PAEDIATRIC FIRST AID Here's a simple and easy way to learn basic first aid skills to help keep children and babies safe. Note: a baby is less than one year old and a child is aged between one and puberty. Severe allergic reaction / anaphylaxis http://www.redcross.org.uk/What-we-do/First-aid/Baby-and-Child-First-Aid/Allergic-reaction Common causes of a severe allergic reaction are the injection of a drug, pollens, some food items such as nuts, shellfish or eggs, and stings and bites. The baby or child may develop a red, blotchy rash, itchiness or swelling on their hands, feet or face. Their breathing may slow down. Vomiting and diarrhoea can also occur. When you observe any of these symptoms, call 999. The baby or child needs urgent medical assistance. An allergic reaction can affect someone very quickly, and is potentially very serious as it may result in swelling of their airway, which causes them to stop breathing. When there is a known allergy, use their auto-injector, following the recommended guidance. Once an allergy has been identified, the doctor may provide the baby or child with an auto-injector (or epi-pen). Tell the ambulance personnel if the auto-injector has been used. Reassure the baby or child, and make them as comfortable as possible while you wait for the ambulance. Asthma attack http://www.redcross.org.uk/What-we-do/First-aid/Baby-and-Child-First-Aid/Asthma-attack A child having an asthma attack will wheeze and find it difficult to breathe. Help the baby or child to sit in a comfortable position and take their medication. When a baby or child has an asthma attack, the muscles in the airways narrow, making it difficult for them to breathe. Using an inhaler relaxes the muscles, allowing the air passages to expand and ease their breathing. Reassure the baby or child. If the attack becomes severe, or they don't have their medication, call 999. A mild attack should ease within a few minutes. If it doesn’t, or their inhaler has no effect, call 999. Do not leave the baby or child, in case the attack becomes severe quickly. Bleeding heavily http://www.redcross.org.uk/What-we-do/First-aid/Baby-and-Child-First-Aid/Bleeding-heavily If there is blood flowing from a wound and it is too big for a plaster to cover, then your baby or child is bleeding heavily. Put pressure on the wound with whatever is available to stop or slow down the flow of blood. You are acting as a 'plug' to stop the blood escaping. The pressure you apply to a wound that is bleeding heavily 2 will stop or slow the flow of blood. This will help the blood to clot and stop the bleeding. Call 999. Keep pressure on the wound until help arrives. Significant loss of blood can lead to a potentially serious condition called shock. Broken bone http://www.redcross.org.uk/What-we-do/First-aid/Baby-and-Child-First-Aid/Broken-bone TINY ADVENTURES Limited Because every day is a tiny adventure A baby or child may have a broken bone if they are in a lot of pain, or are lying in an unnatural position, following a fall or a blow from an object. Support the injury with cushions or items of clothing to prevent unnecessary movement. Supporting the injury may give pain relief and prevent loss of future movement. If possible, support the limb above and below the injury. Call 999. Continue supporting the injury until help arrives. Burns http://www.redcross.org.uk/What-we-do/First-aid/Baby-and-Child-First-Aid/Burns Cool the burn under cold running water for at least ten minutes. Cooling the burn will reduce pain, swelling and the risk of scarring. The faster and longer a burn is cooled, the less the impact of the injury. After the burn has been cooled, cover it with cling film or a clean plastic bag. This helps prevent infection by keeping the area clean. Cling film or plastic bags provide an ideal covering because they don't stick to the burn and reduce pain by keeping air from the skin’s surface. Call 999 if necessary. The burn may need urgent medical treatment. Always seek medical advice for a baby or child that has been burned. Choking baby http://www.redcross.org.uk/What-we-do/First-aid/Baby-and-Child-First-Aid/Choking-baby Give up to five back blows. Hold the baby face down along your thigh with their head lower than their bottom. Hit them firmly on their back between the shoulder blades. If back blows do not dislodge the object, move on to step two. The back blows create a strong vibration and pressure in the airway, which is often enough to dislodge the blockage. Dislodging the object will allow them to breathe again. Ensure you support their head while you hold them in the position described above. Give up to five chest thrusts. Turn the baby over so they are facing upwards and place two fingers in the middle of their chest just below the nipples. Push inwards and upwards up to five times. If chest thrusts do not dislodge the object, repeat steps one and two. Page 2 of 8 Version 9 TINY ADVENTURES Limited Because every day is a tiny adventure Chest thrusts squeeze the air out of the baby’s lungs and may dislodge the blockage. Call 999 if the object has not dislodged after three cycles of back blows and chest thrusts. Choking child http://www.redcross.org.uk/What-we-do/First-aid/Baby-and-Child-First-Aid/Choking-child A child who is choking may be clutching at their chest or neck and won’t be able to speak, breathe or cough. Give up to five back blows. Hit them firmly on their back between the shoulder blades. If back blows do not dislodge the object, move on to step two. This creates a strong vibration and pressure in the airway, which is often enough to dislodge the blockage. Dislodging the object will allow them to breathe again. Give up to five abdominal thrusts. Hold the child around the waist and pull upwards and inwards above their belly button. If abdominal thrusts do not dislodge the object, repeat steps