FIRST AID basics for Parents and Caregivers

Has your child ever had an accident or you have been in a situation where a child needs medical intervention or treatment but you don’t know what to do?

Here are some useful first aid tips and questions that are commonly asked by parents and caregivers.

I have split them up into the following categories which appear to be the most common first aid related injuries in children:

• Bleeding

• Nose Bleeds

• Allergic Reaction

• Broken Bones

• Burns

• Choking

• Head Injury

• Poisons

1. BLEEDING

If your child has fallen over and is bleeding, the best thing to do first is evaluate the wound. If it a minor cut or graze, you can clean the wound (water and antiseptic solution) to make sure there is no dirt or grind and then let it heal naturally. The wound should heal by itself in a few days.

If it is a bigger cut and bleeding quite a lot, then you can control the wound by applying pressure and elevating the wound. If you are unable to stop the blood flow after applying pressure, take your child to the hospital for medical treatment.

Q – What can I use to put pressure on the wound?

A – The ideal thing to use would be a clean gauze or dressing pads but if you don’t have this and you need to apply something quickly then use anything available to you. You can use your hand, your child’s hand, a t-shirt, a towel – anything that can be put over the wound to stop or slow down the flow of blood.

Q – What do I do if the bleeding soaks through the item I’ve used?

A – Do not remove the item but add more items and maintain firm pressure. Get to the hospital as soon as possible.

Q – Should I worry about cross-infection or catching something from their blood?

A – If you don’t have a cut on yourself, you are very unlikely to get an infection, or infect them. However, if you are worried and want to use a barrier, you can use a plastic bag (over the blood) or plastic gloves.

Q – Should I wash the wound?

A – If it is a minor cut or graze, then yes you can wash the wound to clean it up. DONT however, wash a wound that is bleeding heavily. If you put a heavily bleeding wound under a tap, you may make it bleed more.

Q – How should I elevate the wound?

A – Once pressure has been applied to the wound, you can raise and support the part of the body that’s injured. If it’s a hand or arm, raise it above the head. If it’s a lower limb, lay them down and raise the cut area above the level of the heart.

Q – What do I do if my child has an object in the wound, should I remove it?

A – Do not remove the object. The object is helping to plug the hole and stop the blood flow. Removing it from the wound could make the bleeding much worse. Instead, simply apply pressure around the object and go straight to the hospital.

Q – What is shock, and what are its signs and symptoms and how do we treat it?

A – Shock is caused by a lack of blood circulating in the body due to an injury. A baby or child with shock will look pale, feel cold to touch, and be sweating. If you think a baby or child is going into shock, continue to apply pressure to the wound to stop the blood coming out. Cradle or lay them with their legs higher than the rest of their body. By having their legs higher than their heart you will increase the flow of blood to the brain and heart. You should also wrap them in a blanket to keep them warm and get them to the hospital as soon as possible.

2. NOSEBLEED

A nosebleed is when tiny blood vessels inside the nose are ruptured. Children normally get them due to a bang to the nose, sneezing, picking or blowing their nose and sometimes because of high blood pressure. They can be quite frightening to a parent and child who have not experienced one before as often the blood can come out thick and fast. Don’t panic though, they are generally minor and only last for a few minutes. If your child is having a nosebleed, your priority is to control the bleeding and keep their airway open. Get your child to sit down (not lie down), and bend them forward so the blood runs from the nose. You do not want to tilt them backwards as you do not want the blood running down their throat. Pinch the soft part of the nose until the bleeding stops.

Q – I was always taught to tilt the head backward to treat a nosebleed. Why can’t I do this?

A – Doctors have advised to bend the child forward because tilting the head backward may cause blood to enter the airway or stomach, which may cause your child to choke or feel sick.

Q – Should I be concerned if my child’s nose starts to bleed again soon after it has stopped?

A – If your child’s nose starts to bleed again soon after stopping, it may be because they knocked, blew or picked their nose, or because the blood had not properly clotted after the first bleed. Treat the nosebleed again, and then advise them to sit quietly to give the nose time to heal. If the bleeding continues for more than 30 minutes, go to the hospital.

Q – What should I do if my child wants to blow their nose after a nosebleed?

A – Encourage your child not to blow, cough, spit or sniff for sometime as this may break the blood clots that have started to form.

3. ALLERGIC REACTION

An allergy is a reaction that a child gets when they come into contact with allergens. Allergens can be eaten, inhaled, injected or can come in contact with your child’s skin. A lot of children suffer with allergies these days. Most children who have these allergies tend to inherit them from their parents and they often tend to be minor and treatable. The best things to do is avoid going to a place where you know your child could come into contact with certain allergens.

If your child has a severe reaction to something and you are unable to control it, get them to the hospital as soon as possible.

Q – What is anaphylactic shock?

A – Anaphylactic shock is a severe allergic reaction which makes it difficult for someone to breathe.

Q – What sorts of food items can cause a severe allergic reaction/anaphylactic shock?

