If you are a parent or work in the childcare sector then having an understanding about first aid for children and babies is essential. This article is meant as an introductory guide only and should not be used as a replacement for paediatric first aid training.
Children are by nature inquisitive beings and love to learn by investigating new things. They will use their hands, fingers and their mouths to touch, feel and taste new objects. As they begin to learn to toddle, walk and then run, the world around them becomes their adventure playground.
Unfortunately babies and children have a diminished ability to recognise dangers and often find themselves in trouble. It is your role as a parent, child minder, nursery nurse or teacher to take on the responsibilities of a first aider. The following article will give a brief overview of the skills required by a paediatric first aider. It is essential that you receive training in these skills as you could mean the difference between the life and death of a child in the case of an accident or emergency.
Very often in the event of an accident or an injury the first aid given immediately can improve recovery time and even in extreme cases save the life of the patient. The roll of first aiders cannot be underestimated.
Dealing With Emergencies
Having a first aid kit specifically designed with children in mind and keeping up-to-date with paediatric first aid skills are essential in dealing with emergencies. Your first aid kit should contain:
- Waterproof children’s plasters in different sizes
- Triangular bandages
- Safety pins
- Dressings in various sizes
- Microporous Dressing tape
- A Plastic finger applicator
- Tubular Gauze bandages
- Wipes – Alcohol-free
- Gauze Swabs – Sterile
- A Resuscitation Face Shield
- A Paediatric First Aid Guidance leaflet
- Eye pad dressings
The first aid kit should be checked regularly to make sure that everything is in date and that anything that has been used has been replaced. It should be stored in a clearly marked first aid kit plastic container and it is essential that it is easily accessible. Ensure that everyone knows where it is.
CPR For Children Over One Year Old
CPR or Cardiopulmonary Resuscitation is a technique to be used when a child is unconscious and has stopped breathing normally. The aim is to keep the oxygen flowing through the child’s body. If you have not been trained the give mouth to mouth resuscitation then you should do chest compressions only. The following information is no substitute for getting proper training in the correct CPR techniques.
- First check the child’s airways (nose and mouth) for any foreign objects that may be interfering with normal breathing. Do this by gently tilting the child’s head back, with one hand on their forehead, and lifting the chin. Remove any foreign object from the child’s nose and mouth.
- Give five rescue breaths to the child to begin with by pinching their nose and creating a seal with your mouth over the child’s mouth. Blow into the child’s mouth steadily yet firmly and check that the child’s chest rises.
- Give chest compressions by placing your hands in the middle of the child’s chest and pressing down with the heel of your hand. Press down to around a third of the depth of the child’s chest.
- Give the chest compressions at a speed of slightly more than one compression per second. After giving the child 30 chest compressions, give the child 2 rescue breaths.
- Continue with the above cycle until the emergency services arrive or until the child begins to recover.
CPR For Babies Under One Year Old
The NHS website outlines the technique for doing cardiopulmonary resuscitation on a baby:
- Open the baby’s airway by placing one hand on their forehead and gently tilting the head back and lifting the chin. Remove any visible obstructions from the mouth and nose.
- Place your mouth over the mouth and nose of the infant and blow steadily and firmly into their mouth, checking that their chest rises. Give five initial rescue breaths.
- Place two fingers in the middle of the chest and press down by one-third of the depth of the chest. After 30 chest compressions at a steady rate (slightly faster than one compression a second), give two breaths.
- Continue with cycles of 30 chest compressions and two rescue breaths until they begin to recover or emergency help arrives.
Methods For Handling Electrocution and Shock
Of course, prevention is better than a cure and all electric sockets and appliances should be out of bounds for an inquisitive young child. If a child does suffer an electric shock, then always make the area safe. Turn off the electrical power or, if this is not possible, then move the child away from the cause of the electrocution. Use a wooden or plastic pole, such as the handle of a broom, to push the child away. Call the emergency services.
Next try to stimulate the child by speaking their name to them loudly and asking them if they are awake. Tap the child’s feet or hands but never shake them in case they have injured their neck in the accident. If a child does not respond and is not breathing then you will need to begin CPR. If you suspect that the child has injured their neck then tilt the head very carefully. Stay with the child until emergency help arrives.
After any kind of accident, a child may go into shock. A child that has gone into shock will look pale or may complain of feeling unwell or feeling faint. In these cases make the child lie down and ensure that the child is kept warm. Do not allow them to get too hot and ensure that they stay led down until the faint feeling passes.
