The Nurse Is In - Sprains, Fractures, and Stitches: When to Worry?

Ahhh… summer time. A time for running, jumping, and playing outdoors all day.

When I was working in the ER I would look towards Mt. Rainier while driving to work, and if I could see the mountain, I knew there would be a lot of patients with scrapes to clean out, cuts to suture, sprains to immobilize, and broken bones to fix. Now that I am also a mom, these nice clear days can cause stress. If something happens to our children, when do we need to get care or help? How do you tell the difference between a sprain and a fracture? How do you know if a scrape will heal or if stitches are needed?

My biggest advice is to trust your internal Momma Instinct – she is ALWAYS right!!!

Scrapes vs. Deeper Cuts: Does it Need Stitches? Will it Scar?

One general rule is that if the cut is on a moving part (think a knuckle or chin) it will most likely need stitches. Another rule about the lip is if it crosses from the pink part of the lip onto the face it will need stitches. If a tooth hits only the inside of the mouth or gums and does NOT go through, it usually does not need stitches. However, if it does go through, it definitely needs stitches.

Many moms are also concerned about scarring during the healing process. Yes, there will be a scar afterwards – whether a plastic surgeon or a brand new intern does the suturing. How you care for the stitches is most important in lessening the scar’s appearance. Sunscreen and vitamin E greatly help scars diminish over time. Once stitches are out, be diligent in applying sunscreen and protecting the cut from the sun. Applying vitamin E on the scar to can also help reduce its appearance over time.

Sprains/Strains and Fractures: How to Tell if it’s Broken? How to Care for the Cast?

“Do you think it’s broken?” is one of the most common questions parents ask in the ER, and it is still the most common question friends and family ask me today. The answer is that sometimes it is hard to tell if it’s broken without an x-ray. Luckily, most urgent cares have x-ray capabilities. If there is not an obvious deformity but you want to make sure it’s not broken, urgent cares are a great option. Depending on the severity of a break, an urgent care may be able to set or at least stabilize the bone until you can get to an ER. If the bone looks deformed to the naked eye, you will need to go to an ER for setting, or in rare cases, potential surgery. The good news is that children’s bones are amazingly resilient – they bounce back WAY faster than those of adults.

Lastly, cast care. It can be hard to have a kiddo in a cast during the summer. What kid doesn’t want to go swimming or play at the water table? But, if your kiddo has a cast you need to ensure it doesn’t get wet. If it becomes soaked, the child needs to be seen as soon as possible by an orthopedic doctor or the ER so the cast can be replaced.

I hope these brief pieces of information can help you navigate the challenges of summer injuries with confidence! Always remember to call your pediatrician’s office or answering service for additional help – they are always there for you. And of course, listen to that Momma Voice!!

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