First Aid - General & Other

First Aid (General)

Burns

Burns are one of the leading causes of accidental death in childhood, second only to motor vehicle accidents. Burns are often categorized as first, second, or third degree, based on the severity of damage to the skin.

All burns should be treated quickly to reduce the temperature of the burned area or to wash off chemicals, which helps reduce damage to the skin and underlying tissue.

First-degree burns, the mildest of the three, are generally caused by brief skin contact with hot water, steam, or hot objects or by overexposure to the sun. First-degree burns cause some blistering, swelling, redness, and pain.

Second-degree (or partial thickness) burns result from contact with chemicals, hot liquids, or solids or from clothing catching on fire. The skin can appear mottled white to cherry red, and the burn is quite painful. Blisters are common.

Third-degree (or full thickness) burns can result from prolonged contact with hot liquids or solids, chemicals, or electricity. Skin can be charred, leathery, or have a very pale appearance. There may be little or no pain because of nerve damage.

Eye Injuries

You can treat many minor eye irritations by flushing the eye, but more serious injuries require medical attention. Injuries to the eye are the most common preventable cause of blindness; so when in doubt, err on the side of caution and call your child's doctor for help.

• Do not try to remove any "foreign body" except by flushing, because of the risk of scratching the surface of the eye, especially the cornea.
• Wash your hands thoroughly before touching the eyelids to examine or flush the eye.
• Do not touch, press, or rub the eye, and do whatever you can to keep the child from touching it (a baby can be swaddled as a preventive measure).
• Tilt the child's head over a basin with the affected eye down and gently pull down the lower lid, encouraging the child to open her eyes as wide as possible. For an infant or small child, it is helpful to have a second person hold the child's eyes open while you flush.
• Gently pour a steady stream of lukewarm water from a pitcher (do not heat the water) across the eye. Sterile saline solution can also be used.
• Flush for up to 15 minutes, checking the eye every 5 minutes to see if the foreign body has been flushed out.
• Since a particle can scratch the cornea and cause an infection, the eye should be examined by a doctor if there continues to be any irritation afterward.
• If a foreign body is not dislodged by flushing, it will probably be necessary for a trained medical practitioner to flush the eye.

Fainting, Fractures, Sprains and Head Injuries

Head injuries fall into two categories: external (usually scalp) injuries and internal head injuries, which may involve the skull, the blood vessels within the skull, or the brain.

Fortunately, most childhood falls or blows to the head result in injury to the scalp only, which is usually more frightening than threatening. An internal head injury has more serious possible implications, since the skull serves as the protective helmet for the delicate brain.

External (Scalp) Injury
The scalp is rich with blood vessels, so even a minor cut to the scalp can bleed profusely. The "goose egg" or swelling that may appear on the scalp after a head blow results from the scalp's veins leaking fluid or blood into (and under) the scalp. It may take days or even weeks to disappear.

What to do:

• Call your child's doctor if your child is an infant or has lost consciousness, even momentarily.
• If your child is not an infant, has not lost consciousness, and is alert and behaving normally after the fall or blow, apply an ice pack or instant cold pack to the injured area for 20 minutes. If you use ice, always wrap it in a washcloth or sock; ice applied directly to bare skin can cause frostbite damage.
• Observe your child carefully for the next 24 hours. If he shows any of the signs of internal injury (see below), call your child's doctor immediately.
• If the incident has occurred close to bedtime or naptime and your child falls asleep soon afterward, check him every few hours for disturbances in color or breathing, or twitching limbs.
  • If color and breathing are normal, and you observe or sense no other abnormalities, let your child sleep (unless your child's doctor has advised otherwise). There is no need to keep a child awake after a head injury.
  • If color and/or breathing are abnormal, or if you are not comfortable with your child's appearance (trust your instincts), arouse him partially by sitting him up. Your child should fuss a bit and attempt to resettle. If he does not protest, try to awaken him fully. If he cannot be awakened, or shows any signs of internal injury (see below), call your child's doctor or an ambulance.