How to Deal With Bleeding
If a child has injured themselves then the first priority is to stop any bleeding. If there is a lot of bleeding then use the following techniques:
- Using a clean towel press down on the area of bleeding firmly and keep the pressure on until the bleeding stops. This could take over 10 minutes so just keep the pressure on with your hands and do not tie anything in place that may stop the circulation.
- Raise the injured limb, if you do not think that the limb is broken. By raising the limb you can help to stop the bleeding. Keep the wound covered.
- A wound only usually requires the emergency services if the wound continues to bleed non-stop after the above techniques have been used. A trip to Accident and Emergency may also be required if you think that there may be a piece of glass or some other object in the wound.
Dressing Scolds and Burns
The very first thing you should do if a child burns or scolds themselves is run cold water over the burn to reduce the heat and any further damage. If you do not have access to cold running water then place the burn in a container of cold water if you can.
When covering a burn use fabric such as cotton or linen that is clean and will not stick to the burn. Clingfilm also works very well and by covering the wound in this way you are helping to prevent any infection. If the child’s clothes are stuck to the burn then do not try to take them off as you may cause more damage. In this case get the help of a doctor.
Never apply anything such as butter or toothpaste to a scold or burn as it will not help and will only make the job of treating it harder. If the burn is not too severe then make an appointment to see a GP, if it is more severe then take the child to the accident and emergency department.
A burn may well blister, but these will burst by themselves. Ensure that they are covered appropriately when they do burst to protect the sore skin underneath.
Choking in Babies
A baby is a child who is under 1 year old. A baby may choke for a number of reasons but it is often caused by food or an object getting stuck in their airways. When a baby is choking they will usually be unable to cry or breathe so immediate action is vital. The NHS website gives this advice on what to do when a baby is choking.
- Lie the baby face down along your forearm or thigh, with their head low. Support their head.
- Give up to five firm slaps to the baby’s back between the shoulder blades with the heel of your hand. (The heel is between the palm of your hand and your wrist.)
- Stop after each slap to check if the blockage has cleared. Look inside the baby’s mouth and remove any obvious blockage. Do not poke your fingers into the baby’s mouth unless you can see and reach the blockage. You may push it further in.
- If the airway is still blocked, give up to five chest thrusts.
To give the chest thrusts the NHS recommend the following method:
- Lie the baby along your forearm on their back, with their head low. Support their back and head.
- Give up to five chest thrusts. Using two fingers, push inwards and upwards (towards the head) against the baby’s breastbone, one finger’s breadth below the nipple line.
- Check if the blockage has cleared after each thrust, by looking inside the baby’s mouth and removing any obvious blockage. Do not poke your fingers into the baby’s mouth unless you can see and reach the blockage as you may push it further in.
- Stop after each thrust to check if the blockage has cleared.
If after three cycles of the above method the baby still cannot breathe and you could not dislodge the blockage then call for an ambulance immediately. Keep the baby with you as you phone for the emergency services and then continue the above methods until help arrives.
How to Deal With Broken Bones
If you suspect that a child has broken their arm or their leg then help to move the child very gently. Support the injury by placing one hand below the injury to steady it and keeping one hand above the injury. The child will need to be taken to accident and emergency to have the break treated. Keep the child calm by comforting them. If the child is in too much pain for you to move them then call for an ambulance.
Do not attempt to move a child if you suspect that they have injured their spine or their neck as this can cause paralysis. Keep the child still and comfort them whilst you phone for emergency services.
You can give the child painkillers if they are in a lot of pain. Take care to follow the recommended dose for the child’s age.
What to do if a Child Starts Fitting
If a child starts to fit then try to keep calm. Lie the child on one side so that they do not choke if they vomit and try to keep them cool by removing any coats and blankets. If the fit does not stop within 3 minutes then call the emergency services. Most fits will stop by themselves within 3 minutes but try to keep calm if they do not stop. To do any brain damage a fit would need to last over half an hour.
If a child has not had a fit before then they will need to be taken to hospital to be checked out. It is still important to keep the child’s GP up-to-date after the child has had a fit.
The role of a paediatric first aider is vast and it is important to have a good knowledge of a wide range of skills and techniques. Everyone who has dealings with children as part of their job or their day to day lives should have basic paediatric first aid training. First aiders are the first people on the scene of an accident or an emergency and their aid is so important that it saves the lives of children every day. The above described techniques are a basic guide to the role of a paediatric first aider and should in no way be used as a replacement for proper up-to-date training.
Lebreton Training strongly recommends that anyone responsible for the care of children seeks training in paediatric first aid techniques. If a first aiders techniques are poor or are not performed correctly then they could cause the child more harm than good.