotton swab or similar probe. This may push the insect further into the ear or cause damage to the middle ear or eardrum.
  • Tilt your child's head to the side and gently shake (do not hit) it.
  • If your child has tubes in his or her ears or has a history of ear problems call your child's medical provider immediately for further treatment recommendations.
  • If your child does not have tubes or ear problems and:
    • If you think the insect is still alive and it does not come out with gentle head shaking, pour a small amount of vegetable or baby oil into the ear canal. This will usually suffocate the insect.
    • If you think the insect is dead and it does not come out with gentle head shaking, pour a small amount of warm water into the ear canal to flush it out.

When should I call my child's medical provider?

Specific treatment for insects in the ear that require more than minor treatment at home will need to be determined by your child's medical provider. In general, call your child's medical provider:

  • To have the insect removed if it does not come out after shaking or irrigation. Insects are able to cause damage to the inside of the ear by stinging or scratching the eardrum.
  • If you are able to remove only parts or pieces of the insect.
  • If your child develops signs of infection, such as a fever or foul smell or drainage from the ear.

Osteomyelitis is an inflammatory reaction in a bone that is caused by an infection. This is a very serious infection that needs treatment immediately. Please go to your local emergency room if you suspect your child has such an infection.

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Patients can be seen by Texas Children's experts in Texas Children's Emergency Center and Texas Children's West Campus Emergency Center and Infectious Disease.

Causes & Risk Factors

Infection of the bone can happen:

  • When an infection in another part of the body has moved through the bloodstream to the bone (most common)
  • When the skin and bone are punctured by a contaminated object such as a nail
  • When a broken bone has penetrated the skin

Symptoms & Types

Symptoms may include:

  • Fever                                                   
  • Pain near the affected bone
  • Tenderness to touch
  • Swelling near the affected bone
  • Warmth over swollen area
  • Refusing to stand or walk using the involved leg or foot
  • Refusing to move the infected limb

Diagnosis & Tests

Tests may include:

  • Blood tests to identify the presence of infection and inflammation
  • X-rays of the affected area to locate the infection
  • Sometimes a bone scan or an MRI to evaluate the affected area better
  • A bone biopsy to identify the type of bone infection. A small piece of bone is sent to the lab for analysis. It usually takes a few days to get the results.

Treatment & Care

Orthopedic surgeons work hand-in-hand with infectious disease physicians to treat bone infections. Depending on the details of your child’s diagnosis, the doctors may choose one or both of the following methods to treat Osteomyelitis.

Surgery

Your doctor may decide to take your child to surgery to:

  • Get a culture or bone biopsy
  • Remove parts of the infected bone and cleanse the surrounding tissue and bone

Medication

Infection of the bone requires long term treatment with antibiotics.

Living & Managing

If you think that your child has a bone infection, please go to your local emergency room.

Publications

Jaramillo D, Delgado J, St. Geme JW, Dormans, JP. Hematogenous osteomyelitis in children: Imaging of a changing disease. Radiology. June 2017; 283(3):629-643.

A puncture wound is a deep wound made by a sharp object, such as a nail, a jagged piece of metal, or a piece of wood. Puncture wounds may be small in diameter and may not seem serious. They do, however, require treatment by a doctor.

Puncture wounds may become infected easily, because dirt and germs are carried deep into the tissues. Sometimes, an infection may be delayed, so it is very important to have your child see a doctor for any puncture wound.

Foot wounds that happen from punctures with objects found outside have a high risk of infection. Wounds that penetrate through a shoe can become contaminated with sock and shoe particles and also have a high risk of infection. Infections with bacteria that cause long-term bone infections can occur.

First aid for puncture wounds

  • Calm your child, and let him know you can help.
  • Apply pressure with a clean cloth or bandage for several minutes to stop bleeding. If the bleeding is profuse, hold pressure for 5-10 minutes without stopping to look at the cut. If the cloth becomes soaked with blood, put a new cloth on top of the old one. Do not lift the original cloth.
  • Once bleeding has stopped, wash your hands and then wash the wound with soap and water. Do not scrub the wound to avoid further tissue injury. Remove any dirt particles from the area, and rinse the wound under the water faucet for 5 minutes.
  • Cover the area with an adhesive bandage or gauze. Do not use tape or butterfly bandages to close the wound as this could trap harmful bacteria in the wound.  
  • Call your child's doctor. If bleeding is severe, call 911 or take your child to the emergency room for further care.

Treatment for puncture wounds

Once a doctor has seen your child, you will be given specific instructions on how to care for your child's wound. Treatment at home will be based on the location and size of the wound, type of treatment needed, and any special needs noted by the doctor. Antibiotics and a tetanus vaccine may be given to help prevent infection in the wound.

