Search for tag: "swelling"

Dr. Gellner: You may think that an injury to your child's outer ear isn't a big deal, and you're probably right, but there are some times when it is a big deal. When should you worry about ear injuries? I'll tell you on today's Scope. I'm Dr. Cindy Gellner.

Announcer: Keep your kids healthy and happy. You are now entering "The Healthy Kids Zone" with Dr. Cindy Gellner, on The Scope.

Dr. Gellner: Most injuries to the outer ear are minor, like small bruises and scratches, and these are easily taken care of. But the large blood supply to the cartilage of the outer ear can lead to problems. If your child's ear is just scratched or scraped, then treat the injury just like any other skin scrape. Wash the injured area with soap and water, make sure the bleeding has stopped, and put over-the-counter antibiotic ointment on it until the injury's healed over.

But the one ear injury pediatricians get very concerned about is called cauliflower ear, and it's seen in boxers and wrestlers, and it happens when the ear cartilage is so badly damaged from a direct blow to the ear that there's a lot of swelling in the ear itself because of blood collecting under the skin. And that's a medical emergency, and your child will need to be seen in the emergency room right away to help reduce the swelling and make sure there's no other ear damage. Your child's ear could be permanently disfigured if action is not taken quickly.

And remember, while outer ear injuries are often minor, inner ear injuries can cause major problems.

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Dr. Gellner: Insects bites and allergic reactions, what's a myth and when to worry is today's topic on The Scope. I'm Dr. Cindy Gellner.

Announcer: Keep your kids healthy and happy. You are now entering The Healthy Kids Zone with Dr. Cindy Gellner on The Scope.

Dr. Gellner: We see a lot of bug bites especially in the spring, summer, and fall, and they can cause quite a lot of swelling. It may look shocking if your child has a very large lump where they were bit. This means they're allergic to that bug, right? Not in the sense that we worry about an allergy. That's an old wives' tale. The size of the swelling can vary from a small dot to a few inches in diameter, and the larger size does not mean that your child is allergic to the insect. In fact, take the example of mosquito bites near the eye. They can usually cause enough swelling to close the eyelid almost shut for two to three days, and some mosquito bites in sensitive children form hard lumps that can last for months.

Children who have allergies or eczema can have a larger reaction than other kids do. Why? It's just because their immune systems are ramped up to attack anything it deems a threat, and more histamine is released. Histamine is the chemical in our bodies that causes allergic reactions. A bug bite triggers a local histamine reaction, but we don't say that people are allergic to mosquitoes or other common biting insects. A true concerning allergic reaction to an insect bite would involve excessive swelling, difficulty breathing, hives, and maybe even vomiting or passing out. Bees are an insect many people are allergic to, and these are the symptoms that concern us and why people who are allergic to bees carry epinephrine injections.

If your child just has a localized reaction, whether it's hot, tender, or swollen, try hydrocortisone cream along with an over-the-counter antihistamine. These medicines will help keep your child from scratching. Now, if the swelling continues after a few days especially with treatment or you notice red streaks from the site of the swelling or your child starts acting sick with a fever, then it's time to see your child's doctor to make sure they're not developing a skin infection as a result of the bite.

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Interviewer: All right, it's time to play the game ER or Not, where you get to play along and decide whether something that happened is worth going to the emergency room or not.

Dr. Troy Madsen is an emergency room physician at University of Utah Health. All right, here is today's ER or Not. You've got your ear pierced. Now you believe that there might be an infection in the ear. ER or not?

Dr. Madsen: So when you think of an ear piercing, you might think, "Okay, this is a pretty minor thing." Maybe you got your ear pierced, maybe there's just a little bit of redness around it. And again, that would be a pretty minor thing and something you don't need to go to the ER for if it's just some local irritation or maybe just a small infection. You could probably go to an urgent care or go see your doctor. But there's so much else going on around the ear that can really cause problems.

So the ear is made of cartilage. If you get an infection that's spreading up beyond just the site of the piercing, where the full ear appears red and swollen or just even the lower half of it, then I would be a lot more concerned about an infection in the cartilage itself, and that would definitely be a reason to go to the ER.

Interviewer: So a cartilage infection is a lot worse than infections elsewhere. Why is that?

Dr. Madsen: It's just tougher to treat, you know? You figure cartilage doesn't have all of the blood going into it. You don't have all the vessels running into it so if you start antibiotics, it has a tougher time getting into that. So if you have an infection that's getting down into the cartilage of the ear, we may need to think about IV antibiotics, you know, something where we're admitting you to the hospital for that. And then behind the ear as well, the bones back there are notorious for getting infected and that can be a very serious thing as well.

