Managing Falls at Home

How to handle your children’s falls and wounds, including cuts, scrapes and sprains.

Falling is part of growing up. As toddlers learn to walk and children enjoy physical play while growing up, they’ll inevitably experience a few tumbles. In this feature, we will identify what kind of falls can you can treat at home, and when to seek medical help.

In general, mild injuries from a fall such as minor scrapes, bruises and sprains can be treated at home. Although sprains often cause pain and difficulty in walking, if the child can move about immediately after the injury—although in a halting manner—the sprain is considered mild. Minor scrapes are cuts that have not given rise to wounds with gaping edges. If you can see tissue below the skin, you need to seek medical attention immediately.

You can administer simple first-aid measures for such minor injuries. For cuts, clean wounds under running water and apply an antiseptic ointment, if you have any. If the wound is still bleeding or oozing, apply firm and steady pressure on it, using a clean cloth or gauze for 3 to 5 minutes. Once the bleeding has stopped, apply a clean dressing such as an adhesive plaster on the wound.

If you see blood spurting from the wound or are unable to stop the bleeding with a firm, direct pressure, please seek immediate medical attention as your child may have an injured/cut vessel.

For bruises and sprains, get your child to lie down and elevate the injured limb above the level of the heart to reduce swelling. Next, ice the affected area to ease their pain. Use a gel ice pack or compress as these are soft and you can wrap these around the injured area easily. If not, place some ice cubes in a clean towel before breaking it into smaller chips. Place this towel containing the ice chips in a plastic bag before wrapping it around the affected area.

However, if you’re unsure about the severity of your child’s injury, do seek medical help early, especially if your child hasn’t begun to speak or if there aren’t any witnesses to the injury.

Warning signs to look out for

A moderately bad fall resulting in an open wound will require medical attention within 12 hours. If the fall is a very bad one, you’ll notice a significant head injury, an open gaping wound or a fractured bone.

If the wound gapes, a doctor will need to close the gash properly.

You should suspect that your child has a fractured bone if the affected limb is clearly deformed or notice very early and rapid swelling plus bruising of the affected area. The bruising is caused mostly by blood leaking from the broken bone, and isn’t usually seen in simple sprains. These injuries become an emergency if your child complains that the injured area is numb, or if the affected area looks pale as these indicate either nerve or vascular injuries.

A fall may also cause moderate to severe head injuries when there is a significant force of impact to the head and/or neck region. Worrying signs of a severe head injury include drowsiness, a bruise that is more than 5cm in diameter, an inability to walk after the fall and loss of consciousness at any point after the fall.

Be alert to mental changes

Parents should also be alert to the warning signs of a concussion in their child: such as an inability to recall events before or after the injury, clumsy movements, slowed reaction times (delay in answering questions), headache with nausea and/or vomiting, and obvious changes in behaviour after the injury. In cases of head injuries, it’s important for someone who knows the child best to observe him/her for any change in their mental status. This way, that caregiver will notice any early changes in the child’s behaviour and bring him/her to the doctor quickly.

Stay calm and offer comfort

If your child refuses to walk, distract and allay their anxiety before you assess the situation. It is also important to check if the extent or pattern of your child’s injury corresponds to the account he/she gives. This is to eliminate the likelihood of foul play or child abuse if your child is being looked after by a non-family caregiver.

Usually, there are no long-term issues for mild injuries. However, severe head injuries can cause long-term brain damage. Fractures of the long bones of the arms and legs can also potentially injure the part of the bone where growth occurs and cause shortening. A specialist will be able to advise if your child’s growth might be affected.

While falls are common in children, do seek doctor’s advice if your child:

  • Is always falling to the same side.
  • Appears weak in a particular limb or side of the body.
  • Shows a reversal of motor abilities (such as from being able to walk to only crawling or not being able to walk)
  • Is waddling when they weren’t before.
  • Keeps falling after an injury.
  • Has headaches that worsen after a fall.

6 Ways to Keep your Children Safe

  1. Keep the house as uncluttered as possible.
  2. Offer only age-appropriate toys and place soft mats around play areas.
  3. Keep children away from dangerous areas, such as kitchens and bathrooms, unless they are under close supervision.
  4. Keep toilet bowls closed.
  5. Insert child-proof plugs in electrical points.
  6. Keep button batteries and magnets/ household cleaners/soaps/mouthwashes/all medications out of children’s reach.