one and two. Abdominal thrusts squeeze the air out of the lungs and may dislodge the blockage. Call 999 if the object has not dislodged after three cycles of back blows and abdominal thrusts. Page 3 of 8 Version 9 TINY ADVENTURES Limited Because every day is a tiny adventure Croup http://www.redcross.org.uk/What-we-do/First-aid/Baby-and-Child-First-Aid/Croup The baby or child has difficulty breathing, and a short barking cough. Their cough may also sound like crowing or whistling. In severe attacks, the baby or child may use muscles around their nose and neck as they struggle in their attempts to breathe. They may also have blue-tinged skin. When you observe these symptoms, sit the baby or child up and create a steamy atmosphere by boiling a kettle or running a bath. Sitting them up may help them to breathe easier. Reassure the baby or child, as they may be frightened. Encourage the baby or child to relax enough to breathe in the steam, and if the symptoms continue seek medical advice. Breathing in the steam may ease the baby or child’s cough and help them breathe more easily. Epileptic seizure http://www.redcross.org.uk/What-we-do/First-aid/Baby-and-Child-First-Aid/Epileptic-seizure The baby or child has collapsed and is making sudden jerking movements. They may also have froth around their mouth. Use a blanket or clothing to protect their head from injury. Do not restrain them. Restraining them may cause injury to you or them. Let the seizure run its normal course. Remove objects that may injure the baby or child while they are having the seizure. When the seizure is over, help the baby or child to rest on their side with their head tilted back. Helping them to lie on their side with their head back will make sure they keep breathing. Call 999 if necessary. Febrile seizure http://www.redcross.org.uk/What-we-do/First-aid/Baby-and-Child-First-Aid/Febrile-seizure Febrile seizures are caused by a fever or high temperature. The baby or child may arch their back, stiffen their body and have clenched fists. They look red-faced, are hot to touch and sweating. Their eyes may roll upwards and they may hold their breath. Protect the baby or child from injury. Do not restrain them. Remove objects that may injure the baby or child while they are having the seizure. Use a blanket or clothing to protect their head from injury. Remove outer clothing to help cool them. Febrile seizures are caused by a raised temperature so it is important to cool the baby or child. If the room they are in is hot, ensure there is a flow of fresh air (e.g. open a window). Page 4 of 8 Version 9 TINY ADVENTURES Limited Because every day is a tiny adventure When the seizure is over, help the baby or child to rest on their side with their head tilted back. If the symptoms continue or it is their first seizure, seek medical advice. Helping them to lie on their side with their head back will help them to keep breathing. Fever http://www.redcross.org.uk/What-we-do/First-aid/Baby-and-Child-First-Aid/Fever The baby or child has a raised temperature (above 37°C), hot, flushed skin and is sweating. In the early stages of fever, a baby or child may have a raised temperature but complain they feel cold, and look pale. A baby or child may also complain of a headache. Check their temperature by using a thermometer. A moderate fever may not be harmful but should be monitored. In young children, a temperature above 39°C can be dangerous. Remove excess clothes and give them fluids such as water or diluted juice. This will cool the baby or child and help to prevent them becoming dehydrated. Do not cover the baby or child with blankets or anything that may make them hotter. Give the recommended dose of paracetamol syrup. This will help to reduce the baby or child’s temperature and pain. Head injury http://www.redcross.org.uk/What-we-do/First-aid/Baby-and-Child-First-Aid/Head-injury A blow to the head may result in the baby or child having pain or a headache. There may be a bump on their head and they may look pale. Get the baby or child to rest and apply something cold to the injury (e.g. frozen vegetables wrapped in a tea towel). Applying something cold to the injury will reduce external swelling and pain. In addition to external swelling, when a person suffers a blow to the head, the brain can be shaken inside the skull. This may result in a more serious head injury (e.g. concussion), which may make them feel sick or drowsy. If they become drowsy or vomit, or their condition deteriorates, call 999. This could be a sign of a serious injury to the head. Meningitis http://www.redcross.org.uk/What-we-do/First-aid/Baby-and-Child-First-Aid/Meningitis The baby or child may have flu-like symptoms, a headache and a high temperature. They may also complain of a stiff neck and be sensitive to light. At a later stage, a rash may form (that does not disappear when a glass is pressed against it). Other symptoms include: cold hands and feet, joint pain, drowsiness and vomiting. A baby or child with meningitis can have one or more symptoms, and some symptoms occur later on as the infection develops. If you observe any of these symptoms, call 999. Page 5 of 8 Version 9 TINY ADVENTURES Limited Because every day is a tiny adventure A baby or child with meningitis can deteriorate very quickly. It is potentially very serious and needs immediate attention. Do not wait for all the symptoms to occur. Give them constant reassurance while waiting for the ambulance. If they have a fever, you can give them cold drinks to cool them down. Nosebleed http://www.redcross.org.uk/What-we-do/First-aid/Baby-and-Child-First-Aid/Nosebleed Pinch the soft part of the child’s nose and ask them to lean forward. Pinching the nose will help the blood to clot. Leaning them forward will prevent blood from entering the child’s airway or stomach. Ask the child to