Chapter 9
Management of Injuries and Acute
Illness
Responding to An Emergency
An emergency involves an unexpected
event or condition that requires a prompt
response.
Program Planning
• Every program should develop policies
and response procedures to follow in the
event of an illness or serious emergency.
– Plans should be reviewed and updated
frequently.
– Staff should be familiar with these plans and
know how they are to be implemented.
Program Planning (continued)
• Staff members should be trained in basic
first aid and CPR.
• First-aid supplies should be available and
accessible.
• Families should also be informed of
program emergency response policies and
procedures.
Basic Principles
• Remain with the child at all times.
• Do not move unless there is danger of
further injury.
• Do not give fluids or medications unless
prescribed.
• Call for medical assistance.
• Notify the child’s family.
• Record all information about the event.
©2012 Cengage Learning.
All Rights Reserved.
Evaluating a Victim
•
•
•
•
•
Assess the child
Alert another adult
Attend to the victim
Record all observations and treatments
And, never attempt to diagnose or give
medical advice
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All Rights Reserved.
Absence of Breathing
• Establish that a victim is not breathing.
• Position (head tilt-chin lift) and give two
small breaths.
• Begin CPR (using a compression-toventilation rate of 30:2 for persons of all
ages except newborns).
• Continue until the victim begins breathing
or emergency medical assistance arrives.
©2012 Cengage Learning.
All Rights Reserved.
CPR
• View a quick demonstration of CPR
techniques by clicking on the links:
– http://depts.washington.edu/learncpr/videode
mo/infant-cpr-video.html
– http://depts.washington.edu/learncpr/videode
mo/child-cpr-video.html
©2012 Cengage Learning.
All Rights Reserved.
Airway Obstruction
• Children under five years are at highest
risk.
– Why?
– What other groups of children are at high risk
for choking?
– What items do children choke on most often?
©2012 Cengage Learning.
All Rights Reserved.
Airway Obstruction (continued)
• Use the Heimlich maneuver to dislodge an
item in the child’s airway. Know how this
technique is applied differently for:
– Infants
– Toddlers
– Older children and adults
• Stop compressions and begin CPR at
once if the child stops breathing
©2012 Cengage Learning.
All Rights Reserved.
Heimlich Maneuver
Infant
Heimlich Maneuver
Shock
• Shock is life-threatening and can occur
with many different types of injuries.
• The victim may appear pale, weak, and
confused.
• Help the victim to lie down; elevate feet 8
to 10 inches and observe closely for
breathing.
• Call for emergency medical assistance.
©2012 Cengage Learning.
All Rights Reserved.
Asthma Attacks
• Encourage the child to relax.
• Administer prescribed medications
(inhaler).
• Monitor the child’s breathing.
• Call for emergency medical assistance if
the attack is prolonged or the child
becomes fatigued and is struggling to
breathe.
• Notify the child’s family.
©2012 Cengage Learning.
All Rights Reserved.
Bleeding
• Call for emergency medical assistance if
bleeding comes in spurts or cannot be
controlled.
• Follow Universal Precautions.
• Apply direct pressure; elevate if possible.
• Notify the child’s family.
©2012 Cengage Learning.
All Rights Reserved.
Diabetes (continued)
• Teachers must work closely with the
families of children who have been
diagnosed with diabetes.
• Emergency management requires:
– Recognizing symptoms of hypoglycemia and
hyperglycemia (Table 9-6)
– Administering treatment and calling for
emergency medical assistance if needed
©2012 Cengage Learning.
All Rights Reserved.
Drowning
• Drowning is the leading cause of death
among young children under 14 years.
• Prevention is essential!
– What precautions must be taken to protect
children from accidental drowning?
• Administer CPR if the child is not
breathing.
• Call for emergency medical assistance
and contact the child’s family.
©2012 Cengage Learning.
All Rights Reserved.
Head Injury
• Every head injury should be considered
potentially serious.
• Observe the child carefully for 48 hours.
– What signs should you observe a child for?
• Become familiar with developing signs of serious
complications.
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Poisoning
• Why are young children at high risk for
unintentional poisoning?
• What signs might indicate a potential
poisoning?
• Know how to distinguish different
categories of ingested substances
(Table 9-7).
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All Rights Reserved.
