Paediatric emergency first aid

1. Understand the role of the paediatric first aider

1.1 identify the responsibilities of a pediatric first aider As a paediatric first aider you should aim to preserve life, prevent the condition worsening, and promote recovery. A paediatric first aider needs to stay calm at all times and appear confident and reassuring. Assess the risk around the injured person

Identify and assess the extent of the illness or injury.
Give immediate and appropriate treatment.

1.2 Describe how to minimise the risk of infection to self and others. To minimise the risk of infection to myself and others I should always:- Wash my hands before and after giving first aid treatment.

Wear disposable gloves when dealing with bodily fluids such as blood and vomit. Make sure I dispose of any alcohol wipes or cloths I have used to clean the wound properly. Cover the open wound with sterile dressing.

1.3 Describe suitable first aid equipment, including personal protection, and how it is used appropriately.

First aiders should use personal protection to provide protection from infection when assisting an injured person. One of the ways to prevent the spread of infection or disease is to wash your hands with disinfectant after coming into contact with an open wound or bodily fluids. Facemasks should be used whenever blood or other body fluids may become air born. Disposable gloves to prevent cross infection

Goggles for eye protection
Apron
Suitable first aid equipment should include:-
Alcohol
Scissors
Hypoallergenic bandages
Thermometer
Plasters, in a variety of different shapes and sizes
Gauze dressings
Sterile eye dressing
Safety pins
Sticky tape

1.4 Identify what information needs to be included in an accident report/incident record, and how to record it.

Every accident or incident that happens within the setting needs to be reported, as it is a legal requirement. While writing a accident report you must include the following:-

Name of child
Time of accident or incident
Date of accident of incident
Who was present during accident or incident
What happened
What care or first aid was given

7.1 Describe how to recognize and manage an infant and a child who is suffering from shock.

Physical symptoms
No crying at all, or excessive crying that is unexplained
Not very present; dissociated; out of body
Lack of focused eye contact, vacant or distant look
Development delays
Easily startled
Over- or under-tense muscles
Tremors
Dryness in eyes
Dry mouth
Tight jaw
Chronic muscle tension
Shallow breathing
Difficulty breathing
Frequent sighs
Chronically tired
Poor general health

Emotional symptoms

Easily frustrated
Lack of confidence to try new things
Gets unreasonably angry, overly expressive, hysterical
Dominating and clingy
Feel damaged or flawed

7.2 Describe how to recognize and manage an infant and a child who is suffering from anaphylactic shock

Anaphylactic shock is a rapid and severe allergic reaction. It starts when the immune system mistakenly responds to a harmless substance as if it were a serious threat. This triggers the release of histamine and other chemicals that cause a number of symptoms — some of them life-threatening. The symptoms in an infant include:

Swelling of the skin, lips, throat, tongue or face
Hives
Wheezing or severe breathing problems
Rapid pulse or irregular heartbeat
Loss of consciousness
Vomiting
Diarrhea
Extremely pale skin and sweating, skin redness, or blue skin color Symptoms usually appear within two hours after exposure to the substance

3.1 Describe how to manage an infant and a child with foreign bodies in their eyes, ears and nose When things get stuck up a child’s nose or ears, you need to call the first aider of take the child to the nearest walk in center or the minor injuries unit for it to be removed. It may only be a simple procedure but it still needs to be done professionally as if anything goes wrong it can usually be treated there and then. The first aider within the setting may be able to remove some of the foreign bodies for example, if something is stuck in a child’s eye you can Sit the child down and put on a pair of disposable gloves. Gently pull down the lower eyelid and any visible foreign body removed with either a clean wet piece of tissue or a small piece of wet gauze swab.

3.2 Describe how to recognize and manage common eye injuries

Some signs for a common eye injury may include:
The person has obvious pain or trouble seeing.
The person has a cut or torn eyelid.
One eye does not move as well as the other.
One eye sticks out compared to the other.
The eye has an unusual pupil size or shape.
There is blood in the clear part of the eye.
The person has something in the eye or under the eyelid that can’t be easily removed.

