What To Do In An Emergency Involving Your Baby Or Toddler - Part 1

The unexpected could happen at any time. It's important to know what to do and how to react if something would happen to your baby or toddler.

Keeping calm is the most important thing. You won't be able to think clear and realistic if you are panicking.
Although this is a guideline to what to do in an emergency situation, I would recommend that all moms should take a First-Aid course.

CPR FOR A BABY UNDER 1 YEAR

If your baby is unresponsive and has stop breathing, every second counts.

Try to keep calm and remember A-B-C

A – IS FOR AIRWAY

Your first task is to make sure that air can pass freely into your baby’s lungs.

1. Place your baby onto his back on a firm, flat surface such as the floor or table ( not a bed)
2. Keep your baby’s airway open by tilting his forehead back with one hand, while gently keeping this chin up with your other hand ( head tilt-chin lift)
3. Remove any visible object from his mouth, being careful not to push it further down.

B- IS FOR BREATHING

Your next task is to get air in your baby’s lungs.

1. While maintaining head tilt-chin lift, seal your mouth over your baby’s mouth and nose. Give 2 breaths
2. Fill your cheeks with air and blow gently into his lungs, at the same time to see if his chest is rising
3. As soon as his chest rises, stop blowing and lift your mouth to let air flow out of his lungs
4. Repeat this rescue breath one more time. Avoid hyperventilation. When breathing, use enough force necessary to make his chest rise.

C- IS FOR CIRCULATION

You now need to get oxygen from your baby’s lungs to the baby’s brain.

1. After giving 2 initial rescue breaths, you need to start chest compressions immediately

2. Using 2 fingers, press down in the middle of your baby’s chest, a finger’s width below an imaginary line drawn between the nipples

3. Press down approximately 1/3 of the diameter of the chest (about 2 cm)

4. Perform 30 cycles of chest compressions followed by 2 effective ventilation's, with as short a pause in chest compressions as possible.
Make sure to open the airway before giving ventilation's.

5. Repeat the routine of 30 compressions followed by 2 breaths

6. After approximately 1 minute, check for breathing and movement to see if they have returned. Ensure that an ambulance is on the way

7. Continue with 30 compressions followed by 2 breaths until professional help arrives, or until your baby recovers.

It is essential to get professional help as quickly as possible. If someone is with you, send them to call for an ambulance immediately.
If you are on your own, do 1 minute CPR first, and then go to the nearest telephone, taking your baby with you. Call an ambulance even if you’re not sure how serious the situation is. If your baby looses consciousness:
ASSES AIRWAY, BREATHING, and CIRCULATION.


CPR FOR CHILDREN OVER 1 YEAR

A – IS FOR AIRWAY

Your first task is to make sure that air can pass freely into your child’s lungs.

1. Place your child onto his back, on a flat, firm surface

2. Keep your child’s airway open by tilting his forehead back with one hand while gently keeping his chin up with your other hand (head tilt-chin lift)

3. Remove any visible object from his mouth, being very careful not to push it further down.

B- IS FOR BREATHING

Your next task is to get air into your child’s lungs.

1. While maintaining head tilt-chin lift, seal your mouth over your child’s mouth. Pinch the nose closed, using the hand that’s on the child’s forehead

2. Blow gently into his lungs, at the same time looking to see if his chest is rising

3. As soon as the chest rises, stop blowing and lift your mouth to let air flow out of the lungs.

4. Repeat this rescue breath one more time

C- IS FOR CIRCULATION

You need to get oxygen from the lungs to your child’s brain.

1. After giving 2 initial rescue breaths, check again for breathing or movement for up to 10 seconds. If there is no response, you need to start chest compressions.

2. Using 1 hand, press down in the middle of the child’s chest, between the child’s nipples

3. Press down approximately 1/3 of the diameter of the chest ( about 3 cm)

4. Perform 30 cycles of chest compressions followed by 2 effective ventilation's with as short a pause in chest compressions as possible.
Make sure to open the airway before giving ventilation's.

5. Repeat the routine of 30 compressions followed by 2 breaths

6. After approximately 1 minute, check for breathing and movement to see if they have returned. Ensure an ambulance is on the way.

7. Continue 30 compressions followed by 2 breaths until qualified help arrives, or until the child recovers.

Get professional help as soon as possible. If someone is with you, send them to call for an ambulance immediately.
If you are on your own, do 1 minute CPR first, and then go to the nearest telephone, taking your baby with you. Call an ambulance even if you’re not sure how serious the situation is.


IF YOUR CHILD HAS SWALLOWED CHEMICALS OR POISON

Children's curiosity makes the easy targets for household and other common poisons. Make sure all you household chemicals are kept safely out of reach or locked away.

