PREVENTION & FIRST AID
CPR
This is a transcript of the Raising Children Network video available at
http://raisingchildren.net.au/articles/child_cpr_video.html. It features a St John
Ambulance trainer using a dummy child to show how to perform cardiopulmonary resuscitation (CPR) on a child. This video is not intended as a substitute for first aid training.
Call 000 in for any emergency
Call 1300 360 455 to find out about choking and CPR classes in your area.
Melanie McPherson [first aid trainer, St John Ambulance Australia]: In the event that we have to perform CPR on a child, we need to follow the DRABCD action plan and the first step in that plan is to check for danger: to myself, to bystanders and to the casualty.
Onscreen tip: DRABCD = Danger, Response, Airways, Breathing, CPR, Defibrillation.
Once we find out there’s no danger, we now need to go in and try to get a response from the child.
We do that by clapping over their face, ‘Can you hear me? Hello? Squeeze my hands if you can hear me, open your eyes’. There’s no response, so we are presuming this casualty is unconscious. So the first thing we need to do is get on the phone and call for help. So call 000.
Onscreen tip: Call 000 for any emergency
Then what we need to do is have a look into the airway and if there’s something in there, we’ll need to roll them over and then clear out the airway.
We’ll then need to check for breathing, for 10 seconds, look, listen and feel [checks breathing].
If there’s no breathing, we then roll them back on their back, while supporting the neck.
So we’ll need to give the child, two rescue breaths, make sure we’re squeezing the nose, slight head tilt, make sure your mouth is covering their mouth. One [gives rescue breath], two [gives rescue breath]. We then need to check for signs of life just briefly.
If there’s no signs of life, we then begin CPR.
Now CPR – what we are actually doing is compressing on the chest to keep the heart pumping, to get the blood to flow up to the brain to keep oxygen up to the brain. I get my hand and put it in the centre of the chest, stabilise yourself from your knees, get over the top and we do 30 compressions to two breaths:
[Counting compressions out loud] One, two, three, four, five, six, seven, eight, nine, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30.
And then go and give them two breaths: 1 [gives rescue breath], 2 [gives rescue breath].
Back to the compressions [counting compressions out loud]: One, two, three, four, five, six, seven, eight, nine, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30.
Two breaths: 1 [gives rescue breath], 2 [gives rescue breath] and we continue doing that until help arrives or until he shows signs of life.
Now the D on the end of the DRABCD action plan stands for Defibrillation and if it’s available we can then use it.
In the event that you are working with children, infection control is important. If you are performing first aid, remember to wear a pair of gloves and use a face shield if performing resuscitation.
Facts about scalds
Hot drinks are the major cause of scalds. A freshly poured hot drink will burn a child instantly. Other common causes include boiling water, hot tap water and hot baths, as well as hot food, soups and sauces. Hot water can scald up to half an hour after it’s been boiled.
Children under two are most at risk of scalds from hot liquids in kettles, teapots, saucepans and cups.
It takes less than a second for a child to be severely scalded with hot water at 65°C – this is the hot-water temperature in most Australian homes. The maximum safe temperature for your hot-water system is 50°C. At this temperature, it takes five minutes to severely scald a child.
The safe bath temperature for newborn babies is around 36°C, and for older children is between 37°C and 38°C. Grown-ups tend to have baths in water between 41°C and 42°C.
The best way to prevent burns and scalds is to keep hot drinks and other hot liquids away from your child.
In the kitchen and dining room, these simple safety precautions will help protect your child from scalds:
· Set the temperature of your hot-water system to 50°C.
· Keep kettles, teapots and hot drinks at the back of the bench or centre of the table so your child can’t reach them.
· Make sure kettle cords don’t hang down within reach of your child. Use appliances with short cords so your child can’t use the cord to pull the appliance closer.
· Put your baby down when you’re drinking something hot. Your child can move quickly and unexpectedly, which means that sipping a hot drink while holding your child could lead to burns.
· Use spill-proof mugs with wide bases and narrow rims. This reduces the risk of scalds – but it doesn’t get rid of the risk altogether.
· Use placemats instead of a tablecloth to help stop hot food and drinks spilling on your child. Children sometimes tug on tablecloths to see what’s on the table or to pull themselves up, bringing everything down on top of them.
· Use the back burners on the stove. Turn pan handles towards the back of the stove.
· Carry plates to the pans on the stove, instead of carrying hot pans across the kitchen to the plates.
· Test the temperature of soups, stews and other liquid-based dishes before serving them. Stir microwaved foods to even out any hot or cold spots, but still test the temperature before serving.
· Teach your child about the dangers of hot things.
First aid for scalds and burns
Seek immediate medical attention for any burn bigger than a 20-cent piece. Call an ambulance for any burns to the face, airway, hands, neck or genital area, or burns that are larger than a child’s hand. If you’re not sure how severe the burn is, contact a doctor, hospital or medical centre immediately.
