Level 2 Paediatric Emergency First Aid

CU1514 Paediatric Emergency First Aid 20 pages 1. 1 Identify the responsibilities of a paediatric first aider. I should aim to preserve life, prevent the condition worsening, and promote recovery. Responsibility Description -Remain calm at all timesAppear confident and reassuring -Conduct a scene surveyAssess the situation without Endangering my own life. -Conduct a primary surveyIdentify and assess the extent of the Illness, injury or condition of the casualty. Attend to the needs of otherEnsure their safety and manage children or bystandersbehaviour. -Send for medical helpAmbulance, police or emergency rescue services (as a first aider, I should always stay with the casualty and send someone else to call for help if possible) -Give immediate, appropriate treatmentto preserve life, prevent the condition worsening and promote recovery -Take appropriate precautions to minimise infection Protect yourself and casualty by using appropriate techniques and equipment Arrange for further, qu alified medical attention Transporting the casualty to hospital or arranging for medical examination. -Reporting and recordingVerbal and written records, completing accident and incident reports -Maintaining first aid equipment, including first aid kits Ensure equipment is up-to-date and first aid kits are well stocked -Keeping up-to-date with first aid procedures Take part in regular updating and training 1. 2 Describe how to minimise the risk of infection to self and others.I should do the following to minimise the risk of infection to self and others:- * I should always wash my hands before and after giving first aid treatment * I should always wear disposable gloves for dealing with any first aid situations involving blood or other body fluids (e. g. vomit) * Cover the casualty’s open wounds with appropriate sterile dressings * Make sure my own cuts or sores are adequately covered by plasters * Use appropriate protective equipment where my own safety may be put at risk, e . g. face shields * Dispose of any soiled dressings (e. g. lood soaked), or other first aid materials, in appropriate clinical waste disposal bags. 1. 3 Describe suitable first aid equipment, including personal protections, and how it is used appropriately. First aid equipment usually consists of collection of supplies for administering first aid, minimising the risk of infection and personal protective equipment (PPE). A first aid kit must be easily identifiable and clearly labelled, usually with a white cross on a green background. It is important that first aid equipment is easily accessible and not locked away, it should be clearly signed.The first aid box should be checked regularly to make sure that nothing is damaged and nothing is missing. The contents of a first aid kit may vary slightly depending on the policies and procedures of the setting. Some settings do not use plasters or cleansing wipes because of allergy risks for children. General first and kits should never cont ain medicines of any kind, even basic painkillers. First aiders are not qualified to give medicines to children as they do not know the medical history or any allergies the child may have. A standard first aid kit will usually contain the following: * Sterile dressings of different sizes (e. . sterile gauze pads, eye pads) * Bandages of different types and sizes (e. g. triangular, roller, finger bandages) * Adhesive tape (non-allergenic) * Disposable gloves * Scissors * Tweezers * Safety pins * Disposable face shields * Disposable thermometers 1. 4 Identify what information needs to be included in an accident report/incident record, and how to record it. It is important that all settings complete a specific from to accidents and incidents, these forms are completed for this purpose. * It is a legal requirement * It provides a record in the event of complications (e. . following a head injury). * It informs parents and carers. * It can help to monitor potential hazards in the setting . * It may be required as evidence in suspected cases of abuse of non-accidental injuries. Information should always be recorded clearly and accurately and should be signed and dated by the first aider. Some accident report forms use body diagrams to help in the descriptions of specific injuries, for example, showing exactly where bruising appeared or the particular area where a child feels pain. The main information recorded should include:- Details of the injured or sick child (name, date of birth, main contact details) – Details of the accident or incident (date, time, where it happened) – Details of action of treatment given (what happened, extent of any injuries, treatment given) – Advice of further treatment recommended (e. g. hospital treatment) – Information parents and carers (when and how parents have been contacted) – Signature of the first aider, the date and time. – Information should be written in black pen. 1. 5 Define an infa nt and child for the purposes of first aid treatment.An infant is usually defined as under the age of one year and child from one year to approximately 12 years old. However, some first aid treatment will vary depending on size and weight of casualty and techniques should always be adapted accordingly. 2. 