From the Guidelines
Bruising in children should be evaluated for potential child abuse, and a thorough medical history, physical examination, and laboratory tests should be conducted to rule out bleeding disorders, as recommended by the American Academy of Pediatrics 1. When evaluating bruising in children, it is essential to consider the possibility of child abuse, as well as underlying medical conditions that may contribute to easy bruising or bleeding. The American Academy of Pediatrics recommends a comprehensive approach to evaluating bruising in children, including a thorough medical history, physical examination, and laboratory tests to rule out bleeding disorders 1.
Key Considerations
- A thorough medical history should be taken to assess for any symptoms suggestive of a bleeding disorder, such as significant bleeding after a circumcision or other surgery, epistaxis, bleeding from the umbilical stump, or excessive bleeding after dental procedures 1.
- A physical examination should be performed to assess the location and pattern of bruising, as well as any other signs of trauma or abuse 1.
- Laboratory tests, such as prothrombin time (PT) and activated partial thromboplastin time (aPTT), should be conducted to rule out bleeding disorders, such as coagulation factor deficiencies or platelet disorders 1.
- The possibility of other medical causes of easy bruising or bleeding, such as Ehlers-Danlos syndrome, scurvy, cancer, and other infiltrative disorders, should be assessed 1.
Management
- For minor bruises, the RICE protocol (Rest, Ice, Compression, and Elevation) should be followed, and over-the-counter pain relievers like acetaminophen (Tylenol) may be used to manage pain [@Example@].
- Topical arnica gel may be applied 3-4 times daily to reduce bruising, although evidence is limited [@Example@].
- Medical attention should be sought if bruises occur frequently without injury, are extremely large or painful, don't improve within two weeks, or occur with medications like blood thinners [@Example@].
Conclusion is not allowed, so the response will be ended here.
From the Research
Bruising Treatment and Management
- Bruising, also known as ecchymosis, can be mitigated by certain treatments, including arnica and bromelain, as suggested by studies 2.
- Arnica has been shown to have a positive effect on reducing ecchymosis, particularly after rhinoplasty and facelifts/facial procedures 2.
- Bromelain, on the other hand, has been found to reduce swelling and pain, especially after molar extractions 2.
Soft Tissue Injuries and Bruising
- Soft tissue injuries, which can cause bruising, can be treated using the PRICE method (protection, rest, ice, compression, and elevation) 3, 4.
- The PRICE method is used to reduce complications, alleviate pain, and restore normal limb function after soft tissue injuries 3.
- However, there is limited evidence to support the effectiveness of the PRICE method for acute ankle sprains in adults 4.
Natural Anti-Inflammatory Compounds
- Bromelain, a natural anti-inflammatory compound, has been found to reduce inflammation by modulating the production of proinflammatory cytokines 5.
- Arnica, another natural compound, has anti-inflammatory and antioxidant properties, which may contribute to its potential in reducing bruising and swelling 6, 2.