Ask Dr. Marla – When a cut needs an ER visit

Question

My child recently cut his hand and it was bleeding a lot. After several hours I got it to stop bleeding. We did end up going to the doctor’s the next day to make sure it was OK and it was, but she said it could have probably used a stitch or two. How do you know when to go to the hospital with a cut?

Answer

It is often difficult to know when to go to the hospital. In this case I think the length of time that it took to stop the bleeding – several hours – was a clue that it might be prudent to go to the emergency room. While there are no specific guidelines and we often rely on personal judgment, cuts that are deep or bleeding heavily may require stitches. I usually advise parents to apply pressure to the area. Use a clean cloth and compress the area for several minutes. If that doesn’t stop the bleeding you can try applying pressure for a longer period of time but if, after five minutes or so, there is still profuse bleeding, I think it is prudent to seek medical attention.

In this case the cut was a hand and despite the fact your doctor suggested a stitch might have been helpful, it will heal likely with a small scar. Cuts to the face or near the eye should be seen by a health care provider. 

If the cut is very painful, or it happened with a rusty object, or you are concerned there is dirt, gravel or a foreign object embedded, these are all good reasons to have the cut evaluated.

According to SickKids Hospital in Toronto, a cut or laceration warrants a visit to the emergency room when any of the following conditions exist: 

• You cannot stop the bleeding;
• The cut seems very deep or keeps opening;
• The edges of the cut are jagged or are far apart from each other;
• Your child has been bitten by an animal or another child;
• Your child has a puncture wound;
• You cannot clean the injury properly;
• You are concerned there may be a deeper injury such as a broken bone or possible tendon injury;
• Your child is not using the affected hand, arm, or leg;
• The injury involves sensitive areas like the eyes, face, or genital/anal area;
• Your child’s pain is not easily managed;
• Your child is not immunized or has not had a tetanus immunization within the last five years;
• You see signs of infection while the wound is healing, such as redness, pain, pus, fever or red streaks.

Dr. Marla Shapiro is a medical doctor, author, broadcaster, lecturer and parent.

Originally published in ParentsCanada magazine, May 2014.