These chemicals include the following:

• Oven cleaner
• Drain cleaner
• Toilet cleaner
• Paint stripper
• White spirits
• Methylated spirits
• Bleach
• Disinfectant
• Anti-freeze
• Rat or insect poison
• Washing powder
• Detergent
• Pills or medicines

SIGNS AND SYMPTOMS OF POISONING

1. Burns or redness around the mouth
2. Empty or half empty containers near your child
3. Plant or berry pieces in his mouth
4. Drowsiness
5. Unconsciousness

A number of common garden and house plants are also poisonous, here are a few examples:

• Oleander

• Foxglove

• Wisteria

• Elephant ear

• Azaleas

• Arum Lilly
• 
  
  
  SWALLOWED POISON
  
  It’s not always easy to tell whether your child has actually swallowed the substance, or how much has been swallowed. If you even suspect that your child has swallowed a hazardous substance, here’s what to do:
  
  1. Call an ambulance immediately
  2. Remove any visible pills, berries etc from the child’s mouth
  3. DO NOT try to make his vomit. If he has swallowed something corrosive, it will burn again on the way back up
  4. Keep the container of the product with you and tell the paramedics what your child has taken
  

FIRST AID AND MEDICINE SAFETY

• ANIMAL BITES

Toddlers sometimes tease pets, or hurt them accidentally, and nips and scratches are the result. Tetanus injections are always recommended for deep bites and scratches, although if your child’s vaccinations are up to date, he should be protected against Tetanus.

IF YOUR CHILD IS BITTEN
He should be seen by a doctor for examination and treated. In the meanwhile:

1. Reassure your child – an animal bite can be very frightening
2. Wash the wound thoroughly with warm water
3. Cover the bite with clean, dry dressing, not cotton wool
4. If the bite is deep and serious, you will need to control the bleeding by pressing directly on the wound with a sterile dressing. Raise the wounded part of the body and wrap it firmly in a bandage, but not too tight to restrict blood flow.

• INSECT BITES AND STINGS

Insect bites are generally painful and itchy. In some cases, they can be serious. The most serious problem that can occur is an allergic reaction.
This should be treated as an emergency.

Symptoms to watch out for are puffy eyes, swelling of the face and neck, blotchy skin, wheezing and gasping.

Bees are the most common culprits in the summer. Teach your child to stay clam around them. If your child is stung by a bee or a wasp, don’t try to remove the stinger with your finger, as this will squeeze the venom sac, forcing more venom into the flesh. To remove a bee sting, gently scrape the stung area with a blunt, flat object like a plastic ruler, butter knife or even a tough leaf. Use a motion that is flush with the skin to remove the sting. Wash the area with soap and water. To reduce inflammation and give relief, use an ice- pack or cloth soaked in cold
water.

Spiders can give quite nasty, painful bites. Scorpions can cause painful stings too. Relatively few spiders and scorpions are dangerous. If your child is stung by a thick-tailed scorpion, immediate medical attention is required.
For minor bites and stings, antihistamine cream or calamine lotion should give relief. Holding the affected area under cold water also helps.

• CUTS AND GRAZES

Like bruises, cuts and grazes are common amongst toddlers. If they are not infected or bleeding profusely, they should heal with little treatment.

1. Run cold water over the affected area
2. Clean all wounds not bleeding profusely with common soap and water
3. Wash well to make sure that any bits of gravel or soil in the graze are removed
Your child may protest a bit, but you do need to get it properly clean -
1. Pat dry
2. Apply an antiseptic
3. Cover with a plaster or sterile dressing
Do not use cotton wool on any wound.

REMEMBER:
If the cut is bleeding profusely or is very deep, or very jagged, it may require stitches.
If the cut has been caused by fingernails, teeth or something very dirty, there is a risk of infection, so seek medical attention.

• JELLYFISH AND BLUE BOTTLES

These stings can be very painful and depending on the jellyfish it can be dangerous. Use seawater to lift the tentacles off the skin immediately. Do not rub sand in the area. Meat tenderizer helps relieve the sting. Make up a paste with water and apply to blue bottle or bee stings. Urine also helps to sooth the pain.

• TICKS

To remove a tick, cover it with Vaseline. Hold tweezers as close to your child’s skin as possible and pull the tick straight out, with steady pressure. Apply disinfectant. Watch for symptoms of tick bite fever, such as headaches, nausea and flu-like symptoms.

• BLISTERS

Blisters are normally the result of ill-fitting shoes and they are seldom serious. In a couple of days, new skin will form and the blister skin will peel away.

Do not pop a blister – the fluid and skin protects
Do not put a sticky plaster onto the blister as this will burst it.