To manage an eye injury you:
Must not touch, rub or apply pressure to the eye
Do not try to remove the object stuck in the eye
Do not apply ointment or medication to the eye
See a doctor as soon as possible

4.1 Describe how to recognize and manage chronic medical conditions including diabetes, asthma and sickle cell anaemia.

Managing chronic medical conditions you need to
Understand the chronic illness.
Understand how to medicate and handle the condition
Be aware of the symptoms

4.2 describe how to recognize and manage serious sudden illnesses including meningitis and febrile convulsions

Meningitis
Meningitis is an infection of the meninges (protective membranes) that surround the brain and spinal cord.Although anyone of any age can get meningitis, babies and young children are often affected. The signs and symptoms to look out for in your child are: A very high fever with cold hands and feet

They may feel agitated but not want to be touched
They may cry continuously
Some children can become very sleepy and it may be difficult to wake them up They may appear confused and unresponsive

They may develop a blotchy red rash that does not fade when you roll a glass over it If you suspect a child had meningitis inform your manager and call the child’s parents.

Febrile convulsions
Febrile convulsions are seizures (fits or convulsions) occurring in children aged 6 months to 5 years, associated with fever, without other underlying cause such as infection or electrolyte imbalance.

Emergency treatment of febrile seizures
If the child is still convulsing or not fully alert:
Recovery position, check and maintain Airway, Breathing, Circulation. Check blood glucose.

If seizing for 5 minutes, give rectal diazepam (this may be repeated after 5 minutes if the seizure has not stopped), OR a single dose of buccal midazolam (off-licence use). Benzylpenicillin or cefotaxime if meningococcal disease is suspected: Suspect meningitis in any child who is systemically unwell, irritable, or who was drowsy before the seizure. Important signs are: neck stiffness; petechial rash, photophobia; Kernig’s sign; Brudzinski’s sign; bulging fontanelle; reduced level of consciousness. Call 999

5.1 Describe how to recognize and treat the effect of extreme cold for an infant and a child

Symptoms of Cold in Infant
Running nose or congestion in nasal passages
Breathlessness
Mucus discharge from nose and ears
Coughing and sneezing frequently
Watery eyes, accompanied with a low-grade fever
Excessive weeping

Colds usually go away on their own without special medical treatment but if the cold is severe you should contact a doctor.

5.2 Describe how to recognise and treat the effect of extreme heat for an infant and child

Heat exhaustion is a more severe heat illness that can occur when someone in a hot climate or environment hasn’t been drinking enough fluids. Symptoms can include: increased thirst
weakness
fainting
muscle cramps
nausea and/or vomiting
irritability
headache
increase sweating
cool, clammy skin
elevation of body temperature, but less than 104°F (40°C)

What to Do:
Bring the child to a cooler place indoors, an air-conditioned car, or shady area. Remove the child’s excess clothing.
Encourage the child to drink cool fluids containing salt and sugar, such as
sports drinks. Put a cool, wet cloth or cool water on your child’s skin.
Call the child’s parents. If the child is too exhausted or ill to drink, treatment with intravenous (IV) fluids may be necessary. If left untreated, heat exhaustion can develop into heatstroke, which can be fatal.

6.1 Describe how to safely manage an incident involving electricity 6.2 Describe first aid treatments for electric shock incidents

An electric shock can be very minor and not cause any long-term damage. A strong enough current, though, can enter the child’s body at one location and leave it at another, damaging all the tissue in its path. If the child is no longer in contact with the current, check his breathing. If he’s not breathing, have someone call 999 while you give CPR. If you’re alone with the child, give him CPR for two minutes, then call 999.

If the child’s breathing is fine, check his skin color.

Call for emergency help if he seems pale. Continue to monitor the child’s breathing and begin CPR if he stops breathing.

Look for burned skin. An electric shock can cause a serious burn. Even if a burn doesn’t look too bad on the outside, it could be deep and painful. And burns on the lips are sometimes hard to see.

If the child has a burn, don’t put ice, ointment, or anything else on it. Call the parents of the child right away and take the child to the hospital.

7.1 Describe how to recognise the severity of burns and scalds to an infant and a child and respond accordingly

7.2 Describe how to treat burns and scalds to an infant and a child

Burns occur when the skin is exposed to heat or chemicals, for example fire, sunburn, friction, acid, bleach or garden chemicals. Scalds happen when the skin is exposed to hot fluids, for example boiling water, steam or hot fat.

Burns and scalds are usually divided into three categories depending on how much damage they cause to the skin and underlying tissues. First-degree or minor burns are superficial and affect only the outer layer of the skin, making it red and sore.

