Eye Trauma in Teenagers

Eye Trauma in Teenagers

“Trauma is the second most frequent eye problem that we see in the teenage years,” says Dr. Koller, a pediatric ophthalmologist since 1971. Sports-related injuries are the leading cause, followed by bicycle spills and injuries involving BB guns and air rifles. Baseball is responsible for more eye injuries among children aged five to fourteen than any other sport—typically as a result of a batter being struck by the ball—while inadvertent elbow jabs and stabbing fingers account for the majority of eye injuries in basketball, which holds the same dubious distinction among fifteen- to twenty-year-olds.

Treatment: Call your pediatrician or eye doctor at once. There are several different treatments for eye injuries ranging from mild to serious and your pediatrician or ophthalmologist can make the correct determination as to how to treat your teenager.

Steps To Take When A Teenager Suffers An Eye Injury

Cuts and lacerations to the eye should be left untouched. Do not attempt to put medicine in the eye or flush it with water, and remind the young person not to rub his eyes. Gently place a bandage or gauze pad over the eye and head to the ophthalmologist right away.

Helping Teenagers Help Themselves

Every year, some thirty-three thousand young athletes injure their eyes participating in sports. Nine in ten of those mishaps could have been avoided. Insist that your sports-minded youngster wear protective lenses made of polycarbonate, a rugged material that is twenty times stronger than conventional eyewear.

Last Updated 11/21/2015

Repetitive Stress Injury

Repetitive Stress Injury

The National Academy of Sciences estimates that thirteen million to twenty million American adults are plagued by repetitive stress injuries (RSIs), the nation’s number-one on-the-job hazard. Most RSIs involve the hands and wrists, and many cases are related to computer use. With more and more teenagers typing, clicking and dragging, it was inevitable that the epidemic would begin to make inroads in this age group.

All that time spent on-line has a cumulative effect on the soft tissues of the hands, wrists, elbows, shoulders, neck and back. (Another name for repetitive stress injury is cumulative trauma disorder.) Physicians are reporting growing numbers of pain complaints among cyberspace travelers in their twenties. The initial damage to nerves and tendons, however, was most likely sustained as many as five to ten years earlier, when they were teens.

Symptoms That Suggest Repetitive Stress Injury May Include:

Minor aches and pain in the affected area; if left unchecked, may progress to:

  • Sensations of tightness, soreness, numbness, tingling, burning, coldness in the hands, wrists, fingers, forearms and/or elbows
  • Loss of hand strength and coordination
  • Severe pain

How Repetitive Stress Injury Is Diagnosed

Physical examination and thorough medical history, plus one or more of the following procedures: (1) nerve conduction study and (2) X rays.

How Repetitive Stress Injury Is Treated

  • Immobilization: Mild cases of repetitive stress injury frequently heal just by resting the affected area. The young patient might have to be fitted with a lightweight splint or a more rigid brace temporarily. Be sure that he wears it as instructed; in a small study of people with carpal tunnel syndrome, researchers at the Medical College of Virginia in Richmond found that those who kept their splints on twenty-four hours a day improved more than the group that didn’t wear the splint.
  • Drug therapy: More severe cases of RSI may require over-the-counter or prescription oral non-steroidal anti-inflammatory drugs (NSAIDs), to reduce swelling. Examples include naproxen and ibuprofen.
  • Surgery: An operation is rarely necessary for treating bursitis, tendinitis and tenosynovitis. Carpal tunnel syndrome, though, does not always respond to nonsurgical interventions. If surgery is necessary, the surgeon performing the outpatient procedure cuts one of the ligaments in the wrist, to relieve the pressure on the median nerve.

Helping Teenagers Help Themselves

Repetitive-stress injuries are infinitely easier to prevent than to treat. Mom and Dad, you can help. The next time your youngster’s at the computer, check to see that she is observing the healthy habits below and write out a list of these habits, to be kept near the computer.

