When Do Injured Kids Require Trip to E.R.?

At 9:30 in the morning, the emergency room in Washington, D.C.'s Children's National Medical Center is already a busy place.

The patients include a little girl who fell on a gate and got badly scratched up, a toddler who tumbled over at daycare and hit his head, and a teenager who hurt his hand while playing basketball. All in all, it is a typical summer's day in the E.R.

Nearly half of all serious childhood injuries occur in the four-month period from May to August, amounting to 3 million hospital visits over the summer, with children rushed to the hospital for everything from minor cuts to concussions to broken bones.

But bumps, scrapes and bruises are everyday fare for active kids — so when is an accident an emergency?

When Are Wounds Serious?

If a wound won't stop bleeding, if it cannot be cleaned, or if it is on a delicate body area such as the face or the genitalia, it needs medical attention within 12 hours, emergency room experts say. These days, cuts can be not only stitched together, but glued or even stapled shut.

When 18-month-old Benjamin Nozik injured his head, his mother felt he needed special attention to check for serious injury.

"He was just in daycare and he fell backwards and hit his head on the hinge of a door," said Gabriella Nozik.

A child who has fallen more than two times his own height is at higher risk for a concussion. If your child loses consciousness, is excessively sleepy, has difficulty walking or talking, or throws up repeatedly, see a doctor right away.

It turned out that Benjamin needed stitches to close up his cut.

"I have trouble cutting his nails, I don't know how you'll staple it," his mom told doctors.

But one staple closed her son's cut, and he was doing just fine.

When he entered the emergency room, 15-year-old Frederick Thomas looked fine, but an X-ray showed he broke his hand on the basketball court. The pain was concentrated in his pinkie.

Doctors gave Thomas a simple splint to let his bones heal.

Even without a physical deformity, pain may mean a broken bone, experts say. It is wise to head to the emergency room in those cases.

Emergency Room Quiz


1. Can you have a broken bone without seeing a physical deformity? a. Yes b. No

2. Which of the following are signs of wound infection? a. Redness b. Clear liquid coming from the wound c. Whitish liquid coming from the wound d. Swelling e. All of the above

3. After washing a wound and applying antibiotic ointment, what is the best way to help a wound heal? a. Apply a bandage right away to keep germs from getting in b. If the wound will stay clean, don't cover it — oxygen will help the wound heal

4. How do you know if a wound needs medical attention? a. It won't stop bleeding b. It is gaping and won't close c. It is in a sensitive area like the face or genitalia d. It can't be cleaned e. All of the above

5. How can you minimize scarring on cuts and wounds? a. Apply sunscreen to the scab once it forms b. Put alcohol on it c. Leave it alone

6. Which of the following are ways emergency rooms treat cuts? a. Staples b. Glue c. Bandages d. Stitches e. All of the above


1. a 2. a and c 3. b 4. e 5. a 6. e