So if someone comes into the ER and they've got ear pain and ear swelling, and then I push on the bones behind the ear, kind of at the base of the skull there, and they're really tender there, that can be a very serious thing too. And that, typically, requires IV antibiotics, sometimes even surgery.

Interviewer: So beyond the dangers of an infection, which infections aren't good, is there a danger to the actual ear itself if this goes untreated?

Dr. Madsen: Absolutely. Yes, I mean, you could have damage to the cartilage, you can have a breakdown of that cartilage, something that could cause long term issues, possibly deformity there.

Interviewer: So they're hearing loss?

Dr. Madsen: Absolutely. If you get enough swelling in there and enough long term issues, you could have some sort of, at least, hearing impairment or hearing issues. So, you know, it's kind of the thing again you hear about it, maybe an infection from an ear piercing sounds pretty minor but there's just so much going on around the ear. If that infection spreads, if it's deep or if it's into the bone absolutely come to the ER. Probably IV antibiotics, hospital admission for that.

Interviewer: So be sure you're going to a reputable place and don't let your friends do it, I guess is the lesson here, right?

Dr. Madsen: Yes. To me, too many memories as a kid of seeing kids in the boy's bathroom with a needle, stick it into the ear trying to piece their ear. You don't want to do that. This is not a home procedure.

updated: June 19, 2020
originally published: April 28, 2017

Interviewer: You think you got a concussion? Go see a doctor, and here's why. Dr. Greg Hawryluk is a neurosurgeon and a concussion expert.

Dr. Hawryluk: One of the big things that we need to do after a concussion is to make sure that it's not something more serious. A lot of times, we think that these are pretty minor injuries, but the reality is, and fortunately it's rare, but these can be sometimes very serious. Sometimes there can be bleeding in the head. Sometimes you need to see a neurosurgeon so we really want to make sure that you don't fall into that category.

And the other thing is that there's this thing we call second impact syndrome. And this is more common in young patients, where they get a second injury a short time after the first one and it can lead to fatal brain swelling. Another major benefit of seeing a doctor is that we can help to guide you through a pretty well established six-step process that has been shown to really achieve symptom resolution and a return to normal activities as quickly as possible.

updated: June 21, 2021
originally published: January 16, 2019

It can be really scary to see your child get bonked in the nose. Some noses seem to be trauma magnets and when they get hit, they get bloody, bruised and swollen. Luckily, in most cases, the nose isn't broken.

If your child's nose is hit, first, take care of the bruising and the swelling, by putting ice on the nose for about 20 minutes, and repeat this again in an hour.

You can give your child Tylenol or Motrin for pain. If there is a cut on the nose, clean the area with soap and water, and then cover it with gauze to stop the bleeding. Once the bleeding has stopped, you can put on antibiotic ointment and a Band-Aid to keep the area clean.

Be prepared for a nose bleed because this will happen. Noses have a great blood supply which means, they can make a literal bloody mess. Bleeding that goes on continuously for more than 30 minutes, though, that's concerning. When to Seek Professional Help

If you're not sure if your child's nose is really broken, wait a few days and let the swelling go down. If you're not sure, and your child can breathe okay, and the nose isn't crooked, wait about four to five days, to see what the nose looks like after the swelling is gone. If it still looks odd, ENT needs to see them quickly, because the nose will need to be reset by ten days after the injury.

If your child's nose is crooked, or they can't breathe out of it, they need to be seen in the ER. X-rays won't help diagnose a broken nose, and if there's a concern that your child's nose needs ENT to see them urgently, a CT scan may be done to see how bad the damage is, and how quickly it needs to be fixed.

Noses will get hit, but most heal fine by themselves.

updated: October 3, 2022
originally published: September 26, 2016

Dr. Gellner: Everyone wants pretty feet, but what if your child's toe gets all red and angry looking? The problem might be an ingrown toenail.

Announcer: Keep your kids healthy and happy. You are now entering the Healthy Kid Zone with Dr. Cindy Gellner on The Scope.

Dr. Gellner: An ingrown toenail is a toenail that grows into the skin of the toe, and it's usually the big toe. It causes your child to have tenderness, redness, and swelling of the skin around the corner of the toenail on one of the big toes. Ingrown toenails are usually caused by tight shoes, which is very common with growing kids' feet, or improper cutting of the toenails.

They can take several weeks to heal, so how can you help your child during this time? First, soak your child's foot twice a day in warm water and antibacterial soap for 20 minutes. While the foot is soaking, massage the swollen part of the cuticle outward away from the nail. If your child's cuticle is just red and irritated, an antibiotic ointment is probably not needed.