A – The most common foods that can cause allergic reactions are things like nuts, shellfish, dairy products and eggs. Other things such as latex, bee and wasp stings, and certain medications can also cause allergic reactions.

Q – How will I know if it is a severe allergic reaction?

A – Babies and children may occasionally have mild allergies, or abnormal reactions resulting in itchy skin and eyes. However, a severe reaction can result in more worrying symptoms such as swelling of the tongue or neck and difficulty in breathing.

Q – Can I do anything to prevent an allergic reaction?

A – Once a baby or child has a known allergy, you can prevent a severe allergic reaction by keeping them away from the cause of the allergy.

Q – How will I know if my baby or child is at risk of anaphylactic shock or has a severe allergy?

A – It is likely you won’t know your baby or child has a severe allergy until they come into contact with the thing they are allergic to. For all children with a severe allergy there will be a ‘first time’, which may be very frightening.

Q – How can I get an insect sting out of a baby or child’s skin?

A – If the sting is still in the skin, brush or scrape it off sideways with your fingernail or a credit card. After the sting has been removed, apply something cold to the area (such as an ice pack) to minimise the pain and swelling. Be aware: this may not reduce the risk of an allergic reaction for a baby or child with an allergy.

4. BROKEN BONES

Bones that are still growing (children’s) are supple and can break easily with not a lot of force. It happens to a lot of children so don’t panic if it happens to your child. They will heal.

Signs of a broken bone include:

1. Swelling

2. Difficulty moving

3. Limb in an unnatural direction

4. Loss of strength

5. Shock

Q – How do I support a broken bone?

A – Do not move the area unnecessarily. If you can, place soft padding (like clothing and blankets) around the limb to align it, but do not force it. If the injury is to their leg, gently pad the gaps between their leg and the floor to support the limb. Continue to support it until you can get medical help.

Q – What can I do if my baby or child is in a lot of pain?

A – Get to the hospital as soon as you can so the doctor can administer something to relieve the pain.

5. BURNS

A burn is damage to your child’s skin caused by heat. Burns fall into two main categories: burns and scalds. Burns are caused by contact with hot objects, flames, or by friction. Scalds are caused by steam or hot liquids such as tea or oil. Both burns and scalds are treated by cooling the burn under cold running water for at least ten minutes and then seeking medical help. Burns can be very dangerous, depending on the age of the child and the size, depth and location of the injury. Even small burns can be potentially life-threatening to a baby or child, so always go direct to the hospital.

Q – If my child or baby is wearing clothing on the area of the body that has been burned, should I remove the clothes?

A – If the clothing is stuck to the burn area you should leave the clothing in place. However if the clothing is not stuck to the burn, and you can remove it quickly, you should do so.

Q – Can I use a shower to cool the affected area?

A – A shower is a good way of flooding the burn with cold water to help the cooling. Cooling should focus on the site of the burn itself rather than the whole of a limb or body. Putting the whole body under a cold shower could induce hypothermia and is not advised.

Q – Why is cooling the burn so important?

A – Cooling the burn is important because it not only reduces any pain the baby or child will feel, but also reduces the risk of long-term scarring.

Q – If it is a severe burn, should I cool the burn for ten minutes and then go to hospital, or should I go straight to hospital?

A – If it is a severe burn, cool the burn under cold running water immediately. Run it under the water for about ten minutes and then go to the hospital, keeping the burn as cool as possible on the way.

Q – I’ve heard I should put a plaster over the burn to make sure it doesn’t get infected. Is that right?

A – Don’t use any adhesive bandages to cover a burn as they’ll stick to the skin and may cause further damage. After the burn has been cooled, cover it with cling film or a clean plastic bag as this will help prevent infection and won’t stick to the burn.

Q – Should I put butter, honey, ointment or cream on a burn?

A – No, these will not help to cool the area. All oils retain heat, which is the opposite of what you’re trying to achieve. Also, if you put anything on top of a burn and it later needs to be removed in hospital, it may cause further pain, distress and damage.

Q – Should I use ice to cool the burn?

A – No, use water only. Ice may further damage the skin.

Q – I was told that rubbing toothpaste into a burn will soothe it, is this right?

A – No, there is no clinical evidence to suggest a benefit from putting toothpaste on a burn. People tend to apply toothpaste because it often contains ingredients like menthol or eucalyptus, which give some superficial relief to the surface of the burn area, but the importance of cooling a burn is to reach deep down under the skin where it is damaged.

6. BABY/CHILD CHOKING

Choking is when your child’s airways get blocked and they can’t breathe properly. Young children are more likely to choke, because they often put small objects in their mouths that they may breathe in and get stuck.

If a child or baby is choking they’ll get upset quickly and you need to act fast to clear what’s stuck. Normally children manage to cough the object out but If they can’t cough or make any noise, it’s serious.

