1 The case is a girl who is going to be three years old. Usually the old people take care of her. On this day, the old man ignored her for a while, and I don't know why this naughty girl with the spirit of inquiry swallowed a 50-cent coin! It was too late for the old man to stop him. (Emphasize not to play with small foreign objects for children, and take good care of them)
The old man quickly informed the parents of the children, and the mother of the children called me for help at the first time. After a brief understanding of the situation and confirmation of swallowing coins by mistake, she focused on asking about the children's recent situation, including the current situation, and how did they react? What's your complexion like? Do you have shortness of breath or obvious dyspnea? Abdominal pain, nausea, vomiting, etc. Knowing that there was nothing unusual in the above situation, I comforted the child's mother. Don't panic after the accident and get to know the situation quickly.
It was noon on Sunday, and I told her to go to the hospital quickly. Mother asked: Is it okay not to go to the hospital? Will you pull it out yourself? Indeed, this fifty-cent coin may discharge itself. But what if the child is too young to be discharged? If the coin gets stuck in the narrow part of digestive tract, it may lead to esophageal obstruction, digestive tract ulcer, bleeding or perforation and laceration. Don't take any chances, some consequences are very serious, so you should send your baby to the hospital for examination in time. )
You should still go to the hospital. First of all, you should have a check-up in the hospital. If the coin is still in the esophagus, it can and should be taken out immediately. If it's already in the stomach, it can still be taken out with an endoscope. If you have moved down through the stomach to the small intestine or even the large intestine, you will have to wait for the coins to be discharged casually in the future. (the size, shape and location of the digestive tract of foreign bodies will be different. )
Which hospital is more suitable? I want you to go directly to the emergency department of children's hospital. Considering all aspects comprehensively, children's hospital is relatively the most suitable. First of all, it is close to home, and the emergency department of Children's Hospital is well equipped at noon. Most importantly, this is a specialized hospital that handles many such accidents. In addition, the digestive endoscope should be used to take money, and the size of the digestive endoscope to be used should be the most complete in children's hospital.
In addition, children's anesthesia, doctors' experience (many accidents encountered and handled), postoperative observation and nursing, combined with various situations, so I suggested that she go to the children's hospital and told me that she could contact me at any time and would give some professional advice and help in time. (To comprehensively consider the conditions of the hospital; It's good to have doctor friends)
After going to the hospital, the emergency doctor quickly gave him a chest X-ray examination. I found the coin stuck in the lower end of the esophagus and did not enter the stomach. As mentioned above, if this small coin is stuck at the narrow joint between the lower end of esophagus and gastric antrum (cardia), it may lead to bleeding, even tearing and perforation of the lower end of esophagus or gastric antrum due to muscle spasm. Take out the coin as soon as possible. (It is important to see a doctor in time)
After my mother got this chest X-ray, she immediately sent it to my mobile phone through WeChat, which is the chest X-ray in the picture, saying that the emergency doctor informed her of hospitalization, and she had to make a series of preliminary preparations and sign some consent forms and other documents. Mother asked me what to do next. I told her to follow the doctor's advice and sign the operation as soon as possible, but I finally decided to come by myself. Soon after, my parents called to thank me and said that the coin had been taken out smoothly and a stone had finally fallen to the ground. (Give professional things to professional people to do)
Another case of a child swallowing hard coins by mistake is similar to the previous situation. This is a little over two years old boy. Also, the curious baby swallowed a coin because of poor family care. Mom got a call from home at work and hurried home. When she realized, it was another 50-cent coin. The mother of the child was very anxious and called me urgently to ask what to do. As before, after I got a preliminary understanding of the general situation, I also asked to go to the hospital quickly to avoid being discharged by luck.
However, the child went to the hospital and found that the coin had fallen into the baby's stomach through chest and abdomen X-ray. The doctor communicated with the parents for a while, solicited their opinions, and finally decided to observe temporarily. Two days later, my parents finally found this precious coin in the poop. (Foreign bodies falling into the gastrointestinal tract are small in volume and may be discharged by themselves. But pay close attention to it, and do surgery at any time if there is any abnormality.
Suggestion: If the baby can't talk, cough, cry, turn blue or struggle, it is often too late to go to the hospital. At this time, parents should be calm, do not pat the baby's back or put their hands into the baby's mouth to dig. They should immediately implement the Heimlich method on the spot and call 120 emergency number.
In daily life, children may fall down and get injured if they are not careful, resulting in bleeding from the wound. Usually, parents will hesitate in two aspects. One is whether to go to the hospital for wound treatment, and the other is. Can't you sew? Or even didn't realize that some wounds had to be stitched up.
In this regard, we emphasize the general principle of wound management: except for particularly superficial abrasions, it is recommended to see a doctor as soon as possible. It is very important for doctors to judge how to treat the wound according to its depth, size, location, severity and presence of foreign bodies, and then decide whether the wound needs to be sutured.
I have several cases in which the wounds were not treated in time, to remind parents to pay attention.