But if the cuticle becomes swollen or oozes pus, put over-the-counter antibiotic ointment on the area where the pus is coming out three times a day for up to a week. The pain your child has is usually caused by the corner of the toenail rubbing against the raw cuticle. When to See Your Pediatrician

If the soaks and ointment don't help, it's time to see your child's pediatrician. Your child's pediatrician may need to cut the corner of the nail off or take more off of the nail than just the corner so that the irritated tissue can heal more easily.

Your pediatrician only needs to do this once in most cases. The main purpose of this is to help the nail grow over the nail cuticle rather than get stuck in it. Finally, weather permitting, of course, have your child wear sandals or go barefoot as much as possible to prevent pressure on the toenail until it heals. If your child must wear closed shoes, protect the ingrown toenail by taping a thin piece of gauze over the infected area.

Ingrown toenails can often be prevented. Again, the most common cause of ingrown toenails are those shoes, narrow shoes in particular. So make sure your child's shoes fit properly. Get rid of any pointed or tight shoes. After the cuticle has healed, cut the toenails straight across, leaving the corners visible. You can gently file them so that they're more rounded and don't poke.

Don't cut the nails too short. If your child has ingrown nails over and over, your pediatrician may refer you to a foot doctor called a podiatrist, who can better help manage recurrent nail problems.

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updated: September 28, 2018
originally published: May 8, 2016

Dr. Gellner: Anaphylaxis is a frightening thing to see your child have. What is it and how can you be prepared if your child has a severe allergic reaction? I'm Dr. Cindy Gellner for The Scope.

Announcer: Keep your kids healthy and happy. You are now entering The Healthy Kids Zone with Dr. Cindy Gellner on The Scope.

Dr. Gellner: A severe allergic reaction is called an anaphylactic reaction. It is an immediate, severe reaction, usually due to a bee sting, medication, or food. The symptoms begin within 30 to 60 minutes and include wheezing, trouble breathing, tightness in the chest or throat, and the voice may even change, dizziness or passing out, the skin may become blue, swelling of the lips, tongue, or throat, and widespread hives, swelling or itching. They can also have significant vomiting, diarrhea, or stomach cramps. If your child has hives, swelling, or itching, but these symptoms do not occur with the symptoms we just mentioned, your child is probably having an allergic reaction but not an anaphylactic reaction.

So what should you do if your child has a severe allergic reaction? Remain calm. Call 911 immediately, especially if your child is having trouble breathing, trouble swallowing, or any serious symptom. Have your child lie down with their feet elevated to prevent shock, and if your child stops breathing, start CPR.

If your child has a known anaphylactic reaction to something, make sure you have a prescription for injectable epinephrine in a form called an EpiPen. If you have an EpiPen, give your child the shot of epinephrine immediately. It can save your child's life. Inject it into the thigh muscle. You should be trained by your pediatrician or pharmacist as to how to use this when you get the prescription. Don't hesitate to give epinephrine. If your child has had a life-threatening reaction in the past and now has been re-exposed to the same allergic substance, for example peanuts or a bee sting, give the EpiPen before your child develops symptoms. Again, it could save his or her life.

Your child will feel the effects of epinephrine. He or she may vomit. They will feel shaky, have heart palpitations, and a headache. Your child will need to be monitored for a few hours after the epinephrine to make sure that their blood pressure is stable and that they don't have symptoms of anaphylaxis come back after the epinephrine has worn off. For that reason, EMS will transport your child to the hospital.

If your child has been stung by a bee and is allergic to bee stings, treat the sting by making sure you remove the stinger. Do this by scraping the stinger off with a credit card, rather than squeezing it.

The only way to prevent an allergic reaction is to avoid contact with the food, drug, or other item that causes the problem. It is very important to learn to read food labels if your child has a food allergy. Since the reactions can be fatal, you should keep emergency kits containing epinephrine at home, school, and in a backpack if you're traveling. Educate others about your child's allergy. Tell all pharmacists, healthcare providers, and dentists who treat your child about any allergies he or she has. This goes for school personnel as well. Your child will be able to keep epinephrine at school. You will just need to have a form completed by your pediatrician, so that the epinephrine can be kept at the school nurse's office or with the secretary and can be used if needed at school.

Your child should have a medical ID bracelet or necklace that tells the insect, drug, or food allergy as well. Remember, if your child is not with you and he or she has an anaphylactic reaction, they may not be able to speak. The medic alert ID will speak for them and provide crucial information to others that could save your child's life. Anaphylactic reactions are serious. If your child is old enough, teach them what they are allergic to so they can help avoid their triggers as well.

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