  • Sit up straight in the chair (which should have a back support), shoulders relaxed.
  • Keep both feet on the floor or on a small stool.
  • Eye level should be even with the top of the monitor screen, so that your head is tilted slightly down, not with the chin jutting out.
  • Keep your wrists straight and level with the keyboard. You shouldn’t have to stretch your fingers to reach the keys.
  • Don’t contort your hands while typing; the fingers should form a straight line with your forearms.
  • Wrist rests are for parking your hands only when taking a breather, not while typing.
  • The keyboard should be tilted toward you, but slightly.
  • Dance lightly over the keys, don’t stomp on them. Similarly, refrain from gripping the mouse too hard. If possible, learn as many keyboard command codes as you can, so that you don’t have to rely so heavily on the mouse.
  • Use both hands to perform combination key strokes such as CTRL-K or ALT-F8.
  • Both the monitor and the keyboard should be directly in front of you, not off to the side, forcing you to turn to see them.
  • When using the mouse, try to move it with your hand and arm instead of with your hand and fingers.
  • Don’t let the room get too chilly; cold temperatures contribute to muscle stiffness.
  • Don’t talk on the phone while you’re typing, with the receiver tucked between your shoulder and cheek. Invest in a headset or use the speakerphone function.
  • Take a ten-minute break every hour that you’re on the computer. Stand up and shake out your wrists. Step outside. If you get so immersed in your work or play that you tend to forget, set an alarm clock or watch.

If your teen complains of stiffness and other early signs of repetitive-stress injuries, consider purchasing a voice-recognition program, which allows the user to speak into a microphone and watch in amazement as his words appear on the screen.

Last Updated 11/21/2015



About 2.2 million people swallow or have contact with a poisonous substance each year. More than half of these poison exposures occur in children under six years of age.

Most children who swallow poison are not permanently harmed, particularly if they receive immediate treatment. If you think your child has been poisoned, stay calm and act quickly.

You should suspect poisoning if you ever find your child with an open or empty container of a toxic substance, especially if she is acting strangely. Be alert for these other signs of possible poisoning.

  • Unexplained stains on her clothing
  • Burns on her lips or mouth
  • Unusual drooling, or odd odors on her breath
  • Unexplained nausea or vomiting
  • Abdominal cramps without fever
  • Difficulty in breathing
  • Sudden behavior changes, such as unusual sleepiness, irritability, or jumpiness
  • Convulsions or unconsciousness (only in very serious cases)


Anytime your child has ingested a poison of any kind, you should notify your pediatrician. However, your regional Poison Center will provide the immediate information and guidance you need when you first discover that your child has been poisoned. These centers are staffed twenty-four hours a day with experts who can tell you what to do without delay. Call the national toll-free number for Poison Help Line at 1–800–222–1222 which will provide immediate and free access around the clock to your regional Poison Center. If there’s an emergency and you cannot find the number, dial 911 or Directory Assistance and ask for the Poison Help Line.

The immediate action you need to take will vary with the type of poisoning. The Poison Help Line can give you specific instructions if you know the particular substance your child has swallowed.

Last Updated 11/21/2015

Organ Donation

Organ Donation

By: Claire McCarthy, M.D., FAAP

Did you know that every year more than 1,700 children are saved by organ donation?

And did you know that there are more than 2,000 children waiting for an organ donation?

Organ and tissue donation saves lives—and gives sight to the blind, hearing to the deaf, new faces or new hands to those who have had terrible accidents. It’s a donation that literally changes everything for the recipient; it’s a donation that gives life and hope in the truest way possible.

But there aren’t enough donors. While every day about 79 people of all ages receive an organ donation, every day 22 people die while they wait for one.

Organ donation isn’t always easy to talk and think about—because while some donations (such as bone marrow or kidney donations) come from people who are alive and well, most (such as heart or lung donations) come from someone who is dying. Nobody wants to think about that.

But we all do need to think about it—because there may come a time when the unthinkable happens and a doctor will come and ask us about organ donation. Time is of the essence when answering. That’s why it’s better to think about it and never have to answer the question than to not think about it and waste precious, life-saving time.

Did you know that 8 lives can be saved by one donor?

That’s a lot of lives to save. It doesn’t make the tragedy of losing someone we love any less—but saving lives is a beautiful way to honor our loved one, and let something good come of something unspeakably horrible.

To learn more about organ donation, and register to be an organ donor yourself, visit www.organdonor.gov.

Last Updated4/6/2015


Loss of Consciousness

Loss of Consciousness

Head Injuries

When a child loses consciousness, you need to take the situation very seriously. Although unconsciousness can have sev­eral causes, head injuries are responsible for many cases. Quite often the child will regain consciousness just seconds after a blow to the head, but even so, she should still be examined by a doctor.