The first situation. I remember that it was around eleven o'clock in the evening, and a parent and friend sent me a photo of their injured hand in Bao Xiao on WeChat @ me. This photo clearly shows that the second knuckle of Bao Xiao's right index finger was injured, his skin cracked and the wound was deep. It was said that his brother took his two-year-old brother to play on the windowsill in the afternoon. My brother accidentally pressed his brother's hand when he closed the window.
At that time, both parents were at work, and only the elderly were at home. I did some local treatment, such as applying iodophor and dressing. I didn't go to the hospital and said I would wait for my parents to deal with it at night. When my parents came back, the wound was bandaged and there was no more bleeding. The child didn't cry so much that he didn't care. In the evening, after Bao Xiao went to bed, his father opened the wound and prepared to do something for him. When he saw the wound, he asked me for help.
The wound should have been treated in the hospital by then. Although it is very late at this time, it should be treated in the hospital immediately. The parents asked the child if he was asleep now. How about tomorrow morning? I said no, go! Because this wound is not treated in time, the purulent infection of tendon goes deep into the injured part of this finger, which will lead to the later movement disorder and even disability of this finger. Coupled with rust, it pollutes the wound, so you need a tetanus shot.
Later, my parents listened to me and went to the hospital for emergency treatment overnight. The next morning, I was told that the doctor criticized them and said that the best time for suture would be over if they came again. They were debrided and sutured at night, and some antibiotics were prescribed. (After the injury, you should see the wound clearly and seek medical advice in time. Wound suture has a certain time limit and cannot be delayed. )
The second case is about a baby who just turned one year old. She accidentally fell from the stroller in the mall and her mouth was broken. At that time, she cried, her mouth was bleeding, and then she stopped crying. When she got home, she could still eat normally, and her mother didn't care too much. But at night, I am not at ease. When the baby was asleep, I opened my mouth and saw a deep incision in Bao Xiao's mouth near the inside of his lower lip.
I remember it was early in the morning, and my mother asked me what I was doing in the group. But I did fall asleep very late that night. When I saw it in the morning, I immediately replied that she was going to the hospital for debridement and suture. Later, Bao Xiao went to the stomatology department of Children's Hospital for treatment in the morning. To see the wound clearly, go to the hospital in time, and don't be covered up by the illusion that you can still eat.
The third case, a six-year-old boy, hurried to school in the morning, walked too fast and threw himself on the ground, with a scratch on his chin, with a gap of about two centimeters and a general depth. Parents were worried that their children would cry in pain and asked if they could go to the hospital to handle the wound suture. They sent me a photo from WeChat.
I will contact and reply immediately. This wound still needs to be debrided and sutured in the hospital. Later, parents took their children to the hospital for debridement, because the wound was not too wide and shallow, and finally they put it on with composite tape. Two weeks later, the photos were sent to me, and the wound healed well. (cracks should not be too wide and shallow, and the surface tension is small. Sometimes it can be pulled with tape without sewing. )
Suggestion: After the child is injured, parents should first stabilize themselves and look at the wound. If the amount of bleeding is large, it means that there is a blood vessel rupture. It is necessary to hold the wound with gauze or clean towel to stop bleeding and protect the wound. If there is no bleeding, it can be covered with gauze and treated by a doctor after arriving at the hospital. It is not recommended to sprinkle "powder" on the wound for so-called hemostasis and anti-inflammation, so the chance of wound pollution is greater.
The time limit for suture after trauma is generally less than 6 hours, of course, the sooner the better. However, there are also clinical examples that head and face wounds with good blood supply may heal within 24 hours.
Many parents and friends asked me if I could use cosmetic debridement and suture. Of course, the cosmetic suture method is worth recommending. Only sometimes, the time of injury is during abnormal working hours, and at this time, most hospitals' beauty departments have rested. Perhaps with the progress of society and the development of medicine, there will be more social doctors to fill this gap in the future.
Beauty suture is a kind of fine suture, which integrates therapy and beauty. Using the principle of wound treatment and suture technology in medical cosmetology department, we can reduce scar formation and restore beauty as much as possible. Therefore, cosmetic surgical suture can be considered if conditions permit.
Cosmetic debridement and suture can achieve the purpose of reducing wound scar by thorough debridement and hemostasis, accurate stratification and reducing tension. Cosmetic suture is much thinner than ordinary suture, with smooth surface, extremely fine surface, no irritation and no tissue reaction, and less interference to the blood circulation of the incision, so the incision heals quickly. The suture needle is connected with the thread to form a non-invasive structure, and no suture and needle eye scar will be formed after operation. So the healing effect will be better. Of course, in order to reduce the stimulation of foreign bodies, the beauty line should also be removed.
Of course, cosmetic suture can also be performed after general surgical suture, but cosmetic suture should be performed on the premise of not infecting the wound after the swelling of the wound subsides, which can better facilitate the doctor's fine anastomosis.
Well, I talked about the right and wrong handling of several children's accidental injuries today. I wonder what you have. I hope I can help you!
If you think this popular science article will be helpful to your family and friends, please share it with them. thank you