1 Demonstrate how to conduct a scene survey A scene survey involves your initial assessment of the emergency situation and deciding on the priorities of your action. Use your senses to assess what might have happened: * Look for clues (e. g. an empty medicine bottle beside an unconscious child). * Listen to information form others (e. g. ther children telling you what happened). * Smell anything unusual (e. g. gas or other fumes) When conducting a scene survey, you must consider: * Whether I or the casualty are in any danger (e. g. if the building is on fire) * If the casualty has any lie-threatening conditions (e. g. not breathing) * If any bystanders can help you (e. g. other chi ldren or colleagues) * Whether you need to call for further assistance (e. g. ambulance, police or rescue services). Conducting a scene survey helps the first aider to assess the seriousness of the situation and decide on the priorities for action.It also assist in deciding what further help, if any, is required, If there is more than one casualty, then the first aider needs to prioritise treatment, deal with the most serous first and remember that the quietest casualty often needs the most help. In calling for help, the first aider must decide what help is required and how to send for help, some situations may involve sending for emergency services such as ambulance, police or fire and rescue. Other situations may need the assistance of another adult, a colleague, manager or supervisor. 2. 2 Demonstrate how to conduct a primary survey on an infant and child.Once I have conducted a scene survey and decided on your priorities, then a primary survey will provide a more detailed assess ment of the casualty. To do this you must consider DRABC. * DANGER -If you have not already done so, make sure the casualty is safe. * RESPONSE – Ask the casualty ‘Can you hear me? ’ or ‘what happened? ’ If they respond, then you know that they are conscious and breathing and I should remain calm, reassure the casualty and continue with my examination If there is no response, then I should send for help and proceed as follows: * AIRWAY – Open the airway by gently tilting the head back and lifting the chin.This will prevent the casualty’s tongue from blocking their airway. * BREATHING – Look to see if the chest is rising and falling, listen for breathing sounds and place your cheek close to the casualty’s nose and mouth to feel for breath. If the casualty is breathing normally, place them in the recovery position, unless you suspect a spinal injury and continue with your examination. If the casualty is not breathing, then g ive five rescue breaths and prepare to begin CPR * CIRCULATION – Check the casualty’s pulse by feeling the major artery in the neck, (carotid artery) just below the jaw line. . 3 Identify when and how to call for help. The trained first aider should always stay with the casualty and send someone else to call to help. This allows for first aider to monitor the condition of the casualty and perform any treatment if required, for example carrying out CPR if the casualty stops breathing. Never leave an infant or child casualty unattended. If any of the emergency services are required, this should be done by telephoning, 999.It is essential o communicate the following information accurately * Which emergency service is required ( ambulance, police and/or fire and rescue service) * A contact telephone number (usually the number the call is made from) * The exact location of the incident(Local landmarks provide a useful guide) * The type and seriousness of the incident (e. g. road traffic accident, school bus collided with two other vehicles, blocking a major road junction) * The number and approximate age of casualties involved (e. g. five children and one adult injured, two children in a serious condition).Once you have dealt with the priorities, you should now conduct a more detailed examination of the casualty. This will include any information from the casualty and the signs and symptoms. If the child is old enough, ask them what happened, how they fell and where they hurt. Other children or bystanders may also be able to give you information too. You should always deal with life-threatening signs and symptoms first. For example, obvious and severe bleeding. A general examination should begin at the casualty’s head and work down the body. Remember to move the casualty’s head and work down the body.Remember to move the casualty as little as possible and use your senses to look, feel, listen and smell. Use both hands to compare any diff erences between the two sides of the body. Reassure infants and young children with soothing words and a gentle touch. Signs to look for on examination of casualty Area to examinewhat to look for HEADAny bleeding, bruising or swelling (could indicator a fractured skull) FACEColour of the skin, e. g. pale, blueness (could indicate shock) EYESUnequal pupil size, blood shot eyes MOUTHAny bleeding, vomit, blueness of the lips (could indicate poisoning) flushed, sweating, clammy.EARS AND NOSEAny bleeding (could indicate a fractured skull) WHOLE BODY, NECK, ARMS AND LEGS. Any bleeding, swelling, bruising or deformity (could indicate a fracture) 3. 1 Demonstrate how to place an infant and a child into the appropriate recovery position. The recovery position is very important in first aid. It places the casualty in a stable position and ensures that an open airway is maintained. The main advantages of the recovery position are: * It prevents the tongue from falling back into the throat and blocking the airway and so maintains an open airway. Vomit or other fluid can drain easily from the casualty’s mouth, preventing choking. * It keeps the casualty in a safe and comfortable position. Recovery position for infants and children. For an infant less than a year old, a modified recovery position must be adopted: * Cradle the infant in you arms, with their head tilted downwards to prevent chocking on the tongue or inhaling vomit. * Monitor the infant’s breathing and pulse continuously. For a child over the age of one year, follow these instructions: * Turn the child onto their side. Lift the chin forward into the open airway position and adjust the child’s hand under the cheek as necessary * Check that the child cannot roll forwards or backwards * Monitor the child’s breathing and pulse continuously. If you suspect spinal injury, use the jaw thrust technique. Place your hands on either side of the child’s face. With your fingertips gently lift the jaw to open the airway and take care not to tilt the casualty’s neck. 3. 