By Lauren Brave, M.D.

As much as we try to keep our children safe, injuries can't always be avoided. Children fall down and have other accidents during their daily activities that result in cuts, scrapes and bruises. As parents, we cringe when it happens and we worry about whether or not we should take our children to an urgent care center or emergency room. We don’t want to take any chances, but we also don't want to overreact.

According to the National Center for Injury Prevention and Control, more than 200,000 children are treated in emergency departments for playground injuries each year. Forty percent of these children come in with a cut or scrape. In addition, the National Safety Council reports that a dog bites a person every 40 seconds – and many of these victims are children.

When a child receives a minor injury, such as a cut, scrape or bite, parents or caregivers need to determine if the child needs medical attention.

Regardless of depth or severity, most wounds bleed. Areas of the body that receive a large amount of blood flow, including the face and scalp, often bleed profusely. It’s important to remain calm and apply pressure to the wound. Even if a child appears to be losing a lot of blood, injuries are usually minor. A superficial cut will stop bleeding within five to 10 minutes. These types of injuries don’t require stitches, and they generally heal with minimal scarring.

If the wound is deep, however, and direct pressure does not stop the bleeding within a few minutes, you should immediately take the child to the nearest emergency department.

Because the most common complication is infection, it's important to wash any cut or scrape thoroughly with soap and water. Keep the wound dry for the next 24 hours to help it heal. It’s unnecessary to use bandages and antibiotic ointments – there’s no proof they prevent infection. Signs of infection include a spreading redness on the skin, any cloudy or thick drainage from the wound and pain at the wound site. If any of these symptoms are present, seek immediate medical attention.

Severe cuts may require simple stitches or gluing. If the wound pulls apart at all, it probably requires stitches. Stitches minimize the potential scar by bringing the skin back together. A nonstitched wound may have a wide scar, while a stitched wound may have a very thin, even barely visible scar.

Because the healing process begins immediately after a cut occurs, it's important to take a child to the doctor within six hours of the injury if you think stitches might be required.

Scar formation can continue for six to nine months after the injury. No medication or ointment is proven to minimize scar formation. It can help to apply daily sunscreen, preferably SPF 30+, because scars retain pigment from tanning differently from the normal surrounding skin.

If your child suffers puncture wounds or an animal bite, immediately clean the wound with soap and water and take the child to the doctor. Deep punctures or bites are much more likely to become seriously infected by bacteria.

Children are bound to get injuries from time to time. By following these basic guidelines, you can help protect your child from infection and get the appropriate level of medical care.

Dr. Brave is a pediatrician at PAMF's Pediatric Urgent Care in Palo Alto.