While most head injuries are relatively minor, contact your doctor if blood or clear fluid is draining from the ears or nose. Im­mediate examination by your physician is also necessary if your youngster fits any of the following descriptions: She complains of a headache or dizziness; acts agitated, ir­ritable, or incoherent, or exhibits a de­crease in mental alertness; breathes oddly or noisily; has convulsions; has difficulty seeing or walking; looks sweaty and pale; or vomits more than twice or after several hours have passed.

If your child wants to sleep after a minor head injury, your doctor may advise you to let her do so. During the first night, awaken the child every two hours to make sure she can be aroused and recognizes you. Check that her breathing is normal, her color is fine, the pupils of her eyes are of equal size, and she is not vomiting. If she cannot be aroused, or if any of these other signs are present, call 911 immediately.

If the head injury appears to be a serious one, call for emergency help at once. Do not move the child except to prevent addi­tional injury. If she is bleeding severely, apply pressure with gauze or a clean hand­kerchief or towel to stop the flow. Monitor her breathing and pulse until emergency help arrives.


All fainting spells require consultation with your doctor, although brief periods of un­consciousness are usually not serious. Prior to fainting, a child may feel light­headed and nauseated; then she will be­come limp and fall to the floor. These episodes typically take place when there is temporarily an inadequate supply of blood and oxygen to the brain, often related to stress, fear, or overexertion. Hot weather, pain, an empty stomach, or a peculiar odor can also sometimes cause a child to faint.

Generally, fainting spells last for just a minute or less, after which normal blood flow returns and the child regains con­sciousness. Until then, keep your child lying down with her feet slightly ele­vated.

Some fainting episodes require immedi­ate attention. Call 911 if your child remains unconscious for over two minutes, has difficulty breathing, or if she shakes or jerks while unconscious. A weak pulse or shallow breathing requires emergency care.

Last Updated 11/21/2015

Is There ICE in Your Cell Phone?

Is There ICE in Your Cell Phone?

As parents, most of us don’t like to think about the what-ifs when it comes to life-threatening emergencies. But what if the unthinkable happened? How would first responders know who to contact? One of the simplest ways is to ICE your cell phone— and no, we don’t mean putting it in the freezer!

ICE stands for “In Case of Emergency.”

Medical providers, such as paramedics, nurses, and doctors, are increasingly aware of and using ICE to look to notify a person’s emergency contacts and obtain critical medical information when a patient arrives unconscious or unable to answer questions.

Here’s How It Works

  1. Create a new cell phone contact.
  2. In the name line, enter ICE, followed by the first name of your emergency point person (ie, ICE Mark).
  3. Choose someone who knows your medical history and can answer questions about allergies and medications you are currently taking.
  4. Let family members know that you have done this and encourage them to do so as well—especially your own children and teens!

Last Updated 11/21/2015

How to Use an Epinephrine Auto-Injector

How to Use an Epinephrine Auto-Injector


Medical providers can prescribe an epinephrine auto-injector for a child at risk of a severe allergic reaction (anaphylaxis). Epinephrine is a drug that stops the airway from swelling.

Epinephrine in an auto-injector is often marketed as Epi-Pen. Caregivers who are expected to use an auto-injector should be trained by a medical provider at least once a year.

Follow the instructions printed on the package. Here is a summary of the steps:

  1. Take the epinephrine auto-injector out of its package. Do not use the auto-injector if:
    • It is not prescribed for the child
    • It is discolored (yellow vs clear)
    • There are particles in it
    • It is older than the expiration date printed on the side of the box
  2. Remove the safety cap. 
  3. Hold the auto-injector in your fist. The needle comes out of one end, so be careful not to hold your hand over the end.
  4. Push the end with the needle firmly against the side of the child’s thigh, about halfway between the hip and knee. Inject the medicine into the fleshy outer portion of the thigh. Do not inject into a vein or the buttocks.
  5. You can give the injection through clothes or on bare skin.
  6. Hold the auto-injector in place until all the medicine is injected—usually no more than 10 seconds.
  7. Remove the needle by pulling the pen straight out. A protective shield will cover the needle as soon as it is removed from the thigh. Put the injector back into its safety tube. Give it to EMS when they arrive.
  8. Massage the area after the injection.
Last Updated 8/25/2016

How to Stop a Nosebleed

How to Stop a Nosebleed

Even slight damage to the delicate mucous membrane lining of the nose can rupture tiny blood vessels and cause bleeding. Babies rarely have nosebleeds, but toddlers and school-aged children often do. Fortunately, most children outgrow this common but rarely serious event by the time they are teens. A tendency for nosebleeds often runs in the family. Many children have nosebleeds for no apparent reason.