More serious cases of are large blisters that are the result of burns, sunburn or infections. See your doctor.

• MEDICINE SAFETY

Medicating babies is a serious business and should only be given under the supervision of a health adviser, doctor or clinic sister. When medicating your baby or child, take note of the following safety advice.

1. Get rid of old or expired medicines

2. Be aware of what you are giving. Certain ingredients like decongestants, can make a child wakeful

3. Don’t give a child medication that has been prescribed for someone else or for another illness

4. Shake the bottle to disperse the ingredients evenly

5. Double-check the label before you pour, especially if you are giving medicine at night, in bad light

6. Use a medicine spoon or dropper, rather than your kitchen teaspoon, which is unlikely to hold exactly 5ml.

7. Be careful with over-the-counter drugs. Treat them with the same respect you would those prescribed by your doctor.

8. The same applies to "natural" remedies – treat them with caution. They are not all safe to use by children, pregnant- or lactating women

9. Follow your doctor’s instructions carefully. Ask whether medicine should be given as needed (for instance when your child is feverish) or whether you must complete the course(as in the case with antibiotics)

Note storage instructions and when and how often you need to give the medication.

10. As a rule, the less you medicate your baby the better. Try remedies that don’t involve medication first (for instance, a humidifier or saline nose drops rather than a decongestant).

11. Never medicate a baby under 3 months without consulting your doctor.

TIP:
A medicine syringe or dropper is the best way to administer medicine to a baby. Wrap her in a blanket or ask another adult to hold her, so that she cannot swipe the medicine out of your hand. Squirt the liquid into her cheeks.
Do not give your baby medicine in the hope that it will put her to sleep.
This is extremely dangerous.

• TOOTH INJURY

Children often injure their teeth, causing them to become cracked or chipped or more seriously knocked out. A dislodged baby tooth cannot be replaced. A permanent tooth can often be saved if prompt action is taken and the tooth is handled carefully, especially by protecting the delicate
tissue covering the root.

IF A PERMANENT TOOTH IS KNOCKED OUT:
1. Hold the tooth by the top, not the root
2. Rinse the tooth immediately in milk, not tap water
3. If your child is co-operative and old enough not to swallow the tooth, gently replace the tooth in its socket. Have your child bite down on a gauze pad to keep it in place.
4. If the tooth cannot be reinserted, put it in milk
5. Give your child a gauze pad or handkerchief to bite down on, which will help reduce the bleeding
6. Get to the dentist right away

IF A PERMANENT TOOTH IS CHIPPED OR BROKEN:
1. Collect all the bits of the tooth
2. Rinse the mouth wit warm water
3. Give your child a cold compress to place on the injured tooth
4. See your dentist right away

• SOMETHING IN THE EAR

Toddlers often experiment by pushing small objects into their ears.

Here’s what you need to do:
1. Sit your child down and have a good look in the ear
2. Unless the object is easily seen and removed, do not try to remove it. You are likely to push it further into the ear and cause more damage
3. Take your child to the doctor or emergency room

• SOMETHING IN THE NOSE

It may be difficult to identify this problem as symptoms may not appear for days. You may notice swelling, difficulty in breathing through the nose, a bad smell or bloody discharge. Do not try to remove the object, as you could push it further in and cause injury. Seek medical assistance.

• BRUISES

Active toddlers and young children suffer many minor knocks and falls, often resulting in bruises. They seldom require any treatment. A little arnica lotion and all the sympathy you can muster usually do the trick. A cold compress or face cloth dipped in cold water will help if the bruise is more serious. If your child complains of excessive pain or cannot move the affected limb, immediately seek medical attention. Unexplained bruising, without any sign of injury can be serious.

• CRUSHED FINGERS

Slamming doors and drawers on little fingers can be painful. Occasionally a crush injury can be serious so if it’s severe or you suspect there may be a fracture, take your child to the doctor.

1. Release the trapped hand as quickly as possible and calm your child
2. If the skin is not broken, hold the fingers under cold running water, or hold an ice pack or bag of frozen veggies, wrapped in a dishcloth or towel against it
3. Wrap the hand in a bandage
4. If the child has difficulty in moving the fingers, there may be a fracture, consult your doctor.
5. Also see the doctor if there is a deep cut, severe pain, an obvious deformity or blood under the nail.

• CHOKING

Assess your child. More than 90% of deaths from chocking occur in children under 5 years. Young children often put small objects into their mouths.
Be careful with small toys, sweets and deflated or burst balloons. Always watch your child or baby when he is eating.

If your child’s airway is blocked, it is essential that you remove the blockage immediately, so that he can get air into the lungs.