breathe through their mouth and to spit out any blood in their mouth. Continue to pinch the soft part of their nose for ten minutes. Seek medical advice if the bleeding continues for more than half an hour. Poisoning and harmful substances http://www.redcross.org.uk/What-we-do/First-aid/Baby-and-Child-First-Aid/Poisoning Establish what they have taken, when and how much. The emergency services will want to know this information. Call 999. The substance could be extremely harmful and the baby or child may need urgent medical attention. Unconscious and breathing baby http://www.redcross.org.uk/What-we-do/First-aid/Baby-and-Child-First-Aid/Unconscious-and-breathing-baby Check for breathing. Tilt their head back and look and feel for breaths. If they are breathing, move on to step two. Tilting the baby’s head back opens the airway by pulling the tongue forward. Look at their chest to see if it’s moving and feel for breaths on your cheek – this will help you tell if they’re breathing or not. Hold the baby on their side with their head slightly tilted back, supported and lower than their bottom. Holding them on their side with their head back, helps keep the airway open by making sure their tongue falls forward and fluid drains out. This will help the baby to continue to breathe. Call 999. While waiting for the ambulance, talk to the baby and reassure them. Make sure their head remains tilted back. Unconscious and breathing child http://www.redcross.org.uk/What-we-do/First-aid/Baby-and-Child-First-Aid/Unconscious-and-breathing-child Check for breathing. Tilt their head back and look and feel for breaths. If they are breathing, move on to step two. Tilting the child’s head back opens their airway by pulling the tongue forward. Looking at their chest to see if it’s moving, and feeling for breaths on your cheek, will help you tell if they’re breathing or not. Page 6 of 8 Version 9 TINY ADVENTURES Limited Because every day is a tiny adventure Move them onto their side and tilt their head back. Putting them on their side with their head tilted back helps keep the airway open by making sure their tongue falls forward and fluid drains out. This will help the child to continue to breathe. Call 999. While waiting for the ambulance, talk to the child and reassure them. Make sure their head remains tilted back. Unconscious and not breathing baby http://www.redcross.org.uk/What-we-do/First-aid/Baby-and-Child-First-Aid/Unconscious-not-breathing-baby Check for breathing. Tilt their head back and look and feel for breaths. If they are not breathing, move on to step two. Tilting the baby’s head back opens their airway by pulling the tongue forward. Looking at their chest to see if it’s moving, and feeling for breaths on your cheek, will help you tell if they’re breathing or not. If they are not breathing, they may also look pale and blue. Tell someone to call 999. If you are on your own carry out rescue breaths and chest compressions as described below, for one minute, and then call 999. Give five rescue breaths. Tilt their head back, seal your mouth over their mouth and nose and blow five times into the baby. You are acting as the lungs by blowing into them and topping up the oxygen levels in the baby’s blood. This oxygen is needed to keep their organs alive. Give 30 chest compressions. Push firmly in the middle of their chest with two fingers so that the chest goes inward, then release. You are acting as the heart by keeping blood pumping around their body and helping keep the vital organs, including the brain, alive. Give two rescue breaths, then continue with cycles of 30 chest compressions and two rescue breaths until help arrives. Unconscious and not breathing child http://www.redcross.org.uk/What-we-do/First-aid/Baby-and-Child-First-Aid/Unconscious-not-breathing-child Check for breathing. Tilt their head back and look and feel for breaths. If they are not breathing, move on to step two. Tilting the child’s head back opens the airway by pulling the tongue forward. Looking at their chest to see if it’s moving, and feeling for breaths on your cheek, will help you tell if they’re breathing or not. Once you have confirmed they are not breathing, move on to step two. Tell someone to call 999. If you are on your own, carry out rescue breaths and chest compressions for one minute, and then call 999. Give five rescue breaths. Tilt their head back, seal your mouth over their mouth and pinch their nose. Blow five times into the child. By blowing into their mouth you are topping up the oxygen levels in the child’s blood. This is needed to keep their organs alive. Page 7 of 8 Version 9 TINY ADVENTURES Limited Because every day is a tiny adventure Give 30 chest compressions. Push firmly in the middle of their chest with one hand so the chest goes inward, then release. You are acting as the heart by keeping blood pumping around their body helping keep the vital organs alive, including the brain. If you are small or the child is large, you may need to use two hands. Give two rescue breaths, then continue with cycles of 30 chest compressions and two rescue breaths until help arrives. Vomiting and diarrhoea http://www.redcross.org.uk/What-we-do/First-aid/Baby-and-Child-First-Aid/Vomiting-and-diarrhoea Give the baby or child drinks of boiled water that’s been cooled. Encourage them to drink small sips often. This will replace the fluid they have lost. Using a rehydration product is advised for prolonged periods of vomiting and diarrhoea – these will replace the salts lost through the condition. Let the baby or child rest. It is a good idea to place a bowl near them in case they need to vomit. If symptoms persist, seek medical advice. Vomiting and diarrhoea can be dangerous as they can lead to dehydration – a state where the body does not have enough fluids in it to function properly. Page 8 of 8 Version 9