Some general guidelines for caring for a puncture wound include the following:

  • Keep the area clean and dry.
  • Carefully follow the doctor's instructions for wound care.
  • Make sure your child avoids any activity that may cause him to reinjure or open the wound.
  • Observe the wound for signs of infection, such as increased warmth, swelling, redness, drainage, or pain. Call your doctor if these signs develop or if a fever occurs.
  • Return for follow-up care as advised by your child's doctor.

Respiratory syncytial virus, or RSV, is a respiratory virus that infects the lungs and breathing passages. Most otherwise healthy people recover from RSV infection in 1 to 2 weeks. Infection can be severe in some people, however, and infants born prematurely are particularly at risk – although babies born full term also contract the virus and can have complications or need to be hospitalized.

RSV spreads rapidly among children during outbreaks and most children will have been infected with the virus sometime before 2 years of age.

Causes & Risk Factors

RSV passes from person to person in the same way a cold virus does. When someone with RSV coughs or sneezes, tiny drops travel through the air to other people nearby or they land on surfaces that others will touch. The virus then enters the body through the eyes or nose after touching RSV germs.

Children born prematurely (less than 32 weeks), those who are immunocompromised or with chronic lung disease and/or significant congenital heart disease stand a greater chance of developing progressive complications from RSV.

Families can protect babies from RSV by keeping young babies at home as much possible. Encouraging family members to wash their hands carefully to prevent infecting themselves as well as the children is also advised. 

Symptoms & Types

RSV usually starts with cold-like symptoms. Problems develop when it spreads to children’s lower airways, attacking the linings of small airways connecting the bigger airways delivering oxygen to the lungs. This can lead to labored breathing and, sometimes, less color in a child’s cheeks. Infants and children infected with RSV usually show symptoms within 4 to 6 days of infection.

If you think your child has RSV but is eating and breathing normally, call your pediatrician or visit an urgent care clinic. But if breathing is becoming difficult for your child, seek more immediate care at an emergency center. 

Diagnosis & Tests

It is not always necessary to check for RSV. But, if your pediatrician deems it necessary, he/she can check for RSV with a nasal swab, the same swab used to test for the flu in most offices.

Treatment & Care

Most children will recover in 1 to 2 weeks. However, even after recovery, infants and children can continue to spread the virus for 1 to 3 weeks. Some children, with severe cases, may require an emergency room visit and rarely hospitalization.

Related Blog Topics

Small cuts and scrapes are often viewed as part of childhood and growing up. The skin opening may bleed or drain a small amount of fluid but most cuts and scrapes are minor injuries that can be treated at home.

Patients can be seen by Texas Children's experts in Emergency Center.

First aid for cuts and scrapes:

  • Calm your child and let him know that you can help.
  • Wash your hands thoroughly with soap and water.
  • Apply pressure with a clean cloth or bandage for several minutes to stop the bleeding.Wash the injured area well with soap and water, but avoid scrubbing the wound vigorously. Remove any dirt particles from the area and let the water from the faucet run over it for several minutes. A dirty cut or scrape that is not thoroughly cleaned can lead to infection and scarring.
  • Pat excess water from the injured area and allow it to dry. Do not scrub or dry vigorously as this may cause more bleeding.
  • Apply an antiseptic lotion or cream such as Neosporin™.
  • Cover the injured area with an adhesive bandage or gauze pad if it is located somewhere likely to be soiled, like on the hands or feet, or if it is likely to drain onto clothing. Change the dressing daily or more often if it becomes soiled.
  • Check the area each day and keep it clean and dry.
  • Once it is healed, apply an emollient and sunscreen (sun protection factor, or SPF of at least 15 or greater) daily to help prevent scarring.

When should I call my child's doctor?

Specific treatment for cuts and scrapes that require more than minor treatment at home will be determined by your child's doctor. In general, call your child's doctor for cuts and scrapes that are:

  • Bleeding heavily and do not stop bleeding after 5 to 10 minutes of continuous, direct pressure. If the bleeding is profuse, hold pressure for 5 to 10 minutes without stopping to look at the cut. If the cloth becomes soaked with blood, put a new cloth on top of the old one. Do not lift the original cloth.
  • Deep or longer than 1/2 inch.
  • Located close to the eye.
  • Large and on the face or scalp.
  • Caused by a puncture wound, or a dirty or rusted object.
  • Embedded with debris or a foreign material, such as dirt, gravel, or glass.
  • Ragged or with separated edges.
  • Caused by an animal or human bite.
  • Suspicious for an associated broken or injured bone or a head injury.
  • Showing signs of infection, such as increased warmth, redness, swelling, or drainage of pus.

