Lacerations: treat at home, urgent care, or ER?

I have teamed up with Natalie Wescott, an ER RN, to discuss the top 3 reasons she sees kids in the Emergency Room. We’ll also discuss how to support and treat these issues at home, and when to seek a higher level of care. Natalie brings a very unique perspective, as she is holistic minded but works in the field of modern medicine. This is great, because there is a time and a place for both!

The top 3 reasons Natalie has seen kids in the ER:

• Respiratory Distress

• Fevers

• Lacerations

When to Go to Urgent Care

Usually pediatricians do not have the capability to stitch, but they can remove stitches 

• Deep or exposed underlying tissue

  • Deep wounds or wounds with fat exposure

Edges won’t stay closed

• It gapes open even when pinched 

Longer than 1 inch

• This one is case dependent - some lacerations are long, but able to close evenly with just steristrips

On High-Movement Areas

• Joints (knees, elbows, fingers) where movement may reopen the wound

Continues to Bleed

• Bleeding doesn’t stop after 10 minutes of firm pressure

Facial or Cosmetic Concerns

• Wounds on the face, lips, or near the eyes often require stitching for best cosmetic outcome

• Deep wound with muscle or bone exposure

When to Go to the ER

Arterial bleeding

• Spurting heavy, bright red blood

Deep wound with muscle or bone exposure

• Risk of bone infection if not properly treated

How to Treat Lacerations at Home

Clean with warm water and a mild soap immediately. It’s important to remove dirt, debris, and bacteria to prevent infection as the wound heals

No hydrogen peroxide - this damages healthy tissue and can prolong healing.

No neosporin or antibiotic ointment - this kills good bacteria on the skin’s microbiome 

Use butterfly closures or steristrips to hold edges together.

Wounds caused by human or animal bites need to be thoroughly cleaned. Mouths are extremely dirty and bites are high risks of infection. 

Signs of Infection

• fever

• redness around wound

• redness streaking up arm

• pus-like drainage

• warmth around wound

If the wound shows signs of infection, a doctor will want to start antibiotics. It’s important to prevent infection with proper wound cleansing and care so antibiotics are not needed. 

If Antibiotics are Needed

Florastor is a probiotic that is proven to be resistant to most common antibiotics and can be taken during the full course of an antibiotic.

• florastor baby

• florastor kids

• florastor adults

If taking an antibiotic, also consider taking scutellaria supreme and an antifungal to help mitigate yeast overgrowth.

Click below to view next:

• Respiratory Distress

• Fevers