2 Describe how to continually assess and monitor an infant and a child whilst in your care. If an infant or child is unresponsive but breathing normally.It is essential to assess and monitor their condition while I wait for the ambulance to arrive What to check How to assess and what to note AirwayMake sure nothing is blocking the airway or obstructing breathing (e. g. vomit) BreathingNote the rate and depth of breathing and any changes (if the casualty stops breathing, be prepared to start CPR). Circulation Check the pulse at the neck (carotid pulse). Note the rate and strength of the pulse and any changes. ResponsivenessKeep talking and asking questions, gentle shaking or pinching the skin to see if there is any response.Note any changes. Changes in general condition Check the colour of skin and lips. Note any blueness or other changes. Check for the presence of any bleeding or complaints of p ain from the casualty. 4. 1 Identify when to administer CPR to a responsive infant and an unresponsive child who is not breathing normally. As a trained first aider, CPR should always be carried out if a casualty is unresponsive, is not breathing and has no pulse. The procedure should be followed even if you have doubts about its success and you should always carry on until help arrives.If possible, send someone else to call for an ambulance immediately, but if you are on your own, carry out CPR for one minute before calling. If there is any evidence of blood or other fluid around the child’s mouth, then a disposable face shield should be used. 4. 2 Demonstrate how to administer CPR using an infant and child manikin. CPR Procedure for infants and children. CPR for infants (less than I year old) 1. Give five rescue breaths: * Tilt the head back and lift the chin to open the airway * Seal your lips around the baby’s mouth and nose * Blow gently into the lungs, looking al ong the chest as you breathe.Fill your cheeks with air and use this amount each time. * As the chest rises, stop blowing and allow it to fall. Repeat four more times. 2. Give 30 chest compressions: * Place the baby on a firm surface. * Locate a position in the centre of the chest. * Using two fingers, press down sharply to a third of the depth of chest. * Press 30 times, at a rate of 100 compressions per minute * After 30 compressions, give two rescue breaths. 3. Continue to resuscitate at 30 compressions to two breaths until help arrives. CPR FOR CHILDREN (1-12 years old) 1. Give five rescue breaths: Tilt the head back and lift the chin to open the airway. * Seal our lips around the child’s mouth and pinch the nose. * Blow gently and watch the chest as you breathe. Make sure your breathing is shallow and do not empty your lungs completely. * As the chest rises, stop blowing and allow it to fall. * Repeat four more times, then check the child’s carotid pulse. 2. Give 3 0 chest compressions: * Place one or two hands in the centre of the chest (depending on the size of the child). * Use the heel of the hand with arms straight and press down to a third of the depth of chest. Press 30 times, at a rate of 100 compressions per minute. * After 30 compressions, give tow rescue breaths. 3. Continue to resuscitate at 30 compressions to two rescue breaths until help arrives or the child recovers. 4. 3 Describe how to deal with an infant and a child who is experiencing a seizure A seizure (also known as a convulsion or fit) consists of involuntary contractions of muscles in body. The condition is due to a disturbance in the electrical activity of the brain and seizures usually result in loss of impairment of consciousness, the most common causes are epilepsy or head injuries.General signs of a seizure are: * Sudden unconsciousness * Rigidity and arching of the back * Convulsive, jerky movements In dealing with seizures, first aid treatment must always include maintaining an open airway and monitoring the infant or child’s vital signs (their level of response, pulse and breathing). You will also need to protect the infant or child from further harm during a seizure and arrange appropriate aftercare once they have recovered. First aid treatment for a seizure includes: * If you see the child falling, try to ease the fall. If possible, protect the infant or child’s head by placing soft padding underneath it. * Make space around them and if necessary, make sure other children move away. * Remove dangerous items, such as hot drinks or sharp objects. * Note the time when the seizure started. * Loosen clothing around the infant or child’s neck. When the seizure has finished: * Open the airway and check the infant or child’s breathing Be prepared to give CPR if necessary * Place the infant or child into the recovery position they are unconscious but breathing normally. Monitor and record vital signs) level of response , pulse and breathing). * Make a note of how long the seizure lasted Do not move the infant or child unless they are in immediate danger Do not put anything in their mouth or use force to restrain them. If any of the following apply, dial 999 for an ambulance: * The infant or child is unconscious for more than 10 min * The seizure continues for more then 5 minutes * The infant or child is having repeated seizures or having a seizure for the first time. 5. 