A nosebleed usually comes on suddenly, with blood flowing freely from one nostril. A child who has nosebleeds at night may swallow the blood in his sleep. He will vomit it up or pass it in his stools later. Most nosebleeds stop by themselves within a few minutes. For persistent (won’t go away) bleeding, see Chronic Nosebleeds: What to Do.

Nosebleeds are unlikely to signal serious illness, although bleeding can result from injury. Children may cause bleeding by picking their noses; toddlers often injure the nasal membranes by forcing objects into their nostrils. Children are especially prone to nosebleeds during colds and in the winter months when the mucous membranes become dry, cracked, and crusted or when a chronic condition such as allergic rhinitis (hay fever) damages the membrane.

A child with a chronic illness that causes forceful coughing, such as cystic fibrosis, may have frequent nosebleeds. And parents of children with clotting disorders such as hemophilia or von Willebrand disease, should be vigilant about harmful habits such as nose-picking. If your child’s nosebleeds last for longer than 8 to 10 minutes routinely, your pediatrician may wish to test for a blood clotting disorder.

Call Your Pediatrician Right Away If:

  • Your child is pale, sweaty, or not responding to you.
  • You believe your child has lost a lot of blood.
  • Your child is bleeding from the mouth or vomiting blood or brown material that looks like coffee grounds.
  • Your child’s nose is bleeding after a blow or injury to any part of the head.


Consult your pediatrician before giving your child medicated nose drops or nasal sprays to treat problems that affect the nose and respiratory passages. Although sold over-the-counter for the relief of congestion, some medications may actually increase congestion after a few days’ use. This increased congestion is known as the rebound effect, and can be even more uncomfortable and difficult to treat than the original problem. For a natural nose spray, try using a saline, salt water spray.

Stopping a Nosebleed

  • Stay calm; the nosebleed is probably not serious, and you should try not to upset your child. Your child will pick up on your emotional cues.
  • Keep your child sitting or standing and leaning slightly forward. Don’t let him lie down or lean back because this will allow blood to flow down his throat and might make him vomit.
  • Don’t stuff tissues or another material into the nose to stop the bleeding.
  • Firmly pinch the soft part of your child’s nose—using a cold compress if you have one, otherwise your fingers—and keep the pressure on for a full 10 minutes. Don’t look to see if your child’s nose is bleeding during this time; you may start the flow again.
  • If bleeding hasn’t stopped after 10 minutes, repeat the pressure. If bleeding persists after your second try, call your pediatrician or take your child to the nearest emergency department.

While most nosebleeds are benign and self-limited, a child with severe or recurrent bleeding or bleeding from both nostrils should be evaluated by a pediatrician. If necessary, your child will be referred to a pediatric otolaryngologist  (ENT) specialist.

Last Updated 11/21/2015

Head Injury

Head Injury

Almost all children bump their heads every now and then. While these injuries can be upsetting, most head injuries are minor and do not cause serious problems. In very rare cases, problems can occur after a minor bump on the head. This article helps parents understand the difference between a head injury that needs only a comforting hug and one that requires immediate medical attention.

The information in this article is intended for children who:

  • Were well before the injury
  • Act normally after the injury
  • Have no cuts on the head or face (this is called a closed head injury)
  • Have no other injuries to the body

The information in this article is not intended for children who:

  • Are younger than 2 years
  • Have possible neck injuries
  • Already have nervous system problems, such as seizures or movement disorders
  • Have difficulties or delays in their development
  • Have bleeding disorders or bruise easily
  • Are victims of child abuse

Children with these conditions may have more serious problems after a mild head injury.

What should I do if my child has a head injury but does not lose consciousness?

For anything more than a light bump on the head, you should call your child’s doctor. Your child’s doctor will want to know when and how the injury happened and how your child is feeling.

If your child is alert and responds to you, the head injury is mild and usually no tests or X-rays are needed. Your child may cry from pain or fright, but this should last no longer than 10 minutes. You may need to apply a cold compress for 20 minutes to help the swelling go down and then watch your child closely for a time.

What if there are changes in my child’s condition?

If there are any changes in your child’s condition, call your child’s doctor right away. You may need to bring your child to the doctor’s office or directly to the hospital.