If your child chokes, follow these steps:

1. Lay your baby/child face down on your thigh and support their head.

2. Give up to 5 back blows between the shoulder blades with the heel of your hand.

3. Check your child’s mouth by laying them on your thigh face up.

4. If you can pick out the obvious objects, then do so with your fingertips. If you don’t see anything, don’t put your fingers in your child’s mouth as you risk pushing the object further down the throat or actually damaging the soft tissue at the back of the throat, which is extremely sensitive and so could swell and cause further damage.

5. If this doesn’t work, you can try and squeeze the object out by using two fingers to give your child chest thrusts. Give no more than 5 chest thrusts.

6. Go straight to hospital.

Q – How can I tell if a baby is choking?

A – If a baby is seriously choking, they may change colour, will be unable to cry, cough, make any other noise or breathe.

Q – Why do I have to hold my baby with its head lower than its bottom?

A – With babies, the blockage is often a liquid (milk curdle or mucous) so ensuring the head is lower than the bottom helps the liquid to drain out.

Q – Why do I have to support the head?

A – Supporting the head will help to keep the airway open, helping to facilitate the dislodging of the object from the baby’s airway.

Q – How hard should the back blows be?

A – You should modify the force of the back blows depending on the size of the baby, so you need to be gentler with a smaller baby than you are with a larger child. The force with which you deliver the back blows should also be relative to your own strength. However, keep in mind that the most common problem with choking injuries is people not delivering back blows with enough force. They need to be hard enough to cause a vibration in the windpipe and dislodge the object.

Q – Can I do abdominal thrusts (Heimlich manoeuvre) on a baby?

A – No, don’t squeeze a baby’s tummy. Abdominal thrusts are used to treat choking in older children and adults only. Using abdominal thrusts on a baby could cause further damage as their internal organs are fragile and still developing.

Q – If my baby is choking, should I hang them upside down by their feet?

A – No, this is not effective and may cause further injury if you happen to drop them. Tipping them upside down may also embed the object further.

7. HEAD INJURY

All head injuries can be potentially serious. It all depends on how your child hit their head and how hard the impact was. Most children however are used to frequent bumps and falls which are totally normal. If your child has had a head injury and you are worried, here is what you should look out for:

• temporary unconsciousness

• dizziness

• headache

• confusion

• feeling sick

• blurred vision

• increasing drowsiness

• having no memory of what happened.

1. First thing you need to do is sit your child down and hold something cold (ice pack preferably) against the injury.

2. If your child is bleeding, treat the wound the same as mentioned above, with pressure to stop the flow of blood.

3. Check your child’s level of responsiveness – The AVPU Scale

⁃ A – Alert: Are they alert? Are their eyes open and do they respond to questions?

⁃ V – Voice: Do they respond to voice? Can they answer simple questions and respond to instructions?

⁃ P – Pain: If they’re not alert or they’re not responding to your voice – do they respond to pain? Try pinching them – do they move or open their eyes?

⁃ U – Unresponsive: Do they respond to questions or a gentle shake?

If your child is alert and responsive then their head injury is probably mild, but you should be with them until they recover.

If your child is not alert or responsive then they may be partially or fully unresponsive and their head injury could be severe in which case, get to the hospital as fast as you can.

Q – Can I give my baby or child paracetamol or another painkiller for their headache?

A – Painkillers are not advised because they can mask the signs and symptoms of a serious head injury.

Q – Can I let my baby or child go to sleep if they have suffered a head injury?

A – Once you have treated the swelling by applying something cold to the baby or child’s head injury, and if they are not displaying signs of a serious head injury, you could let them sleep. Ensure you check on them regularly.

Q – Do I need to keep a close eye on a baby or child who has a head injury?

A – Yes. Following such incidents, you should monitor them for the symptoms of a serious head injury. If you suspect they do have a serious head injury you should go to the hospital right away. Be aware that sometimes you may not see the symptoms immediately.

Q – Should I go to the doctor every time my baby or child bumps their head?

A – You should see a doctor if they show signs of a serious head injury. You should also seek medical advice if you are unsure of the severity of the injury.

8. POISONS

Poisons are substances that can cause temporary or permanent damage if too much is absorbed by the body. These are substances that can cause harm and include drugs (prescribed or un-prescribed), chemicals (including household cleaning products) and some plants if your child swallows them. If your child has consumed some sort of poison they may vomit or have abdominal pain, or you may see empty containers nearby. They may have evidence of the harmful substance around their mouth, or smell of it. Babies and children can have different reactions to harmful substances, and sometimes it may take some time for symptoms to occur. If in doubt, seek medical advice straight away.

Q – Can I make the baby or child sick if they have taken something corrosive?

A – No, if they have swallowed something corrosive, the liquid will burn the throat on the way back up, causing more pain and distress.

Q – Can I give the baby or child something to drink if they have taken a harmful substance?

A – No, don’t give them anything to drink. The fluid will enter their stomach and break down the harmful substance. This may result in the harmful substance being absorbed into their body more quickly.

If you’re a parent or caregiver, learning first aid will give you confidence to help a child when it really counts. What I have mentioned in this list however is basic information. If your child has a serious injury, take them to the hospital as soon as possible to get help.