When a bang-up is more than a boo-boo

What parents need to know – and which steps to take – when their child suffers an injury

Doctor Checking Knee Injury Athlete, On White Background. Studio

Kids are tough, but not that tough.

That worrisome feeling you have when they get a little rambunctious, fearing they might break a bone or something, isn’t just parental paranoia — sometimes it actually happens.

Take, for example, the recent occasion when I took my 10-year-old son to the Epic indoor BMX park in Nepean. For some reason, I decided to try it myself and wiped out within five minutes.

As I was limping around, trying to find a bandage, I looked up to see my son being helped off the track by facility staff, holding his shoulder area and crying. Like father, like son, I guess.

He’s fallen off his bike several times and has occasionally been hurt. He usually cries like he’s lost a limb for about two minutes, then immediately returns to action.

This time, the pain wasn’t going away and not even the prospect of getting back to this thrill-a-minute sport was enough to make him forget about it. It soon became clear this wasn’t business as usual.

Dr. Ken Farion, CHEO’s medical director of quality improvement, says the sense of something different about your child’s injury should be a signal that more significant actions might be needed.

“Understanding when to seek assessment relies heavily on parents knowing their child,” he says. “If the child would normally jump back up from a minor event but doesn’t, then the parent should be more worried and seek care.”

Making a beeline to the nearest emergency room might not be necessary right away, Farion adds, if you have the means to apply some first aid care on the spot, such as equipment to clean a cut or ice a bruise, or some pain medication.

He says choosing to delay a hospital emergency visit, even by several hours, rarely leads to the injury becoming worse, “so parents should not feel guilty” about not making the hospital their immediate choice.

During my son’s ordeal, I initially called my wife, who happens to be a registered nurse. She told to me to come home so she could check it out. When we got home, my son’s pain was so intense he didn’t even want to get out of the car.

For my wife, this was a telltale sign that something serious was afoot.

Being more comfortable in a hospital setting, my wife ended up driving him to the Queensway Carleton Hospital.

Staff saw the great pain my son was in and got him through the whole process within a very reasonable two hours.

Kudos to QCH!

Farion warns, however, that emergency room wait times can be long, particularly if your child is in less severe shape than others. If feasible, he recommends having things for your child to do, such as card games or a tablet. If needed, hospital staff should be able to provide pain medication to make the wait more tolerable, he notes.

An online resource for parents from CHEO, called Choosing Wisely, notes that walk-in clinics and family physicians can be alternatives to an emergency room. Many doctors leave instructions on their answering machines for how to access care during off-hours.

My son’s diagnosis was a broken collarbone, meaning no contact sports for at least six weeks. This was not going to be easy for an active kid like ours, especially with hockey season just getting underway.

Farion says parents should leave the hospital with a clear idea of what their child can and cannot do for a given period of time. And if anything is unclear, ask.

“Being pain-free and able to move an injured limb freely is typically a good sign that the injury has healed and all activities can resume,” he says. “But any serious injury will typically include at least one recommended follow-up visit with a specialist or primary-care provider to assess healing and clear the child to return to activities.”

The doctor says parents need not beat themselves up over such incidents, as kids will be kids, and that inevitably means occasional injuries. Precautions such as helmets for high-speed activities are recommended, though.

“Acute injuries are very common by the nature of how active children are, as well as their lack of cautionary instinct,” he says. “Parents cannot always foresee danger.”