Heat Illness

Our bodies create a tremendous amount of internal heat. We normally cool ourselves by sweating and radiating heat through the skin. Under certain circumstances, such as unusually high temperatures, high humidity, or vigorous exercise in hot weather, this natural cooling system may begin to fail, allowing internal heat to build up to dangerous levels. The result may be heat illness, which can be in the form of heat cramps, heat exhaustion, or heatstroke.

Heat Cramps

Heat cramps are brief, severe cramps in the muscles of the leg, arm, or abdomen that may occur during or after vigorous exercise in extreme heat. They are painful but not serious. Children are particularly susceptible to heat cramps when they have not been drinking enough fluids.

Most heat cramps do not require special treatment. A cool place, rest, and fluids should ease the child's discomfort. Massaging cramped muscles may also help.

Heat Exhaustion

Heat exhaustion is a more severe heat illness that can occur when a person in a hot climate or environment has not been drinking enough fluids. Symptoms can include dehydration (intense thirst), fatigue, weakness, and clammy skin. There also may be headache, nausea and/or vomiting, hyperventilation (rapid breathing), or irritability.

If a child shows signs of heat exhaustion, resting in a cool area and drinking fluids are the keys to recovery.

What to Do:

• Bring the child indoors or into the shade.
• Loosen or remove clothing.
• Encourage food and drink.
• Give a bath in cool (not cold) water.
• Call the doctor for further advice. If the child is too exhausted or ill to eat or drink, intravenous fluids may be necessary.

If left untreated, heat exhaustion may escalate into heat stroke, which can be fatal.

Nosebleeds

A nosebleed can be scary, but it is rarely cause for alarm. Most nosebleeds are caused by zealous blowing or picking, or a blow during rough play. In the wintertime, especially, if your child's bed is near a heater, the membranes inside the nose can become dried and itchy, causing your child to pick at his nose and further irritate the nasal tissue.

What to do:

• Stay calm and reassure your child.
• Sit the child upright in a chair or in your lap and have him tilt his head slightly forward. Gently pinch his nose (just below the bony ridge) shut with a tissue or a clean washcloth. Keep pressure on the nose for about 10 minutes; if you stop too soon, bleeding may start again. Ice wrapped in a paper towel applied to the nose may also help.
• Do not have your child lean back. This may cause blood to flow down the back of the throat, which tastes bad and may initiate gagging, coughing, or vomiting.
• Keep your child quiet for several hours following the nosebleed. Discourage blowing, picking, rubbing, and any rough play.
• Here are some tips for preventing future nosebleeds:
  • To prevent picking, keep your child's nails short.
  • Following a nosebleed, discourage strenuous activity, which may increase pressure on blood vessels and start the bleeding again.
  • Keep the inside of your child's nose moist with saline nasal spray or dab Vaseline gently around the opening of the nostrils.
  • If the air in your home is dry, humidify your child's room with a vaporizer (be sure to keep the vaporizer clean to prevent mildew).

Call your doctor, or head for the emergency room, if:

• Your child gets a nosebleed as the result of a blow to the head or a fall
• You are unable to stop the nosebleed
• Nosebleeds are frequent, or they last longer than 15 minutes
• Your child has difficulty breathing
• There is bleeding from another place, such as the gums
• Your child has just started taking new medicine
• There is a foreign body stuck in your child's nose

Chemicals, Cleaners, and Other Poisons

In Texas 1-800-POISON1

If you have a poison emergency or a question about poisons and you're in the United States, call 1-800-222-1222.This toll-free number will put you in touch with the poison control center in your state.

If your child has collapsed or is not breathing, call 911.

Seizures and Convulsions

Seizures are caused by abnormal electrical discharges in the brain. Symptoms may vary depending on the part of the brain that is stimulated, but seizures may be associated with unusual sensations, uncontrollable muscle spasms, and loss of consciousness. Some seizures may be the result of a medical problem. Low blood sugar, infection, a head injury, accidental poisoning, or drug overdose may cause a seizure. A seizure may also be due to a brain tumor or other neurological abnormality. In addition, anything that results in a sudden lack of oxygen to the brain can cause a seizure. In some cases, the cause of the seizure may not be discovered. When seizures recur, it may indicate the chronic condition known as epilepsy. Febrile seizures are relatively common in children younger than 5 years old. Febrile seizures can occur when a child develops a high fever, usually with the temperature rising rapidly to 102 degrees Fahrenheit or more. While terrifying to parents, these seizures are usually brief and rarely cause any problems, unless the fever is associated with a serious infection, such as meningitis. A child who has a febrile seizure is not more likely to develop epilepsy.

