​In this ‘Ask the Specialist’ Q&A forum, Dr Ronald Tan, Consultant from the Department of Emergency Medicine at KKH, a member of the SingHealth group, answers your questions on preventing child injuries.

To submit your question, email it to marcom@healthxchange.com.sg

This Q&A forum is open from 1 May to 29 May 2023.

Scroll down to see the questions and answers posted so far for this forum.

When it comes to child injuries, prevention is always better than cure!

The Department of Emergency Medicine at KK Women’s and Children’s Hospital (KKH) sees an estimated 28,700 children presenting with injuries of all severities, in a year. More than half of these injuries occur from falls.

Many of these injuries, whether at home, outdoors, or on the road, are preventable if adequate precautions are taken.

About Dr Ronald Tan

Dr Ronald Tan is a Consultant from the Department of Emergency Medicine, KK Women's and Children's Hospital (KKH). In addition to his clinical work and research activities at KKH where he has interests in child injury prevention and disaster medicine, he is an examiner for the Yong Loo Lin School of Medicine, NUS, Duke-NUS Medical School, and Lee Kong Chian School of Medicine, Nanyang Technological University.

Concurrently, Dr Tan serves as Assistant Commander at the Ministry of Health DSMC (Disaster Site Medical Command), Singapore, and represents KKH in this role.

Dr Tan also chairs the KKH Injury Prevention Working Group, which envisions "A safer Singapore for our future generations" and whose mission is to advance child injury prevention through the 5 Es: Evaluation (surveillance and research), Education, Empowerment, Environmental changes and Enforcement. On behalf of the working group, Dr Tan authored the KKH Child Injury Surveillance Report, with accumulated injury data from 2012-2020. The full report is available here.

Questions and answers on child injuries

1. Question by TK

Hi Dr. Ronald,

My son has turned 9yrs old. He's had a fall as a 15m old toddler on his face which led to some light noise bleeding. Recently, He experienced 7-8 episodes of nose bleeding (in the past 2 weeks) after sneezing. Should I be worried enough to send him in for examination?

Answer by Dr Ronald Tan

Hi TK, thanks for the question!

It’s understandable that you might link back to your son’s previous injury. If the time between this injury and recurrence of nose bleeding is very long (several years in this case), the nose bleeding may be unrelated to the fall experienced as a toddler.

Most nosebleeds in children will resolve with self-care measures: sit up, lean forward, and pinch the lower soft portion of the nostrils together for 5-10 minutes while breathing through the mouth.

You should seek emergency medical care if your child’s nosebleed:

  • Involves massive bleeding or makes breathing difficult

  • Causes your child to become pale, fatigued and disorientated

  • Will not stop even with the self-care measures outlined above

  • Occurs after an injury, such as after being hit on the face or nose

  • Will not stop and your child has other areas of bleeding or multiple bruises over his body.

If your child has more than 4 to 5 episodes of nose bleeding in a month, I would suggest you seek review with a paediatric ear, nose and throat (ENT) specialist, for which you can visit your nearest polyclinic to obtain a referral.

More information on nosebleeds in children can be found here.

2. Question by Jeff

Hi Dr Tan,

What would you recommend are ways parents can take to avoid their child from getting into accidents? What can be done to safeguard the home and what can be done when outside the home? How about for when the parents aren’t around?

Answer by Dr Ronald Tan

Hi Jeff, thanks for the question!

The best way to prevent accidents is parental supervision. Here are some safety tips for the home and outdoors.

a) Fall prevention

* Properly install window grilles to prevent window falls.

b) Water safety

* Actively supervise your child in and around water. Avoid distractions such as reading or mobile phones.

c) Burns and scalds prevention

* Keep hot foods/liquids away from the edge of tables.

d) Car safety

* Use an age-appropriate booster / child car seat.

More detailed information on home safety tips for children can be found here.

This infographic here provides guidelines for age-appropriate car seats for children.

3. Question by Jasmine

Hi Dr,

When an injury happens to a child, what should parents take note of when deciding whether to send their child to the A&E, to the GP or just self-medicate at home?

Answer by Dr Ronald Tan

Hi Jasmine, thanks for the question!

You can go to your GP for minor injuries such as:

  • Shallow cuts or abrasions,

  • Bruises,

  • Sprains and

  • Muscle strains

The Children's Emergency attends to children with significant injuries like lacerations requiring wound repair, fractures, head injuries, accidental ingestions or poisoning, burns, near drowning, and major or multiple trauma such as those caused by road traffic accidents.

The KKH Urgent Paediatric Advice Line (U-PAL) is an online service for parents and caregivers to seek advice for common paediatric conditions including injuries.

Note: In the event of an emergency, please call 995 for the SCDF ambulance.

4. Question by Liz

Hi Dr,

As a parent, what is the best way I can go about educating my child on how to avoid danger and injuries, given that I can’t guarding my child at all times? Do you have advice on how do I broach the topic without me sounding like I’m nagging (am trying to make a conscious effort to cut down on nagging). Thanks.

Answer by Dr Ronald Tan

Hi Liz, thanks for the question!

I would suggest to start good safety habits from young, so that these become part of your child’s routine. For instance, putting your child in a child car seat for every car ride from birth makes it easier for the child to get used to being in a child car seat consistently. At home, you can show and teach your child about the hazards around the house, such as hot food cooking in the kitchen. However, it is best for young children to avoid being in the kitchen in the first place.

More resources can be found here.

Ref: I23