What to Expect the Toddler Years (243 page)

see #13

see page 689

see
Frostbite
, #31;
Hypothermia
, #35

16.
Symptoms of a seizure or convulsion—caused by abnormal electrical impulses in the brain—vary depending upon the type of seizure, but may include: collapse, eyes rolling upward, foaming at the mouth, stiffening of the body followed by uncontrolled jerking movements, and in the most serious cases, difficulty breathing. Brief convulsions are not uncommon with high fevers (see page 584 for how to deal with febrile seizures).

For nonfebrile seizures: Clear the immediate area around the child or move the child to the middle of a bed or carpeted area to prevent injury. Loosen clothing around the neck and middle, and lay the child on one side with head lower than hips (elevate them with a pillow). Don’t restrain, but do stand by ready to prevent injury. Don’t put anything in the child’s mouth, including food, drink, breast, or bottle. If the child isn’t breathing, begin CPR (see page 688)
immediately
. If someone else is with you, have them
call 911
; if you’re alone, wait until breathing has started again to call, or call if breathing hasn’t resumed within a few minutes. Also
call 911
if the seizure lasts more than 2 or 3 minutes, seems very severe, or is followed by one or more repeat seizures. If this was a first seizure, call the doctor to arrange for a medical evaluation as soon as possible, even if the child seems fine after the episode has ended.

Important:
Seizures may becaused by the ingestion of prescription medicines or other poisons, so check the immediate vicinity for any sign that your child may have gotten into a bottle of pills or another hazardous substance.

see #51, #52

17.
Shoulder and elbow dislocations are common among toddlers (see page 645 for why). A visible deformity of the arm and/or the inability of the child to move it, usually combined with inconsolable crying, are typical indications. A quick trip to the doctor’s office or the ER, where an experienced professional can reposition the dislocated part, will provide virtually instant relief. If pain seems severe, apply an ice pack and splint before leaving.

see #3

18.
Even a child who quickly revives after being taken from the water unconscious should get medical evaluation. For the child who remains unconscious,
have someone else call 911
for emergency medical assistance, if possible, while you begin rescue techniques (see page 684). If the child is not breathing or if no pulse is found, begin CPR immediately. If no one is available to phone for help, call later. Don’t stop CPR until the child revives or help arrives, no matter how long that takes. If there is vomiting, turn the child to one side to avoid choking. Also turn the child on one side once breathing is restored. (If you suspect the toddler has a back or neck injury, do not turn the child, since moving someone with such an injury is very risky; see #10.) Keep the child warm and dry.

19. Foreign object in the ear.
Try to get the toddler to shake the object out by turning the ear down and shaking his or her head gently. If that doesn’t work, try these techniques.

For an insect, use a lighted flashlight to try to lure it out.

For a metal object, try a magnet to draw it out (but don’t insert the magnet in the ear).

For an object made of plastic or wood that is protruding visibly from the ear, dab a drop of quick-drying glue (that won’t bond to the skin) on a straightened paper clip and touch it to the object (
never
probe blindly into the ear). Wait for the glue to dry, then pull the clip out, hopefully with the object attached. Don’t attempt this if there’s no one around to help hold your child still.

If the above techniques fail, don’t try to dig the object out with your fingers or with an instrument. Instead, take your child to the doctor’s office or the ER.

20. Damage to the ear.
If a pointed object has been pushed into the ear or if your toddler shows signs of ear injury (bleeding from the ear canal, sudden difficulty hearing, a swollen earlobe, or substantial pain),
call the doctor
.

21.
Break contact with the electrical source by disconnecting the appliance involved or turning off the power to the outlet (whichever can be accomplished most quickly), or separate the child from the current by using a dry nonmetallic object (a broom, wooden ladder, robe, cushion, chair, or even a large book or rubber boot). If the child is in contact
with water,
do not
touch the water yourself. Once the child has been separated from the power source,
call 911
. If the child isn’t breathing, begin CPR (see page 688)
immediately
. If two adults are present, one can disconnect the power source and
call 911
while the other rescues the child.

Important:
Don’t apply pressure to an injured eye; don’t touch the eye with your fingers, or instill medications without a physician’s advice. Keep the child from rubbing the eye by holding a small cup or glass (or an eyecup) over it or by restraining the child’s hands, if necessary.

22. Foreign object in the eye.
Try to wash the object out by pouring a stream of tepid (body temperature) water into the eye while someone holds the child still, if necessary. If this is unsuccessful, try pulling the upper lid outward and down over the lower lid for a few seconds. Don’t be concerned if your attempts provoke crying; the tears may help to wash the object out of the eye.

If after these attempts you can still see the object or if the child still seems uncomfortable, proceed to the doctor’s office or the ER; the object may have become embedded or may have scratched the eye. Never try to remove an embedded object yourself. Cover the eye with a sterile gauze pad taped loosely in place, or with a few clean tissues or a clean handkerchief held on by hand, to alleviate some of the discomfort en route.

23. Corrosive substance in the eye.
Flush your toddler’s eye immediately and thoroughly with plain lukewarm water (in the shower works best, but you can also pour it from a pitcher, cup, or bottle) for about 15 minutes while holding the eye open with your fingers (see illustration). If only one eye is involved, keep the chemical runoff out of the other eye by turning the child’s head so that the unaffected eye is higher than the affected one. Do not use drops, ointments, or an eye cup, and keep the child from rubbing the eye or eyes. Call the Poison Control Center (800-222-1222). Depending on the substance, the Poison Control Center may recommend a follow-up with an eye doctor to be safe.

Giving your toddler an eye bath won’t be easy, but it’s necessary to wash away a corrosive substance.

24. Injury to the eye with a pointed or sharp object.
Keep the child in a semi-reclining position while you seek help. If the object is still in the eye,
do not
try to remove it. If it isn’t, cover the eye lightly with a gauze pad, clean washcloth, or facial tissue; do not apply pressure. In any case, get emergency medical assistance
immediately
(
call 911
). Though such injuries often look worse than they are, it’s wise to consult an ophthalmologist any time the eye is scratched or punctured, even slightly.

Do not put drops in your toddler’s eyes without the advice of a doctor (they are most likely to be recommended if there is an infection, such as conjunctivitis; see page 842). To administer drops, keep the eye open with two fingers of one hand while steadying the head with the other three.

25. Injury to the eye with a blunt object.
Keep the child lying face up. Cover the injured eye with an ice pack or cold compress for about 15 minutes; repeat every hour as needed to reduce pain and swelling (page 836). Consult the doctor if there is bleeding in the eye, if the eye blackens, if the child seems to be having difficulty seeing or keeps rubbing the eye a lot, if the object hit the eye at high speed, or if the child complains of persistent eye pain.

26.
Check for breathing. If it is absent, begin CPR
immediately
(see page 688). If you detect breathing, keep the child lying flat, lightly covered for warmth if necessary. Loosen clothing around the neck. Turn the child’s head to one side and clear the mouth of any food or objects. Don’t give anything to eat or drink. Call the doctor
immediately
.