What to do:

• A child who's having a seizure should be placed on the ground or floor in a safe area.
• Remove any nearby objects.
• Loosen any clothing around the head or neck.
• Do not try to wedge the child's mouth open or place an object between the teeth, and do not attempt to restrain movements.
• Once the seizure seems to have ended, roll your child onto his or her side.

Call emergency medical services immediately if:

• The child has difficulty breathing
• Turns bluish in color
• Has sustained a head injury
• Seems ill
• Has a known heart condition
• You suspect your child has ingested any poisons, medications, etc.
• You have any other concerns

If the child is breathing normally and the seizure lasts just a few minutes, you can wait until it has subsided, then call your doctor. If the child has never had a seizure before, seek immediate care. For a child who is known to have seizures, call emergency services if the seizure lasts more than 5 minutes, or if the seizure is different than usual.

Following the seizure, the child will probably fall into a deep sleep (this is called the postictal period). This is normal, and you should not try to wake your child. Do not attempt to give food or drink until your child is awake and alert.

For the child who has febrile seizures, the doctor may suggest that you give fever-reducing medicine (such as ibuprofen or acetaminophen) to control the fever and prevent seizures from recurring. Your doctor may also recommend sponging your child with lukewarm water to help cool your child down.

Following a seizure - particularly if it is a first or unexplained seizure - call your doctor or emergency medical service for instructions. Your child will usually need to be evaluated by a doctor as soon as possible.

Skin Wounds

Most small cuts do not present any danger. Larger wounds, particularly those where an artery has been damaged, can cause severe bleeding and result in falling blood pressure and shock. Depending on the type of wound and its location, there can be damage to tendons and nerves. Bleeding from large cuts may require immediate medical treatment.

Stings and Bites

If the sting or bite wound is bleeding, apply pressure to the area with a clean bandage or towel until the bleeding stops. If available, use clean latex or rubber gloves to protect yourself from exposure to blood.

• Clean the wound with soap and water, and hold it under running water for at least 5 minutes. Do not apply an antiseptic or anything else to the wound.
• Dry the wound and cover it with sterile gauze or a clean cloth.
• Phone your child's doctor. Your child may need antibiotics, a tetanus booster, or a rabies vaccination. A bite or scratch on a child's hand or face is particularly prone to infection and should be evaluated by your doctor.
• If possible, locate the animal that inflicted the wound. Some animals may have to be captured, confined, and observed for rabies. Do not try to capture the animal yourself. Look in your phone book for the number of an animal control office or animal warden in your area.
• Go to the nearest hospital emergency department if:
  • The wound won't stop bleeding after 10 minutes of direct pressure.
  • The wound is more than 1/2 inch long or appears to be deep.
  • The attacking animal was wild (not tame) or behaving strangely.
  • A body part is severed. Wrap the severed part in sterile gauze or a clean cloth and take it with you to the emergency department.

Reminder to pet owners: Make sure that your pets are properly immunized and licensed.

Tooth Injuries

A dislodged baby tooth cannot be replaced. A permanent tooth, on the other hand, can often be saved if prompt action is taken and the tooth is handled carefully. The delicate tissue covering the root, called the periodontal ligament, must be protected to ensure successful reimplantation.

What to do when a baby or toddler injures gums or teeth:

• If there is bleeding, put cold water on a piece of gauze and apply pressure to the site.
• Offer him an ice pop to suck, to reduce swelling.
• Call your dentist. He or she will probably want to see the child to assess the need for realignment, or removal of a very loose tooth. If the child is very young, the dentist may recommend a spacer to keep the rest of the teeth in place until the permanent tooth appears.
• Over the following week, watch for signs of an abscess: fever and swollen, tender gums above the injury site