Does this Cut Need Stitches

A child’s blood is something no parent wants to see – but they’re likely to see more of it in summer, when injuries are more common. Desiree Thomas, RN, MSN, is program director of the trauma center at Miller Children’s & Women’s Hospital Long Beach. She’s also an instructor for Stop the Bleed (bleedingcontrol.org), an international campaign that offers free, one-hour courses to train parents, teachers and community members how to stop life-threatening bleeding. She offers some advice about treating kids’ cuts. 

How do parents know whether to get medical attention for a cut? 

If there’s blood spurting out of the wound, pooling on the ground, the clothes are soaked in blood or if you’ve put gauze on it and that gauze is soaked with blood – or if the person is bleeding and suddenly becomes unconscious – those are emergencies. Call 911. 

For smaller wounds, if it looks like a decent-size injury, and if you put a bandage on it and the skin is still going to be open, then that needs medical attention. 

If a parent is concerned, if they have an advice or nurse line through their insurance company, I recommend that. And if they don’t, I’d recommend that they take the child to an urgent-care facility. 

Bleeding isn’t always an indication of how severe a cut is, or whether it needs stitches, right? 

Correct. A child might need stitches not because the bleeding is extreme, but because the skin isn’t going to easily come back together and it would cause scarring. Let’s say a kiddo gets a cut on the face. Facial wounds have a tendency to bleed, but you wouldn’t want your child to have a scar, so you’d want that to get medically attended to.  

Cuts on the hands are also cause for concern. There are so many little nerves and tendons in the hands that it can look minor, but you can have cuts into that tendon or that nerve, and you want to get that treated.  

If a child comes to you with a cut, what are the first things you should do? 

If there’s any clothing around it, remove it so you can see the whole area. I recommend washing your hands or using hand sanitizer, because you don’t want to contaminate the wound more or cause an infection. If it’s actively bleeding, apply pressure. If you have gauze handy, that’s great. If you don’t, you can use a paper towel, you can use a clean cloth. Try to stop that bleeding just by applying direct pressure.  

 

If it’s a deep wound, we recommend that you call 911, pack that wound with a clean cloth or a shirt, then hold that direct pressure until medical responders arrive. If it’s a smaller cut, once that bleeding has stopped, clean it with water or hydrogen peroxide. If you are concerned about the size of it or the location of it, then call your nurse advice line or go to the urgent care. 

How soon after the injury should cuts receive medical attention?  

For non-emergency cuts, go within an hour or two, because anything over 24 hours, they can’t really stitch up. Even if we did a good job of cleaning it out, there’s a higher likelihood of an infection developing.