Carolinas Poison Center
(in Charlotte) 355-4000
(out of Charlotte)
toll free:
1-800-848-6946
SIGNS TO WATCH FOR
IN CASE OF POISONING
• drowsiness
• coma
• slow, shallow breathing
• slow pulse rate
• vomiting
• ringing in the ears
• severe burns to lips, mouth
• convulsions
• dehydration
Whenever any of these signs appear
call your doctor or nearest Poison
Control Center.
Do not delay! Death may only be a matter of time if you hesitate.
Non-Life-Threatening Conditions
• Teachers should know how to care for children
who experience a variety of injuries and acute
illnesses.
• How would you respond to each of the following
conditions?
–
–
–
–
–
Scrapes and cuts
Bites
Blisters
Burns
Eye injuries
©2012 Cengage Learning.
All Rights Reserved.
Non-Life-Threatening Conditions
(continued)
– Fractures
– Frostbite
– Heat stroke
– Nosebleeds
– Seizures
– Splinters
– Tooth emergencies
Fractures
• Fractures are breaks, cracks, or chips in a bone.
• A fractured bone that pierces through the skin is called an
open fracture.
– Because of bleeding and the risk of infection, open fractures are potentially the
most dangerous.
– Fortunately, closed fractures, which do not break the skin, are the most common
kind.
– A dislocation occurs when the bone slips out of its normal place in the joint.
The telltale symptoms of a fracture are:
•
•
•
•
Acute pain
Tenderness
Swelling (may be severe or mild)
Limited range of movement
First Aid for Fractures
• Immobilize the injured area. Don't try to
realign the bone, but if you've been trained
in how to splint and professional help isn't
readily available, apply a splint to the area.
• Apply ice packs to limit swelling and
help relieve pain until emergency
personnel arrive. Don't apply ice directly
to the skin — wrap the ice in a towel, piece
of cloth or some other material.
First Aid for Nosebleeds
• Stay calm and reassure the
child.
• With the child upright in a
chair or in your lap, tilt his or
her head slightly forward.
• Gently pinch the nose (just
below the bony ridge) with a
tissue or clean washcloth.
• Keep pressure on the nose
for about 10 minutes; if you
stop too soon, bleeding may
start again. It may also help
to apply ice wrapped in a
paper towel.
• Do not have the child lean
back. This may cause blood
to flow down the back of the
throat, which tastes bad and
may cause gagging,
coughing, or vomiting.
• Have the child to rest for a
while after a nosebleed.
Discourage nose-blowing,
picking, or rubbing, and any
rough play.
First Aid for Seizures
• Get the child away from anything that could cause harm -- out of the
tub, away from stoves or heaters, away from tables and shelves
where items may fall off and cause an injury.
• Roll the child on his or her side, as a seizure victim may vomit and
could choke if lying on his or her back.
• If you can, tilt the child's chin forward, CPR-style, to help open the
breathing passage.
• Do not put anything in the child's mouth.
– A tongue cannot be swallowed; this is a myth.
• Once the convulsive component [of the seizure] is over and the child
then is sleepy, groggy, or not very responsive, the emergency
component is essentially over.
• The child should be taken calmly, at normal driving speed, to the
emergency room for evaluation and care.
FIRST AID FOR BRUISES:
• Apply ice packs for 15-minute periods at least several
times a day during the first 48 hours to reduce swelling.
• A zip-lock bag filled with ice cubes and water or a
partially thawed package of frozen peas may be useful if
an ice pack isn't available.
• Elevating the bruised area also lessens swelling.
• Instruct the child to avoid physical exercise for the time
being, especially if the bruise is on an arm or leg, since
physical activity can delay healing.
• Call your pediatrician if the child has banged his or her
head and has a bruise behind the ear. This may be a
sign of skull fracture.
Tooth Emergencies
• Knocked Out Tooth
Hold the tooth by the crown and rinse off the root of the tooth in
water if it’s dirty (Avoid touching the root end). Do not scrub it or
remove any attached tissue fragments. If possible, gently insert and
hold the tooth in its socket. If that isn’t possible, put the tooth in a
cup of milk and get to the dentist as quickly as possible. Remember
to take the tooth with you!
• Broken Tooth
Rinse the mouth with warm water to clean the area. Use cold
compresses on the area to keep any swelling down. Call the dentist
immediately.