Red Flags & When to Go In Person for Bruising in Children

Audience: pediatric

Bruising in children is common and often harmless, usually caused by minor bumps or falls. However, some bruises may signal a more serious problem that needs in-person medical evaluation. Telemedicine can help assess many bruising cases by reviewing symptoms, history, and photos. It is important to watch for red flags such as bruises without injury, bruises that appear suddenly and spread, or bruises accompanied by other symptoms like bleeding or pain. When these signs occur, prompt in-person care is recommended. This guide helps parents and caregivers understand when telemedicine is appropriate for bruising and when to seek urgent medical attention, ensuring children receive timely and safe care.

Red flags — go in person / ER

• Bruises appearing without any known injury or trauma — seek prompt medical evaluation.
• Bruises accompanied by unusual bleeding (e.g., gums, nose) or signs of infection (fever, redness) — go to emergency care.
• Large, painful, rapidly spreading bruises or bruises in unusual locations (torso, back, face) — seek urgent in-person assessment.

What telemedicine can do

• Assessment of bruises with known minor injury and no other concerning symptoms.
• Review of photos and history to determine if bruising appears typical or mild.
• Providing guidance on home care and monitoring for bruising.

What telemedicine cannot do

• Evaluation of bruises with red flags such as unexplained bleeding or infection signs.
• Urgent assessment when bruising is associated with other serious symptoms like weakness or rapid spread.
• Performing physical exams, blood tests, or emergency interventions.

What Causes Bruising in Children?

Bruises happen when small blood vessels under the skin break, usually from a bump or fall. Children often get bruises during play or minor accidents. Most bruises are harmless and heal on their own within days to weeks. Some children bruise more easily due to sensitive skin or certain medications. Understanding the cause helps decide if medical care is needed.

When Telemedicine Can Help

Telemedicine allows healthcare providers to assess bruising by asking about how the bruise appeared, reviewing photos, and discussing other symptoms. It can help determine if the bruise is likely from a minor injury or if further evaluation is needed. Telemedicine is useful for routine follow-up or when bruising is mild and without concerning signs.

Red Flags That Need In-Person Care

Certain signs with bruising require prompt in-person evaluation:

If any of these occur, seek medical care immediately.

How to Prepare for a Telemedicine Visit About Bruising

Before your telemedicine appointment, gather the following:

Having this information ready helps the provider make a better assessment.

After the Telemedicine Visit

Follow the healthcare provider’s advice carefully. This may include monitoring the bruises, watching for new symptoms, or scheduling an in-person visit if needed. Keep a record of any changes and seek urgent care if red flags develop. If prescribed, follow instructions for medications or tests. Always ask questions if you are unsure about the care plan.

How to prepare for your tele-visit

• Take clear photos of the bruises from multiple angles.
• Note when and how each bruise appeared.
• List any medications your child is taking.
• Record any other symptoms such as pain, fever, or bleeding.
• Have your child’s medical history available, especially any bleeding or clotting disorders.

After your tele-visit

• Follow the healthcare provider’s instructions carefully.
• Monitor bruises for changes in size, color, or pain.
• Watch for new symptoms like bleeding, fever, or spreading bruises.
• Schedule an in-person visit if advised or if red flags develop.
• Keep a record of bruising and symptoms for future reference.

FAQs

Can telemedicine diagnose the cause of my child's bruising?

Telemedicine can help assess bruising by reviewing history and photos, but it cannot replace physical exams or tests needed for a definitive diagnosis. If red flags are present, an in-person visit is necessary.

When should I be worried about bruising in my child?

Be concerned if bruises appear without injury, are large or painful, spread quickly, or come with bleeding, fever, or other symptoms. These require prompt medical evaluation.

How can I help prevent bruising in my child?

Supervise play to reduce injury risk, ensure safe environments, and maintain good nutrition. If your child bruises easily, discuss with a healthcare provider for further advice.

Is it safe to use telemedicine for bruising in children?

Yes, telemedicine is safe for initial assessment of mild bruising without red flags. It allows quick access to advice but does not replace in-person care when serious signs are present.

Sources

1. Bruises in Children — MedlinePlus, U.S. National Library of Medicine.
2. Bruising in Children: When to Worry — American Academy of Pediatrics.
3. Assessment of Bruising and Bleeding Disorders — Mayo Clinic.
4. When to Seek Emergency Care for Bruising — Centers for Disease Control and Prevention (CDC).

This telemedicine guidance is for educational and triage purposes only and is not a substitute for in-person medical care. If your child has any red flags or if you are concerned about their health, please seek prompt evaluation by a healthcare professional in person.