Also call your child's doctor if:

  • Your child has not completed his childhood vaccinations, has not had a tetanus vaccination within the past 5 years, or if you are unsure when your child's last tetanus shot was given.
  • You are concerned about the wound or have any questions.

A splinter is a sharp sliver of wood, glass, or other debris that is lodged underneath the skin. Removal of small, superficial splinters can usually be done at home.

Patients can be seen by Texas Children's experts in Emergency Center.

First-aid for splinters

  • Calm you child and let him or her know that you can help.
  • Wash your hands.
  • Clean the area around the splinter with soap and water.
  • Use a sterilized needle or tweezers.
  • If part of the splinter is sticking out of the skin, gently try to pull the splinter out using the sterilized tweezers.
  • If the splinter is close to the surface but underneath the skin, gently prick the skin over the splinter with the needle and try to pull it out using the tweezers.
  • If the splinter is deeply embedded or you are unable to remove it after one or two attempts, call your child's health care provider.
  • Observe the area for signs of infection such as increased warmth, swelling, redness, drainage, or pain. If you notice any signs of infection, call your child's health care provider. Antibiotics may be needed.
  • If the splinters are very small, painless and superficial, you can leave them alone. Eventually they will make their way out of the skin.

When your child is bitten or scratched by an animal, remain calm and reassure your child that you can help. Specific treatment for an animal bite will be determined by your child's doctor. Treatment may include:

  • For superficial bites from a familiar household pet that is immunized and in good health:
    • Wash the wound with soap and water under pressure from a water faucet for at least 5 minutes, but do not scrub the wound to avoid further tissue injury. Apply a topical antiseptic lotion or cream.
  • For deeper bites, puncture wounds from any animal, or any bite from a strange animal:
    • If the bite or scratch is bleeding, apply pressure to it with a clean bandage or towel to stop the bleeding.
    • Wash the wound with soap and water under pressure from a water faucet for at least 5 minutes, but do not scrub the wound to avoid further tissue injury.
    • Dry the wound, and cover it with a sterile dressing. Do not use tape or butterfly bandages to close the wound as this could trap harmful bacteria in the wound.
    • Call your child's doctor or health care provider for help in reporting the attack and to decide if additional treatment, such as antibiotics, a tetanus booster, or rabies vaccination, is needed. This is especially important for bites on the face or for bites that cause deeper puncture wounds of the skin.
    • If possible, locate the animal that inflicted the wound. Some animals need to be captured, confined, and observed for rabies. Do not try to capture the animal yourself; instead, contact the nearest animal warden or animal control office in your area.
    • If the animal cannot be found, the animal is a high-risk species (raccoon, skunk, or bat), or the animal attack was unprovoked, your child may need a series of rabies shots.

Call your child's doctor or health care provider if there are signs of infection such as increased redness, pain, swelling, or drainage from the wound.

Call your child's doctor or health care provider for any flu-like symptoms, such as fever, headache, decreased energy, decreased appetite, or swollen glands following an animal bite.

Patients can be seen by Texas Children's experts in Emergency Center.

 

Human bites are usually caused by one person biting another or may result from a situation in which one person comes in contact with other person's teeth. Symptoms of human bites may range from mild to severe. Human bites that break the skin, like all puncture wounds, have a high risk of becoming infected. Just like dog and cat bites, human bites can easily become infected due to the number of bacterial in the human mouth. They also pose a risk of injury to underlying tendons and joints. It is important that a medical provider evaluate any human bite that breaks the skin.

Patients can be seen by Texas Children's experts in Emergency Center.

What is the treatment for human bites?

Remain calm and reassure your child that you can help. Specific treatment for a human bite will be determined by your child's medical provider. Treatment may include:

  • If the bite is actively bleeding, apply direct pressure to it with a clean bandage, dry cloth or towel to stop the bleeding.
  • If the area is NOT bleeding severely, wash the wound with mild soap and running water from a faucet for at least five minutes. Do not scrub the wound as this may bruise the skin and underlying tissue.
  • Dry the wound and cover it with a sterile dressing. Do not use tape or butterfly bandages to close the wound, as this could trap harmful bacteria in the wound.
  • Human bites are often treated with oral and/or topical antibiotics to prevent or treat infection.
  • It is important to discuss with your medical provider whether or not a tetanus booster is needed.
  • Call your child's medical provider to find out if additional treatment is necessary.

Prevention

Teach young children not to bite others. Never put your hand near or in the mouth of someone who is having a seizure.