Pediatric Injuries

While there are many different acute and chronic conditions that may affect your child and require medical attention, this section addresses those that we see most frequently in our emergency room and on an inpatient basis. Please remember that this information is not meant to replace that provided by your health care professional, but has been written as a general guide to help you make more informed decisions about your child's health care.

As many parents can attest, illness and injuries can happen any time including after hours, on weekends, and holidays. When your child becomes sick or injured, you've got to quickly decide where to take them. You can take comfort knowing you have access to a dedicated pediatric emergency department at Bryn Mawr Hospital, so close to home. Our pediatric Emergency Department (ED) team has advanced training and certification to care for children with the following injuries and illness:

Burns

Burns are often categorized as first-, second-, or third-degree, depending on how badly the skin is damaged. Each of the injuries above can cause any of these three types of burns. The type of burn and its cause will determine how the burn is treated.

All burns should be treated quickly to reduce the temperature of the burned area and reduce damage to the skin and underlying tissue (if the burn is severe).

Choking or drowning

A child's airways can be blocked by food, toys, buttons, insects and crayons and other objects in the ear, nose or airway. A child can suffocate when the airway is blocked. Children may also swallow water and choke, or drown in pools and lakes.

Fractures

Falls, sporting activities, bicycle accidents or similar activities that result in a break in a bone. If the broken bone punctures the skin and sticks out, it is called an open or compound fracture. Most fractures in children occur in the wrist, the forearm, and above the elbow. Symptoms include:

• Out-of-place or misshapen limb or joint
• Swelling, bruising or bleeding
• Intense pain
• Numbness and tingling
• Limited mobility or inability to move a limb

You need to get medical care right away for any fracture.

Deep cuts and scrapes

Deep, smooth or jagged breaks or openings in the skin caused by sharp objects such as a knife, shard of glass or razor blade, bleed a lot and quickly and when deep, may damage tendons, ligaments and muscles.

If your child has been in a body crushing accident, call 911.

Puncture wounds

Wounds that have an entry hole made by a pointed object such as a nail, knife, or sharp tooth from an animal or human bit require different treatment from cuts because these holes can disguise serious injury, and can result in a skin infection or other complications such as a bone or joint infection. They should be treated within the first 24 hours because they carry the danger of embedding the piercing object under the skin, along with dirt and debris.

Poisoning

Accidental or experimental ingestion of medications, alcohol, cleaning products, cosmetics, pesticides, fertilizers, paints, solvents and even plants or exposure to carbon monoxide from auto exhaust, indoor charcoal grills, faulty fireplaces and chimneys, faulty gas water heaters, gas appliances and heaters should be treated immediately at the emergency room.

Head trauma and concussion

Concussions are a mild injury to the brain that temporarily disrupts how the brain normally works. They are often caused by falls and accidents, with a sudden blow or jolt to the head. Signs and symptoms of a concussion include:

• Dizziness
• Headache
• Vomiting
• Confusion
• Acting dazed
• Forgetting about what just happened before or after the injury
• Being “knocked out” or losing consciousness

Do not try to judge the seriousness of the injury yourself and call 911 for immediate medical attention, especially if a headache gets worse, your child is confused, has trouble walking or talking, there is numbness or tingling in the arms or legs, shows uncontrollable shaking or any other sudden change in thinking or behavior.

Intracranial hemorrhage

Bleeding that occurs inside the skull accounts for approximately 10 percent of strokes, including pediatric strokes. Intracranial hemorrhages are caused by:

• Head trauma from a fall, car accident, sports accident
• Hypertension damage to blood vessels that cause a leak or break
• Blockage of an artery in the brain by a blood clot
• Blood vessel wall—aneurysm—ruptured
• Buildup of protein within the artery walls of the brain
• Leaking of malformed arteries or veins
• Treatment with blood thinners
• Tumors that are bleeding

Hemorrhagic stroke

Bleeding that is caused by a blood vessel in the brain that has leaked or ruptured is called a hemorrhagic stroke. Hemorrhagic stroke generally happens suddenly and can cause brain damage and be life-threatening. When the blood pools in or around the brain, it is deprived of oxygen. When deprived of oxygen for more than three or four minutes, the brain cells die as well as damage the nerve cells and related functions they control. This prevents nerve cells from communicating with the parts of the body and the functions they control, resulting in a loss of movement in the affected area, difficulty swallowing, vision loss, inability to speak or understand words, confusion and memory loss, personality change.

The immediate symptoms include:

• Sudden tingling, weakness, numbness, or paralysis of the face, arm or leg, particularly on one side of the body
• Sudden, severe headache
• Difficulty with swallowing or vision
• Loss of balance or coordination
• Difficulty understanding, reading or writing
• Difficulty speaking—slurring nonsensical speech
• Change in level of consciousness or alertness, marked by stupor, lethargy, sleepiness or coma

If your child is experiencing illness or injury contact your Main Line Health pediatrician. A dedicated pediatric emergency room and inpatient unit is located at Bryn Mawr Hospital. Emergency rooms are also located at Lankenau Medical Center, Paoli Hospital and Riddle Hospital.

To schedule an appointment with a specialist at Main Line Health, call 1.866.CALL.MLH (1.866.225.5654) or use our secure online appointment request form.