Tele-triage for Bruising in Children

Audience: pediatric

Bruising in children is common and often results from minor bumps or falls. Most bruises heal on their own without treatment. Telemedicine can help caregivers understand when bruising is normal and when it might need further medical evaluation. During a tele-triage visit, healthcare providers ask about the bruise's size, location, and any other symptoms your child may have. They also check for signs of more serious conditions, such as bleeding disorders or injuries. This guide helps families decide when telemedicine is suitable for bruising concerns and when to seek in-person care for your child’s safety and health.

Red flags — go in person / ER

• Bruising without any known injury or cause — seek in-person medical evaluation promptly.
• Large, painful, or rapidly spreading bruises, especially if accompanied by swelling — get urgent medical care.
• Bruising along with other symptoms like bleeding from gums or nose, fever, weakness, or unusual behavior — seek emergency care immediately.

What telemedicine can do

• Initial assessment of bruising with clear cause.
• Guidance on home care for minor bruises.
• Monitoring bruises that are healing normally.
• Answering questions about bruising and when to seek care.

What telemedicine cannot do

• Evaluation of bruises with unknown cause or sudden onset.
• Assessment of bruises with signs of serious bleeding or infection.
• Physical examination needed to rule out fractures or internal injury.
• Emergency situations with severe symptoms or rapid deterioration.

What Causes Bruising in Children?

Children bruise easily because their skin is delicate and their blood vessels are close to the surface. Common causes include minor falls, bumps during play, or accidental knocks. Bruises usually appear as purple or blue marks that change color as they heal. Sometimes, bruising can be caused by medical conditions that affect blood clotting or by medications.

When to Use Telemedicine for Bruising

Telemedicine is helpful for initial assessment of bruising when the cause is clear and the child is otherwise well. A healthcare provider can review photos or video of the bruise, ask about recent activities, and check for other symptoms. This can help determine if home care is appropriate or if further testing is needed.

Signs That Need In-Person Care

Some bruises need urgent medical attention. These include bruises that appear without a clear cause, bruises that are very large or painful, bruising with swelling, bruises accompanied by bleeding from other sites (like gums or nose), or if your child shows signs of weakness, fever, or unusual behavior. In these cases, an in-person visit is important for proper evaluation.

How to Care for Bruises at Home

Most bruises heal on their own. You can help by applying a cold compress for 15-20 minutes to reduce swelling. Keep the bruised area elevated if possible. Avoid massaging the bruise, as this can worsen it. Monitor the bruise for changes and watch for any new symptoms.

Preparing for a Telemedicine Visit

Before your tele-visit, gather information about when and how the bruise appeared. Take clear photos of the bruise from different angles and note any other symptoms your child has. Have a list of any medications your child is taking. Ensure you have a quiet, well-lit space for the call.

How to prepare for your tele-visit

• Note when and how the bruise appeared.
• Take clear photos of the bruise from multiple angles.
• List any other symptoms your child has.
• Gather information on any medications your child is taking.
• Find a quiet, well-lit place for the telemedicine visit.

After your tele-visit

• Follow the healthcare provider’s advice on home care.
• Monitor the bruise for changes in size, color, or pain.
• Watch for any new symptoms such as fever or unusual behavior.
• Schedule in-person follow-up if advised or if symptoms worsen.
• Keep a record of bruising episodes if recurrent or unexplained.

FAQs

Can telemedicine diagnose serious conditions causing bruising?

Telemedicine can help identify signs that suggest a serious condition, but it cannot replace a full physical exam or diagnostic tests. If serious issues are suspected, an in-person visit is necessary.

How long does a typical bruise take to heal in children?

Most bruises heal within 1 to 2 weeks. The color changes from purple or blue to green, yellow, and then fades away. If a bruise lasts longer or worsens, consult a healthcare provider.

Is it normal for children to bruise easily?

Yes, children often bruise more easily than adults due to their active play and delicate skin. However, frequent unexplained bruising should be evaluated by a healthcare professional.

What should I do if my child has a bruise and a fever?

A fever with bruising may indicate an infection or other serious condition. Seek in-person medical care promptly.

Can medications cause bruising in children?

Some medications, like blood thinners or steroids, can increase bruising. Inform your healthcare provider about all medications your child is taking during the tele-visit.

Sources

1. Bruises in Children — MedlinePlus | U.S. National Library of Medicine / National Institutes of Health.
2. Childhood Bruises and Bleeding Disorders — American Academy of Pediatrics.
3. Telemedicine: What You Need to Know — Centers for Disease Control and Prevention (CDC).
4. Bruising in Children: When to Worry — Mayo Clinic.

This telemedicine guidance is for educational and triage purposes only. It is not a substitute for in-person medical evaluation, diagnosis, or treatment. If your child’s symptoms worsen or if you have any concerns, seek immediate medical care.