The following are signs of a more serious injury:

  • A constant headache, particularly one that gets worse
  • Slurred speech or confusion
  • Dizziness that does not go away or happens repeatedly
  • Extreme irritability or other abnormal behavior
  • Vomiting more than 2 or 3 times
  • Stumbling or difficulty walking
  • Oozing blood or watery fluid from the nose or ears
  • Difficulty waking up or excessive sleepiness
  • Unequal size of the pupils (the dark center part of the eyes)
  • Double vision or blurry vision
  • Unusual paleness that lasts for more than an hour
  • Convulsions (seizures)
  • Difficulty recognizing familiar people
  • Weakness of arms or legs
  • Persistent ringing in the ears

What if my child loses consciousness?

If your child loses consciousness, call 911. Special tests may need to be done as soon as possible to find out how serious the injury is. If the test results are normal, you will need to watch your child closely for a time. Your child’s doctor will let you know if this can be done at home or in the hospital. If you take your child home and her condition changes, call your child’s doctor right away because more care may be needed.

What should I do if my child needs to be observed at home?

You or another responsible adult should stay with your child for the first 24 hours and be ready to take your child back to the doctor’s office or hospital if there is a problem. Your child may need to be watched carefully for a few days because there could be a delay in signs of a more serious injury.

It is okay for your child to go to sleep. However, your child’s doctor may recommend that you check your child every 2 to 3 hours to make sure he moves normally, wakes enough to recognize you, and responds to you.

If medicine is prescribed, follow the directions carefully. Do not give pain medication, except for acetaminophen, unless your child’s doctor says it is okay. Your child’s doctor will let you know if your child can eat and drink as usual.

If your child gets worse, call 911. Your child’s doctor also may talk with a specialist or admit your child to the hospital for closer observation.

Call your child’s doctor or return to the hospital if your child experiences any of the following:

  • Vomits more than 2 or 3 times
  • Cannot stop crying
  • Has a worsening headache
  • Looks sicker
  • Has a hard time walking, talking, or seeing
  • Is confused or not acting normally
  • Becomes more and more drowsy, or is hard to wake up
  • Seems to have abnormal movements or seizures or any behaviors that worry you

If your child does well through the observation period, there should be no long-lasting problems. Remember, most head injuries are mild. However, be sure to talk with your child’s doctor about any concerns or questions you might have.

Last Updated 11/21/2015

First Aid for a Knocked-Out Permanent Tooth

First Aid for a Knocked-Out Permanent Tooth

  1. Wear medical gloves if available.
  2. Position the child so that bleeding does not cause choking.
  3. Control any bleeding.
  4. Try to find the tooth. If you find the tooth, do not handle it by its roots. If the tooth is dirty, gently rinse it with water. Do not scrub or use antiseptic on the tooth.
  5. Reinsert the tooth if it is a permanent tooth. Do not reinsert a primary tooth.
  6. Gently place the tooth back into the socket in the correct position.
    • Press down on the tooth with your thumb until the crown is level with the adjacent tooth.
    • Have the child bite down on a wad of gauze or cloth to stabilize the tooth until arrival at the dentist.
  7. If you cannot reinsert the tooth, keep the tooth moist by transporting it in milk or the child’s saliva or by wrapping the tooth in a wet cloth. See options below.
  8. The child needs dental care as soon as possible. For the best outcome, the child should see the dentist within 1 hour of the incident.

How to Transport a Knocked-Out Tooth

For the best chance of survival for a tooth that has been knocked out, place the tooth back into the socket while waiting for dental care. If that is not possible, use one of the options below:

Milk Transport

  • Option 1 (Best): Place the tooth in a small plastic bag with some milk. Put the plastic bag in a cup of ice.
  • Option 2: Place the tooth in a cup of cold milk.

Saliva Transport

  • Option 1 (Use only in children older than 12 years): Put the tooth inside the child’s mouth. Caution the child to be careful not to swallow it.
  • Option 2: Put the tooth in a cup. Keep the tooth moist with the child’s saliva (spit).

Wet Cloth Transport

  • If milk and saliva are not available, wrap the tooth in a wet cloth.


If you cannot find a knocked-out tooth, it is still important to have the child see a dentist as soon as possible. The tooth, whether permanent or primary, might be knocked up into the gums.

Last Updated 11/21/2015