Second-degree or partial thickness burns extend below the surface of the skin. The skin looks raw and blisters form.

Third-degree or full thickness burns damage the entire layer of the skin and underlying tissues to affect nerves, muscle and fat. The skin looks pale, waxy and charred.

First-degree burns can be treated at home and usually heal in seven to ten days. Second- and third-degree burns are much more serious and require medical attention as there is a risk of infection and shock (dangerously low drop in blood pressure) developing.

Treatments

Minor burns – bathe the area in cold running water for at least 10 minutes and carefully clean away any dirt from the damaged area of skin while the wound is still underwater. Do not break blisters or interfere with the burn. Do not apply any creams, lotions, butter or fat and do not use any adhesive dressings. Cover the area with a clean plastic bag or cling film to keep the area clean and help avoid infection.

Severe burns and scalds – the priority is to cool the injury and seek medical advice as soon as cooling has begun, but this should not delay transmission of the baby or infant to hospital. Bathe the area in cold water for at least 10 minutes. While cooling the burn, check the child’s breathing and level of consciousness and be prepared to resuscitate. Do not remove anything sticking to the burn, do not touch the burn or burst blisters. Do not apply any creams, lotions, butter or fat to the burn. Remove any jewelry and burnt clothing from the injured area provided they are not sticking to the burn. Wrap the burnt area in a clean plastic bag or cover with cling film to prevent infection as a temporary measure while you are waiting for medical help to arrive.

8.1 Describe how poisons enter the body.

There are four main ways that poisons can get into the body. Through the mouth and swallowing it.
Absorbed through the skin
By injection – including bites and stings
By breathing in, or inhaling

8.2 Describe how to recognise and treat an infant and a child affected by common poisonous substances, including plants Symptoms associated with serious poisoning include:
being sick
dizziness
sudden, noticeable heartbeats (palpitations)
breathing difficulties
uncontrollable restlessness or agitation
seizures (fits)
drowsiness or loss of consciousness

id you think a child has been seriously poisoned and they are still conscious, ask them to sit still and stay with them while you wait for medical help to arrive. If they have been poisoned by swallowing something, try to get them to spit out anything remaining in their mouth. If a harmful substance has splashed onto their skin or clothes, remove any contaminated items and wash the affected area thoroughly with warm or cool water.

If the child doesn’t have any of the serious symptoms listed above, call your local poison control center or take them to the doctors.

If a child eats or gets a skin reaction after touching a plant, berry, seed, bulb or wild mushroom that you think may be poisonous, call your local poison center immediately. When you call the poison center, be prepared to give the following information: Child’s age

Any symptoms or illness the child displays
The name of plant (if you know it) – the poison specialists at the center cannot identify plants over the phone How much and what parts were eaten
How recently the plant was eaten or touched.
The poison specialist will tell you what to do and what symptoms to watch for. Remember, each child can react differently to the same plant. You can take a photo of what was eaten or touched to show your doctor.

9.1 Describe how to recognise the severity of bites and stings to an infant and a child and respond accordingly. 9.2 Describe how to recognise and treat bites and stings

When stung by an insect the baby or infant feels immediate pain, causing her or him to cry. You will recognise this cry as being different from crying associated with hunger or tiredness and should check the child to find the cause. Look at exposed areas of skin, if the baby or infant has been stung, the area around the sting will swell and redden, later it may blister and produce an itchy rash. 

If the baby or infant has been bitten it may take several minutes for the bite to become itchy and swell into a lump or redden. In the case of midges when they attack in swarms there may be several areas where they have successfully attacked.

These areas become hot and itchy and can remain so for several days. Some children are particularly sensitive to insect bites and stings and will suffer a severe allergic reaction resulting in dizziness, fainting, breathing difficulties, rash, raised pulse, sickness, or a swollen mouth and face. In very severe cases the victim may even collapse and die. This severe reaction is called anaphylactic shock.

Seek medical advice if a bite starts to swell up or does not go away after about 2 days, or if the baby develops a rash, experiences flu-like symptoms, or has swollen glands, as the bite may be infected.

You can then treat a baby’s sting or bite in the following way: You can help to relieve any swelling and itching by applying an ice pack or a cold compress, such as a cool damp flannel.

Try to stop the baby scratching at her bite or sting, and keep her fingernails short in case she tries. Scratching can damage her skin and cause an infection such as impetigo. See below for information about infections from bites or stings.