Rinse the wound under lukewarm running tap water until all the grit is gone, wash around it with soap, stop the bleeding with pressure for ten to fifteen minutes and put on a plaster. That is enough for almost all grazes and small cuts. Seek care if the wound gapes, is deep, is on the face, will not stop bleeding, is a bite, or has dirt left in it that you cannot get out. Call 112 for bleeding that cannot be stopped.
Wednesday afternoon in a courtyard in Sundbyberg. The six-year-old has taken the scooter down the little slope, it went fast, and now he is sitting on the ground with both knees full of grit and blood running down into his socks. It looks worse than it is, because knees bleed, and rinsing it will hurt more than the fall did. Here is how to do it properly, in what order, and which wounds are too big for the kitchen table.
Grazes: step by step
- Wash your own hands first, or use hand sanitiser.
- Rinse under running tap water, lukewarm, for several minutes. This is the most important step and the one your child will protest most about. The shower head works well on knees. No alcohol, no hydrogen peroxide; it stings and damages the tissue.
- Remove any grit that is still in there with a clean compress, a soft toothbrush or tweezers. Grit that is left behind heals in and leaves blue-black dots that stay.
- Wash around the wound with soap and water, not in it.
- Dry by pressing gently with a clean towel or compress.
- A plaster or dressing that will not stick to the wound. Change it every day and whenever it gets wet.
- Look every day when you change it: is the redness shrinking, or spreading?
Cuts and bleeding
Blood looks like much more than it is, especially from the head, the fingers and the tongue. Press a clean compress or towel directly onto the wound for ten to fifteen minutes without lifting it to look. Keep the injured part raised. That stops almost all bleeding in children. If you lift the compress after two minutes to check, it starts again, and you lose count.
Once it has stopped bleeding: rinse, look at the depth and at whether the edges sit together. A shallow cut with edges that meet is held together with wound closure strips or a plaster that pulls the edges together, for a few days. If the wound gapes, it needs to be seen. Go quickly, ideally within six to eight hours, because after that wounds are stitched less often because of the risk of infection.
At home or to the doctor?
| Type of wound | At home | To the doctor |
|---|---|---|
| Graze | Shallow, can be cleaned | Large, deep, grit left in, or on the face |
| Cut | Short, edges meet, stops bleeding within fifteen minutes | Gapes, longer than a couple of centimetres, fat or bone visible, keeps bleeding |
| Wound on the face | A very small graze | All cuts, for the sake of the scar |
| Puncture wound | A shallow splinter that can be removed with tweezers | Deep splinter, piece of glass, nail, rusty or dirty object, a wound on the foot through the shoe |
| Bite | None, all bites should be assessed | Dog, cat, human, even small ones |
| Wound with dirt | Can be rinsed clean | Soil, grit or tarmac that stays in |
| Signs of infection | Slight redness right at the edge that is shrinking | Redness that spreads, pus, a red streak, fever |
Call 112 if
- The bleeding cannot be stopped with pressure, or pulses
- The wound is large and deep, or on the neck, chest or stomach
- Something is stuck deep in the wound: do not remove it, hold it steady
- A body part, such as a fingertip, has been cut off: put it in a clean bag, the bag in cold water, and bring it with you
- Your child is pale, drowsy or in a cold sweat
- Your child has fallen onto something sharp and complains of stomach or chest pain, even without a visible wound
Tetanus, bites and splinters
Tetanus is part of the childhood vaccination programme, and a child who has followed it is protected. If you are unsure about the vaccinations and the wound is dirty with soil, call 1177. Bites from dogs, cats or humans should always be assessed by a doctor, even when they are small, because the risk of infection is high and cat bites are the worst: rinse for a long time, wash with soap, seek care the same day. Splinters and pieces of glass that are visible and sit near the surface you remove with tweezers after washing. If they are deep, or it will not work: the doctor. A wound on the sole of the foot through a shoe is a category of its own, because the dirt is pushed in deep.
Healing, scars and sun
A graze heals in one to two weeks; a cut that has been stitched takes one to two weeks before the stitches come out, depending on where it is. Keep the wound clean and covered until it has closed, do not let your child pick at the scab, and cut their nails. Newly healed skin is pink and sensitive for months, and it burns easily: cover the scar or use sunscreen for a year if it is somewhere visible. Itching is a sign of healing; moisturiser helps. More on burns, which are treated differently, in Burns in children.
How we do it with our families
Every nanny with us carries a small wound kit: compresses, plasters in different sizes, wound closure strips, tweezers and a bottle of water that is enough to rinse with when the tap is far away. Nike was looking after a five-year-old in Enskede who fell off his bike at the playground one Tuesday. She rinsed the knees with the water bottle straight away, put on a loose plaster, and then did it all again properly in the shower at home, with a story playing to get it done. The note said where the wounds were, that the grit was out and that the plasters needed changing the next morning. That is the kind of information that means the parents do not have to guess.
This text is general information and does not replace advice from BVC (the child health clinic every family is enrolled in), your vårdcentral (local health centre) or 1177. If you are worried about your child, call 1177. In an emergency, call 112.
Would you like a nanny who knows your child, knows what is normal for them and notices when something is different? Book a free first meeting with the nanny in your home.
Read more: Burns in children · Child hit their head · Wasp and bee stings in children · Paediatric CPR
Frequently asked questions
Should the wound have a plaster or air?
A plaster or dressing for the first few days. A wound that is kept clean and slightly moist heals faster and with less scarring than one that dries into a scab. Change the plaster every day and whenever it gets wet or dirty. After a few days, when the wound is dry and closed, it can go without.
How do we know if the wound needs stitches?
If the edges gape when you are not holding them together, if the wound is longer than a couple of centimetres, deep enough that fat or something white is visible, on the face or over a joint, or keeps bleeding after fifteen minutes of pressure. Seek care the same day, ideally within six to eight hours, because after that the risk of infection increases.
Is a tetanus shot needed?
Children who have followed the vaccination programme are protected against tetanus, with doses in infancy, at five and in the later school years. If your child is not fully vaccinated and the wound is dirty with soil or grit, call 1177. The vårdcentral will assess whether an extra dose is needed, and it should be given the same day.
What does an infected wound look like?
Redness spreading around the wound, increasing swelling and warmth, throbbing pain after it has started to heal, pus, a bad smell or a red streak running from the wound. Fever together with any of these is a reason to seek care the same day. Most wounds in children do not get infected if they have been rinsed properly.
What do we do about a dog bite or cat bite?
Rinse thoroughly under running water for several minutes, wash with soap and seek care the same day, even if the bite looks small. Bites from animals and humans often become infected, and cat bites are the worst. If the bite is on the face or hand, or your child is small, call 1177 straight away.