Follow these steps for a child with a scald:
1. Make sure the area is safe, and that there’s no further risk of injury. Take the child to a safe place if possible.
2. Take off the child’s clothing immediately, but only if it isn’t stuck to the skin. Remove any watches or jewellery the child’s wearing – but only if you can do so without causing any more pain or injury.
3. Treat the burn with cold tap water only. Cool the burned area under running cold tap water for a minimum of 10 minutes, and no longer than 20 minutes. This will reduce tissue damage and pain. This is useful for up to three hours after the burn. Hold the child to provide comfort and warmth.
4. Cover the burn with a loose, light, non-sticky dressing, such as plastic wrap or a clean, wet cloth. Raise burned limbs.
Call an ambulance if the burn is:
· to the face, neck or genital area
· larger than the size of the child’s hand.
Definitely go to the doctor or to a hospital or medical centre if:
· the burn or scald is the size of a 20-cent piece or larger
· the burn looks raw, angry or blistered
· the burn is deep, even if the child doesn’t seem to feel any pain
· the pain persists or is severe.
Things not to do with scalds and burns
Don’t peel off any clothing that’s stuck to the burn. Don’t break any blisters.
Don’t apply ice, iced water, lotions, moisturisers, ointments, creams or powders to the burn. These will only need to be removed to treat the burn properly. Butter or flour can make the damage worse.
If the burn’s large, don’t cool it for longer than 20 minutes. This is because hypothermia can happen quickly in children.
PREVENTING FALLS FOR BABIES AND TODDLERS
You might have noticed how easily babies and children can fall. You can make sure your child has as few falls and bumps as possible by watching his development and adjusting the environment as he grows.y see.
Falls are the most common cause of accidents in every age group. As babies and children become more and more mobile, falls and bumps become more likely.
Injuries to children often happen unexpectedly because grown-ups don’t realise what children can do and how quickly they develop new skills. The most useful thing you can do to try and keep your child safe is to keep an eye on the new skills she’s learning, and the new places she can reach and get to – and then adjust your environment accordingly. Understanding your child’s development will help you plan ahead for safety.
There are three important factors that can influence the seriousness of a fall:
· The height children can fall from: the lower the height, the lower the danger. Children under five shouldn’t have access to heights over 1.5 m, and older children shouldn’t have access to heights over 2 m.
· What children fall onto: hard surfaces such as concrete, ceramic tiles and even compacted sand are more hazardous to fall onto than softer surfaces. A bed of tan-bark or pine mulch under play equipment is recommended to provide a softer landing. These beds are required to be at least 30 cm deep.
· What children might hit as they fall: sharp-edged furniture, such as coffee tables and bedside tables, should be placed in areas where a child is unlikely to fall on them.
For information on preventing falls for older children, see playground safety and safety for bikes and other wheeled toys.
Falls are part of the normal growing process. Most falls lead only to bumps and bruises, but they can occasionally lead to a trip to a doctor or the hospital.
Tips for preventing falls at home
Furniture
Children are at risk of falling even as young babies when they can’t control their movements. If your baby’s on a surface such as a change table or bed, always keep a hand on him. As he grows, you might not even know he can roll over until he rolls off the bed or another piece of furniture.
Check that all furniture is sturdy – your child shouldn’t be able to pull it down or knock it over. You might have to brace furniture such as bookcases and cupboards or attach them to the wall. Put the things your child wants to reach on the lowest levels so she’s less tempted to try climbing up the furniture. As a last resort, you can move the furniture to a part of the house your child doesn’t use, or put a barrier in place so she can’t get to it.
Move furniture with sharp corners away from areas where children run around, such as in hallways and near doorways. If the furniture can’t be moved, pad its corners with foam or commercial corner protectors (these are sold at hardware shops).
Windows, glass doors and balconies
Windows should be locked or shielded with screens so your child can’t fall out. It pays to move chairs, change tables and pot plants away from windows too, because children love to climb up to see outside.
Make glass doors visible using stickers, and place furniture in front of glass doors so your child won’t run into them. Consider using safety glass or shatter-resistant film on glass doors and windows.
Always supervise small children on balconies. Install safety guards across the entry to any balconies, and make sure there are no horizontal bars or footholds children could use to climb on.
Safety aids and precautions
Put away toys at the end of the day so all family members can go to the toilet at night without tripping over them.
Wipe up spills as soon as possible – they can make the floor slippery.
Use anti-skid mats under your rugs and floor coverings, or roll them away.
Install safety gates on stairs – once your baby can crawl, it’ll be hard to keep him away from steps. Keep the gates in place until your child is very good at walking up and down stairs on his own. And always open the gate rather than stepping over it – it’s easy to trip, and stepping over the top doesn’t set a good example for children.
Try to stop your child from standing up in the bath. The bath is a very slippery place, and even adults can fall quite easily.
Move, put away or lock up anything that might be unsafe for a child to climb, or that can be used to get to unsafe places.
