Children and Falls

Dr. Elias Jimenez F

Very frequently children have all kinds of accidents, falls being the most frequent.Every year around 25,000 children victim of an accident arrive to the Children's Hospital in Costa Rica. Out of these, 60% are victim of some sort of fall. The vast majority of the accidents occur at home, and sometimes they are so serious that the child has to be taken to the Hospital.In fact, every day the Hospital receives some 35 children who have been victim of a fall. Most of them are allowed to go back home, but at least one has to remain hospitalized due to the severity of the trauma.Falling down and getting up all the time is due to the child's playful nature. But it is necessary to know some rules that will guide us in what to do and how to prevent certain accidents.When to call a doctor? When the child falls it is necessary to take in consideration certain aspects. For example when there's a wound, with no doubt it deserves to be washed with soap and water and in certain occasions a suture is necessary. In such cases the most disturbing part is the bleeding. To stop the bleeding, it is recommended to apply pressure on the wound with a clean handkerchief or towel. We should never apply a strange ointment or medication on the wound since this action may favor infections or cause greater damage to the skin.We must observe if there is movement or function limitations after the fall, since it may be and indication of a fracture or sprain. If there is swelling or inability to perform certain movements, a doctor should be called.Other signs and symptoms that justify close observation (and probably the need of special tests) are: blood in the urine or lees, pain in the abdomen, accentuated and persistent paleness.Another important point, especially if the blow is on the head, is the child's level of consciousness. A child can remain "stunned" for a few minutes after the blow, but he must recover rapidly. If there is loss of consciousness, mental confusion, headache, vomit, any limb weakness, or any other neurological manifestation, the child must be taken to the doctor immediately.How to prevent falls? Even though it is difficult to prevent falls, there are some necessary precautions we must take in order to avoid the most serious ones. Let's keep in mind that small children don't know how to go down the stairs, and with an appropriate barrier we will be able to avoid a serious accident. We have to get rid of any obstacle that may favor a fall. Examples of them are boards with sharp edges or rugs with bent corners. If we can't get rid of them, we should keep the child from going into the areas where they are located. Also a small child shouldn't be left alone in a bed, he might turn and fall when least expected.

Let's remember that children don't measure dangerous situations, prudence is something that they will have to learn and our obligation is to take the necessary steps in order to avoid accidents.