First aid for bruises

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Definition
A bruise is dark discolouration of skin caused by blood seeping underneath the skin, after small blood vessels near the surface have been broken. As the bruise heals, the body breaks down this blood and reabsorbs it, turning the mark into a typical greenish-blue.

Causes
Bruises are usually caused by bumping into hard objects, falling or being hit with a blunt object. This is particularly common in young children who are learning to walk. Young children have thinner skin too, so the bruise is more obvious.

Treatment
Most bruises are relatively minor and will get better on their own in about 10 days. If the bruise is quite large and swollen, apply an ice pack to reduce swelling and relieve pain. Elevating the area, if the bruise is on a leg or an arm, will also reduce swelling. A painkiller can also be used if the bruise is in a particularly painful position.

When to see your doctor
If your child's bruise is from a serious fall from a bicycle or another traumatic accident, call your doctor immediately. He may want to examine your child for less obvious injuries. 

You should also call the doctor if your child:

  • Has banged his head and has a bruise behind his ear. It may be a sign of a skull fracture.
  • Has a bruise that doesn't fade within 14 days.
  • Is in pain for more than 24 hours. 
  • Has a bruise on a large joint (knee, ankle, elbow, wrist) and is reluctant to use the joint or has difficulty moving it.
  • Has a cut or abrasion and shows signs of infection like pus, unexplained fever, or increased pain and swelling. 

If your child gets a bruise from an injury to his lower back, check his urine for blood. This could be an injury to the kidneys or other organs. If blood is present, call the doctor immediately. Unexplained black-and-blue spots may mean that your child has a tendency to bleed easily. If he develops bruises that aren't associated with injuries, make an appointment to see your doctor.

Black eyes
A black eye is simply a bruise which affects the tissues around the eye, but there are times when this can be a sign of a more serious injury. See a doctor if your child:

  • Complains of not being able to see properly or has double vision.
  • Cannot move his eye normally in all directions.
  • Has pain in the eyeball rather than the eye socket.
  • Is bleeding into the white of the eye. 

If you don't notice any of these symptoms, treat the black eye like any bruise.

If it's accompanied by swelling and your child can stand it, apply an ice pack for 15-minute intervals a few times a day in the first 48 hours to reduce swelling. If the bruise seems painful, check with your doctor if it's okay to give your child paracetamol.

Most black eyes will go away within a week to 10 days. If it persists up to two weeks, check with your doctor.

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