What to do when your child has a fall

(Warning: there are some photos in this post which some of you would rather not see, and I’ve tried to keep them small so as not to shock you. Ha!)

The cut from flinging himself against the corner of the wall.

A few weeks ago, Abacus had a fall at home. His forehead hit the edge of the wall as he was playing. I took one look at it, grabbed the kitchen towel applying pressure on the wound with one hand and calling the hubby with the other, telling him he needed to come home and go to the A&E now NOW. And then in the next few minutes I gave my helper instructions on what to pack, and helped me remember what time was his last intake of water.

2 days after the fall

This is not Abacus’s first time for stitches, as he’s had several falls. First was the time he wriggled out of my arms and fell onto the floor, cutting himself on the chin to which tissue glue was applied, but he subsequently he fell on it again (like WTH are the odds??) and had to have it stitched (which really should have been done the first time, but given his medical history the doctor in-charge was apprehensive about sedation, fair enough.). Second time he was standing on a very slippery wheelbarrow (bad, bad idea!) and fell off and cut his forehead, leaving a Harry Potter-ish mark which again was glued. I’ve been getting a number of questions about stitches, so I thought I would share a little FAQ of sorts.

3-4 days after the fall, after I'd removed the dressing
3-4 days after the fall, after I’d removed the dressing

1. How do you know you need stitches?

You can read more on childhood injuries from the KKH website, but in my layman terms, any deep cut where the skin is pulling apart will need to be stitched so that it can heal properly without leaving a deep scar. Cuts where the skin isn’t pulling apart as much can probably be glued using tissue glue. When in doubt, just have it checked, otherwise the wound might leave a deep scar.

2. What should you do?

Don’t faint, don’t freak out. Children take their cues from adults, so if you remain calm, so will they. Apply pressure to stop the bleeding, clean it up, and dress the wound, even if it is a Disney Princess plaster, anything is better than nothing! Offer up a bribe for good behaviour if necessary. Abacus is 3, so we packed diapers, a change of clothes, a sweater, some water (for both father and son), hospital admission card or birth certificate, iPhone charger for the husband, and some distractions – a toy, a book, iPad.

3. Where should you go?
While your GP and even private paediatrician could possibly do the job, we feel it’s best if you can you head to the Children’s Emergency at KKH or NUH. These are the only 2 hospitals that have CEs. There they stitch so many children a day they can probably do it with their eyes closed. But don’t worry, they won’t do that! GPs often also don’t have the resources to sedate or the experience and manpower to hold a child down (the time we had his forhead wound glued I think we had 4-5 people helping out), so you might have to bear with a child screaming the entire block down. I’ve also heard of cases where people have not been happy with their GPs’ handiwork.

If the bleeding is under control, go as soon as possible but you don’t need to panic and rush to the hospital like he’s had a heart attack.

The chin cut
The chin cut when he was younger

4. What will happen?

If your child is not old enough to not freak out when he sees a needle coming to stitch him, he might be lightly sedated so that they can perform the stitches. For this he needs to have fasted for 3 hours, so refrain from any food and water unless you want to spend the next 3 hours in the hospital just waiting. He will not be able to walk after that, so bring a pram if necessary. In this instance, Abacus was stitched at around midnight, and he barely roused after the sedation and slept through the night. The next morning it was as if nothing had happened. He’s been really good about it, letting me take photos, and just mentioning once in a while that it hurts a little (perfectly normal). Boys will be boys!

Seen at NUH
Seen at NUH

5. How do we look after the wound?

It depends – I’ve heard of kids who have had to go back to have their stitches removed, but in some cases it’s completely fuss free. For the last case the dressing wasn’t really necessary, but we left the it on for a good 4 days in case he scratched it or something, and then we did away with it and now we just have to wait for it to heal in its own time. Children have an amazing ability to heal, but if you have concerns, you can always speak to your doctor about options such as Dermatix and other scar reducing options.

Cuts, falls and accidents are part and parcel of childhood, and there’s no way we can protect them ALL the time. But with proper care and attention they needn’t be traumatic or leave a scar. I hope this has helped eased any fears you might have of your child falling, but please remember to let kids be kids and enjoy their childhood!


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