1) Introduction to First Aid for Children
The Principles of first aid are the same whether it is a child or an adult being treated. That is to preserve life, prevent deterioration and to promote recovery. A child in first aid terms is aged from 1 to adolescence.
When to get help with children
Always seek help when you are concerned for a child’s health. This may be from your GP, casualty department or by calling the Emergency Medical Services (EMS).
How to call the Emergency Services
Dial 999/112. State clearly the service you require. The operator will ask you a series of questions so the most appropriate help can be sent as quickly as possible. You will usually need to give your name, location, number and age of casualties, the injury or likely illness. The operator may stay on the phone to get either further information from you or to give you further first aid instructions do not put down the phone until the operator instructs you to do so.
Essential Information about first aid for Children
It is essential that you know the following information for the children in your care, that is:
- The parent’s or guardian’s current contact number.
- Any illness or diseases the child has such as asthma.
- Any medication the parent has given that day prior to you taking responsibility for the child.
Children need a calm reassuring person to look after them when they are ill. Try to get to their eye level and give clear simple instructions and explanations.
2) First Aid for choking children
Choking occurs when an object becomes lodged in the windpipe. This could lead to the brain being starved of oxygen.
- Child clutching their throat.
- Unable to breathe/cough.
- Noisy breathing.
- Unusual exaggerated movement of the chest, especially around the collar bone.
- Unable to speak.
- Decreasing levels of consciousness.
- Encourage the child to cough.
- If this is ineffective reassure the child and lean them forward.
- Give up to 5 back blows between the shoulder blades.
- Check mouth between each back blow to see if object has been dislodged.
- Perform up to 5 abdominal thrusts. Place your fist between the navel and the bottom of the breastbone. Grasp it with your other hand and pull sharply inwards and upwards up to 5 times.
- Alternate between 5 back slaps and 5 abdominal thrusts until the object is cleared.
ADAPTATIONS FOR A CHILD UNDER 1
To perform back slaps, lay the baby down on your forearm.
If back slaps do not work use chest thrusts. To do this place 2 fingers on the breastbone and give up to 5 sharp chest thrusts.
Abdominal thrusts must not be used on a child under 1 year.
It is essential that any child who has received chest or abdominal thrusts receive urgent medical attention.
This is where the brain’s activity is interrupted. There are several causes of unconsciousness such as a head injury, low blood oxygen, poisoning, seizures and illness.
- Follow the actions from danger to breathing in the resuscitation section.
- Examine the casualty quickly from head to toe to identify any serious injuries.
- Place the casualty in the recovery position.
- Seek urgent medical assistance for all children who have been unconscious.
- Monitor the level of consciousness by checking the AVPU scale.
- Monitor the casualty’s pulse, respiration rate and conscious level continuously, until medical assistance is available.
- Be prepared to take further action should the casualty stop breathing.
4) Recovery Position
The recovery position is used when a casualty is unconscious and breathing. The recovery position allows the head to be placed tilted back and down. This stops the tongue from blocking the airway and will allow any vomit and fluid to drain from the mouth.
UNDER 1 YEAR OLD (INFANT)
Tilt the baby’s head downwards whilst cradling him in your arms, ensuring that the airway is open.
AGE 1 YEAR TO PUBERTY (CHILD)
Same as an adult.
The European Resuscitation Council recommends:
- The casualty is on their side.
- The head tilts downwards to allow fluid and vomit to drain.
- There is no pressure on the chest that restricts breathing.
- The casualty should be able to be turned easily and safely on to their back.
- Good observation and access to the airway.
- Should not cause further injury.
Check for any DANGER such as water, fire or fumes.
Check for RESPONSE. To do this, tap the shoulders of the casualty and shout into both ears. Take care not to shake a baby as this could course serious injury.
SHOUT for help (if not already done to summon assistance).
Open the child’s AIRWAY to stop the tongue obstructing the throat. Lift the chin and tilt the head back. Be careful not to over extend the neck.
Check for BREATHING. Place your ear near to their mouth and nose. Look, listen and feel for breath for up to 10 seconds.
- If breathing is present place in the recovery position.
If breathing is absent perform CPR (CARDIO PULMONARY RESUSCITATION)
If you are on your own, perform 1 minute of CPR. before going for help.
The following modifications as recommended by the resuscitation council (uk) and will
make it more suitable for use in children:
- Give 5 initial rescue breaths before starting chest compressions.
- The use of a Face Shield is advisable at this point.
- If you are on your own, perform 1 minute of CPR before going for help.
TO COMMENCE CPR
- Ensure the casualty is on a firm, flat surface.
- Place your hands one top of the other in the centre of the casualty’s chest.
- Compress the chest approximately one third of the chest depth. Compress 30 times at a rate of 100 compressions per minute using 1 or 2 hands to achieve adequate depth of compression. (2 fingers to be used on an infant).
- The compressions and releases should take an equal amount of time.
- After 30 compressions, open the airway again using head tilt/chin lift.
- Seal the nostrils with your thumb and forefinger.
- Blow steadily into the mouth until you see the chest rise.
- Remove your mouth to the side and inhale some fresh air. When breathing for the casualty, take about a second to make the chest rise.
- Repeat so you have given 2 effective rescue breaths in total.
- Return your hand(s) to the correct position on the chest and give a further 30 chest compressions.
CONTINUE WITH CPR UNTIL:
- The casualty shows signs of recovery.
- Emergency services arrive.
- You become exhausted and unable to continue.
Children often have a raised temperature as a reaction to an illness. In small children this can lead to febrile convulsions (seizures).
RECOGNISING A FEVER
- Hot flushed skin
- Crying / irritable
- Feeling hot alternating with shivering
COOLING A CHILD
- Place in cool surroundings
- Remove excess clothing
- Encourage drinking sips of cool fluids to help prevent dehydration.
- Sponge the skin with tepid water
- Give recommended medication to reduce fever (see below)
- Seek medical help if the temperature does not return to normal, or if you are concerned.
- All or some of the above symptoms.
- High pitched scream.
- Dislike of being handled.
- Septicemia or blood poisoning is seen as a rash or bruising that does not go away when it is compressed with a glass.
ACTION IN A SEIZURE
- Protect the child from injury.
- Position pillows or soft padding to protect the child.
- If the child becomes unconscious place in the recovery position.
- Call EMS
- If you are not the parent of the child you must have parental permission to give medication.
- You must be trained and competent. Written orders or procedure should be followed.
- Only give the stated doses.
7) Asthma and Bleeding
This is where the muscles of the breathing tract go into spasm and the lining swells. This leads to a narrowing of the passages, making breathing difficult.
- Difficulty in breathing, wheezy breathing.
- Grey blue tinge to the skin.
- Crying and frightened.
- Keep calm and move other children away from the child.
- Sit them upright in a comfortable position.
- Find the child’s medication and give one dose if you are trained to do so.
- Call an ambulance if the attack does not ease after 3 minutes, if the casualty becomes exhausted or you are concerned.
SEVERE BLEEDING ACTION
- Protect yourself from the blood by wearing gloves.
- Apply direct pressure to the wound, do not remove any embedded objects in the wound but apply pressure on either side of the wound.
- Apply a first aid dressing, if it is a limb wound, elevate the limb, check the circulation beyond the bandage.
- If further bleeding occurs, apply a second dressing on top of the first. If blood seeps through this dressing, remove both dressings and apply a fresh one, ensuring that pressure is applied accurately to the point of bleeding.
Seek medical assistance.
The information contained in this blog is for guidance only and should not be used as a substitute for recognised training.