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Wounds and Cuts

Another common emergency seen in children are injuries due to falls while playing. Most of these are minor and only require first aid. A shot to prevent Tetanus is also generally required depending on the severity of the wound and the vaccination status of the child. Sometimes, however, the wounds are deep and the doctor will require stitching it to facilitate healing. If the wound is small and the child is old enough to understand the procedure, this can also be done by giving a small injection around the wound, which makes the whole area painless. This is called local anesthesia. If the wound are deep, large, on vital areas like the face,etc then the child is put to sleep by giving general anaesthesia and then the wounds treated.The wound heals by a week. Sometimes the dissolving stitches or special adhesive material can also be used to close the wound.

Foreign Body Ingestion or Aspiration

All of us are familiar with the warning “Choking Hazard- not for use by children younger than 3 years” boldly mentioned on the boxes of toys. Foreign body ingestion or aspiration is a fairly common emergency amongst toddlers and small children who generally tend to put small objects in their mouth/nose and then choke on them. This can sometimes be life threatening if the foreign body goes down the windpipe and blocks breathing. Another common presentation of foreign body aspiration is that of older children trying to blow or suck in on the whistles found in the plastic toys.

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What do we do when we see a child choking on a foreign body and struggling?

There are a few things we can do or must remember not to do in such situations and remembering these tips may come handy in probably saving the life of a child. Here’s a look:

Do not panic or try to pull out the foreign body by putting your finger inside especially when the child is struggling and crying. Sit on a chair, keep the child across your lap with its head lower than the body and give 5 sharp slaps on the back between the shoulder blades. Alternate this with 5 chest thrusts holding the child in a standing position and encircling him/her from the back and using both your hands thrusting up just below the breast bone.


If this fails and the foreign body is still in the airway we should rush the child to a hospital where it is removed in the operation theatre. This is done by passing a rigid tube with a telescope down the windpipe, visualizing the foreign body and removing it with a forcep mounted on a telescope. This procedure is called bronchoscopy. Sometimes the foreign body is not dangerous enough to be life threatening and can wait till we take x rays and confirm its location, to plan its removal.

Foreign bodies in the food pipe or stomach are less life threatening except if they are sharp objects or chemicals especially corrosives like acid and alkalis which are commonly used as household cleaning agents. Another potentially dangerous foreign body is the small button alkaline batteries, which can cause serious injury to the stomach or food pipe. One important point to remember is never to induce vomiting after foreign body ingestion as chemicals agents as this can cause more widespread damage.

Don’t Delay

Parents are often apprehensive about their little ones tolerating surgery, anesthesia, and associated procedures therefore postpone seeking advice. It is assuring to add that in the recent times, all operative procedures in children are supported by professionals capable of managing children e.g. pediatricians and neonatologists, anesthetists, nutritionists, physiotherapists etc. A child’s growing body is a dynamic system. It reaches its milestones in a systematic or programmed manner. Disease manifestations are often a window into the erroneous program. Defects in this program need to be timely detected and intervened. Nevertheless, in children the problem should be best managed when it presents. “Better early than sorry”.

Inguinal or Groin Hernia in Children

It is one of the commonest problems requiring surgery in children. The problem is seen in about 5% of children, and in nearly 30% of premature babies. Hernia can happen at any age, but is more common in the 1st year of life, and more so in boys.

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1.What is a hernia?

Hernia is a protrusion of organs or structures of the abdominal cavity into a sac formed by the inner lining membrane of the abdomen. Though the problem is also seen in adults, hernias in children differ from adult hernias both in cause and in management.

2. Why do hernias occur in children?

In children the commonest site of a hernia is the groin. The condition is called inguinal hernia. This happens due to a persistence of a communication between the abdominal cavity and a canal in the groin through which the testes and its blood vessels and tubes pass down to the scrotum. Normally, this communication is seen only in the fetus, and should close about the time of birth.

3. How would I recognize a hernia in my child?

A hernia generally presents itself as a swelling in the groin, which may extend down to the scrotum too. Sometimes, the swelling appears only when the child cries, coughs or strains. It disappears when he/she is quiet or is lying down. Occasionally, there may be pain associated with the swelling.

4. Can a hernia be dangerous?

Yes. A hernia can be dangerous at times when the abdominal contents coming out into the sac, get trapped and cannot be pushed back. This leads to a strangulating effect and can cause death of the intestinal segment, or the testes, or, rarely, the ovaries. This is more common in hernias seen in infants. For these reasons, a hernia should be operated and corrected when it is diagnosed, especially in infants.

5. Could there be any other problem associated with hernia?

In girls, a hernia might sometimes be a manifestation of a slightly more complex problem related to abnormality in gender development, requiring further evaluation.

6. What is the surgical procedure to correct hernia in children?

Hernia in children is treated by a surgery called herniotomy, wherein a 2cm skin cut is made in the groin skin crease, under anesthesia. The abnormal communication is then closed. Herniotomy is a simple surgery and is usually treated as a day care procedure where the child comes to the hospital on the morning of the surgery and is discharged by the afternoon. The child is ready to get back to normal activities such as attending school, in a couple of days.

Key hole or Minimally Invasive Surgeries

Includes Laparoscopiy, Thoracoscopiy, Cystoscopy and Endourology, Bronchoscopy etc

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