1 Differentiate between a mild and a severe airway obstruction. INFANT Mild ObstructionCheck the infant’s mouth remove any obvious obstructions. Do not sweep your finger around in the mouth (this could push any obstruction further down the airway). Severe obstruction Lay the infant face down along you forearm, with head low, support the back and head If the obstruction is still present, turn the infant onto their back and give up to five chest thrusts. (Using two fingers push inwards and upwards towards the head against the infant’s breastbone, one finger’s breadth below the nipple line). If the obstruction odes not clear after three cycles, dial 999 for an ambulance.Continue until help arrives. CHILD Mild obstruction Encourage them to continue coughing Remove any obvious obstruction from the mouth. Severe obstruction Give up to five back blows with the heel of your hand. Check the mouth and remove any obvious obstruction. If the obstruction is still present, give up to five abdominal thrusts. Continue as for an infant. If I can not remove the obstruction dial 999 5. 2 Demonstrate how to treat an infant and a child who is choking. See answer 5. 1 5. 3 Describe the procedure to be followed after administering the treatment for choking.See answer 5. 1 6. 1 Describe the common types of wounds. These are several types of wounds that can result in bleeding: * Incised: a clean cut, for example from a knife * Lacerated: a jagged cut, for example from barbed wire * Puncture: a penetrating wound, for example from a nail * Graze: a surface wound, for example from a sliding fall * Contused: a bruise, with bleeding under the skin. 6. 2 Describe the types and severity of bleeding and the affect that it has on an infant and a child Please see attached chart. 6. Demonstrate the safe and effective management for the control of minor and major external bleeding. Any open wound is a risk of becoming infected. It is very important to maintain good hygiene procedures to prevent infection between yourself and the injured infant or child. I should always wear disposable gloves and make sure that any cuts on your own hands are covered The most effective way of minimising blood loss from major bleeding is to apply direct pressure over the wound. If the injury is on an arm or a leg, raising the limb will slow down the blood flow and help to stop the bleeding.Minor bleedingFirst aid treatment * Wash and dry your own hands an put on disposable gloves * Clean the cut, if dirty, under running w ater, and pat dry. * Cover the cut temporarily while you clean the surrounding skin with soap and water, and pat the skin dry * Cover the cut completely with sterile dressing or non-allergenic plaster Major bleedingFirst aid treatment * Wash and dry your own hands and put on disposable gloves * Apply direct pressure to the wound with a pad or sterile dressing. * Raise and support (if the injury is on a limb) * Lay the casualty down to treat for shock Bandage the pad or dressing firmly to control bleeding * If bleeding seeps through the first bandage, cover with a second bandage. 6. 4 Describe how to administer first aid for minor injuries. In most first aid situations with children, injuries are likely to be relatively minor, usually with very little blood loos. A common minor injury involving bleeding with children is nosebleed. This usually occurs when tiny blood vessels inside the nostrils burst, either as result of an injury to the nose, or from sneezing, picking or blowing the nose. The first aid treatment for a nose bleed is a follows: Reassure the child and ask them to sit down. * Advise them to tilt their head forwards * Tell the child to breathe through their mouth and to pinch the soft part of the nose (they may need help to do this). * After 10 minutes, release the pressure from the nose. If the bleeding has not stopped, pinch the nose again for two further periods of 10 minutes. * Once the bleeding has stopped, clean around the nose with lukewarm water. * Tell the child not to blow or pick their nose for a few hours (because this may disturb blood clots that may have formed in the nose).Do not let the child’s head top back as blood may run down the throat and cause choking. If the nosebleed is severe, or if it lasts longer than 30 minutes, the child should be taken to hospital. 7. 1 Describe how to recognise and manage an infant and a child who is suffering from shock. The main signs of shock are: * Pale, cold, clammy skin (lips could become blue in severe shock) * Sweating * Weakness and dizziness * Feeling sick and possibly vomiting * Feeling sick and possibly vomiting * Feeling thirsty * Rapid, shallow breathingThe main first aid treatment for shock is: – Give lots of comfort and reassurance. – Lay the casualty down, raise and support their legs. – Use a coat or blanket to keep them comfortably warm – Do not give them anything to eat or drink – Check breathing and pulse frequently. – If the child becomes unconscious, put them in the recovery position – If breathing stops, follow the DRABC resuscitation sequence. 7. 2 Describe how to recognise and manage an infant and a child who is suffering from anaphylactic shock.Anaphylactic shock is a severe allergic reaction which can be life-threatening. It is usually triggered by a substance, to which the casualty is highly sensitive, for example, drugs such as penicillin, insect stings or food such as peanuts. The main signs o f anaphylactic shock are: * Difficulty in breathing, wheezing or gasping for air * General signs of shock * Swelling of the tongue and throat * Puffiness around the eyes * Extreme anxiety The main first aid treatment for anaphylactic shock is: * Send for an ambulance Check whether the child has their own medication and help them to use it if trained to do so * Reassure and comfort the child * Treat for shock * If the child becomes unconscious, put them in the recovery position * If breathing stops, follow DRABC resuscitation sequence Children who are known to suffer from anaphylaxis will usually carry their own medication with them at all times. This is usually in the form of an EpiPen or similar device. An EpiPen is easy to use, although special training should be undertaken and you should always check the policies and procedures in my setting.