Family Affairs and other matters

The first aid course I did the other day was incredibly useful. It was a paramedic technician from one of the ambulance companies who came to talk to us. Things change quite rapidly in the medical world and there was a lot I didn’t know. Therefore, I thought I’d impart the most important bits. Just in case it helps.

All of the following is in relation to children over the age of 5.

If you come across an injured child, this is what you need to remember:

DR AB (Doctor AB as he pronounced it)

D: DANGER

R: RESPONSE

A: AIRWAY

B: BREATHING

DANGER

Aim to remove the child from any further danger – ie fire, electrical items, water, traffic. Don’t move them unless it’s essential even if they’re in the road and blocking traffic, just ensure they’re safe….

RESPONSE

They suggest a 10 second response drill in order to assess the situation. Are they sick or not? Use your gut instinct. Apply DRAB for every situation. Shake the child’s shoulders, shout their name or ask them to open their eyes. If they are conscious ask them if they can feel their toes, legs, where it hurts etc. If unconscious, listen for breathing, place hand on abdomen to check. If no response shout for help – if still no response from anyone and you’re in a public place and you need somebody to call an ambulance shout “fire” instead. That normally gets people to react.

Remain calm, reassure if possible, gain their trust. Always ask the questions starting from toes up. Not from the injury. Need to check for neck injury.

AIRWAY

If the child is breathing, but unconscious you need to ensure the child has a clear airway. Hold their chin and tilt the head right back and place them on their side if they are unconscious. This ensures that the tongue doesn’t fall back to block the oesophagus and they won’t choke on their own vomit. Even if the child is injured, the priority is always life over limb so you have to make sure they can breathe.

BREATHING

If they are breathing but unconscious place them in the recovery position.

If they are not breathing call 999 – if you forget what to do or panic, they will talk you through it whilst the ambulance is on it’s way.

To start CPR (cardio-pulmonary resuscitation) you:

Lie them on their back
Kneel to the side of them
Tilt their chin up
Pinch their nose
Do 5 recovery breaths into their mouth

Place the base of your hand in line with their breastbone and between the nipples. Interlock the other hand on top. Lean over to increase the weight and do 30 compressions

Do 2 breaths into their mouth

Do 30 compressions

2
30
2
30
and don’t stop until the ambulance arrives.

CHOKING

If they can’t cough out the object, call an ambulance and then place the child over your knee and slap them between the shoulder blades between 5 and 10 times quite hard – checking to see whether object has come out between slaps.

You should never put your finger into their mouth to try and retrieve the object as you could push it further down.

If still not working try using the “abdo thrust” (same as the Heimlich Manoeuvre – but they’re not allowed to use that term anymore) which is when you stand behind them, make a fist (with thumb under fingers) hold arms around body and use a firm push in and up just under the ribcage (between the belly button and the breastbone) which aims to push the diaphragm up and wind them).

If it still hasn’t come out you start alternating between 5 slaps and 5 abdo-thrusts.

If and when they become unresponsive (ie floppy) you revert back to DRAB

BLEEDING

DRAB
Find injury
Apply a clean dry dressing (nothing wet)
Apply direct pressure if there is no fracture or foreign body
Raise the limb if possible
Do not apply a tourniquet use direct pressure instead (this is because they have found that most people tend to make it too tight).

HYPERVENTILATING

Don’t use a paper bag anymore. They use something called “talk down” where you try and calm the child down – predominantly found in teenage girls – otherwise known as a panic attack.

CONVULSIONS

Do not attempt to restrain somebody if they are fitting, just lie them down and put something under their head
If they have a temperature, remove as many clothes as possible, put a fan on
They usually stop within 5 minutes
Put them in the recovery position afterwards.

DIABETES

Give them a sugary drink or food
Sit and rest
Either put them into the recovery position or start CPR depending on whether they are conscious or not.

POISONS

7,000 children a year end up in hospital because they have eaten something they shouldn’t have.

Sit them up
Establish what they have taken – what taken, when, how much (if pills make sure you haven’t thrown away bottles, box or instructions)
Open airway
Resuscitate if necessary (DRAB)

If they are conscious don’t induce vomiting. They don’t pump your stomach anymore apparently.

ALLERGIC REACTIONS

Eg Itching hives, vomiting/diarrhoea, anaphylactic shock – sit them up and use medication if you have it. Call the ambulance, open up the airway and resuscitate if necessary.

Apparently it is not usually the first bee sting that the body reacts to if you are allergic, but the second one.

Always go to hospital anyway as the allergy needs to be worked out to know what to avoid in future.

HEAD AND NECK INJURIES

If they cannot feel their toes, or their body and you suspect a neck injury, keep them still and straight and warm. Kneel behind their head, bend down on to the elbows, hold the sides of the head still (nose in line with the belly button) and then do not let go or move the head until the ambulance arrives with the neck brace. Talk to them and reassure them.

FRACTURES

Try and keep the child calm and try to immobilise the injured limb. If the arm keep it out, maybe with a pillow or padding between the arm and the body.

BURNS

Hold the burn under a tap or place wounded area into a bowl of TEPID water (not cold as they can go into double shock from hot to cold) for 10 minutes.

Remove all jewellery

Don’t put any ointments/creams or cotton wool/padding on the wound at all, make sure it is clean and then apply cling film to keep the air off it.

Remove clothing from area unless it’s stuck.