SIGNS OF CHOCKING:
1. Unable to cough
2. Unable to talk
3. Unable to breath
4. Clutching at the throat

WHAT TO DO IF THE AIRWAY IS PARTIALLY BLOCKED

If your child is able to cough, talk or breathe, it means that the air passage is not completely blocked and air is still able to go in and out.
Just encourage your child to cough, but do NOT slap his back (this might push the blockage further down). If your child remains distressed or falls unconscious, get help.

WHAT TO DO IF THE AIRWAY IS BLOCKED

If your child is unable to cough, talk or breathe, then you must act immediately, follow these steps:

CLEAR THE AIRWAY IN A BABY UNDER 1 YEAR

Get someone to call for assistance immediately.

1. BACK SLAPS: Kneel down and place your baby face down along your forearm. Allow your forearm to rest against your thigh, so that your baby’s head is lower than the body, and his face is supported in the palm of your hand. Slap him firmly up to 5 times between the shoulder blades.

2. CHEST THRUSTS: If 5 back slaps are unsuccessful, hold your baby’s head with your other hand and turn him face-up to lie along your opposite arm, resting on your opposite thigh. Remember to keep your baby’s head lower than his body, with the back of his head resting in the palm of your hand.

If there is no obvious foreign object visible in the mouth, place 2 fingers on the centre of your baby’s chest, just below an imaginary line between the nipples, and give up to 5 quick downward chest thrusts. Press down approximately 1/3 of the diameter of your baby’s chest (about 2cm).
Very carefully remove any visible foreign object.

3. If your baby is conscious but still unable to cough, talk or breathe, repeat the sequence of up to 5 back slaps and up to 5 chest thrusts until the object is dislodged or your baby becomes unconscious

4. If the baby becomes unconscious, place him face-up on the floor. Open the airway (head tilt-chin lift) and check for breathing. If the baby is breathing, turn him onto his side (recovery position) and stay with him till help arrives

5. If he is not breathing, open his mouth and very carefully remove any visible foreign object. If you cannot see an object, do NOT blindly put your finger in his mouth (you might push the obstruction further down)

6. Starts rescue breathing if he is not breathing. Put your mouth over his mouth and nose and give 2 slow breaths. If these is no breathing or movement start CPR(5chest compressions followed by 1 rescue breath)

7. Look for a visible foreign object each time you open the airway to give the breaths

8. Continue CPR until professional help arrives or your baby recovers

CLEAR THE AIRWAY IN A CHOCKING CHILD UNDER 1 YEAR

Ask someone to call medical assistance.

1. Abdominal thrusts (also known as Heimlich Maneuver): If the child is more than 1 year old and is too big to safely get his head lower than his chest, stand or kneel behind him and wrap your arms around his waist so that your fist rest against his tummy just above the navel, but well below the ribs. Grasp your fist with your other hand and give up to 5 quick inward and upward thrusts.

2. If the blockage hasn’t cleared and the child is still conscious, repeat the sequence of up to 5 abdominal thrusts until the object is dislodged or your child becomes unconscious.

3. If the child become unconscious, place him face-up on the floor. Open the airway (head tilt-chin lift) and check for breathing. If the child is breathing, turn him onto his side (recovery position) and stay with him till help arrives.

4. If he is not breathing, open the mouth and very carefully remove any visible object. If you cannot see an object, DO NOT blindly put your finger in his mouth ( you might push the object further down)

5. Start rescue breathing if he is not breathing. While maintaining head tilt-chin lift, seal your mouth over his mouth. Pinch the nose closed, using the hand that is on the child’s forehead and give 2 slow breaths

6. If there is no breathing or movement, start CPR. Look for a visible foreign object, each time you open the airway to give breaths

7. Continue with CPR, till professional help arrives or the child recovers

• BLEEDING

If your child is injured, your priorities are to limit blood loss and to
keep the open wound clean. The first thing to do is to apply firm pressure
on the wound with a clean cloth. Hold for 10 minutes or until the bleeding
stops.

MINOR BLEEDING

WHAT TO DO?

1. Gently wash the wound with warm soapy water
2. Cover the wound with an antiseptic cream or ointment and apply a sterile dressing, if necessary
3. Wash the wound daily and reapply the antiseptic cream and dressing until healing is complete. If the wound shows signs of infection, becoming red, tender or excreting pus, you should consult a doctor.

If the bleeding don’t stop or if the wound seems very deep, especially if the edges of the wound do not come together by themselves, treat the wound as outlines here, and take the child to the doctor.

SERIOUS BLEEDING

Get someone to phone the emergency services or if you are alone, first try to stabilize the bleeding and then take your child with you to the phone:

1. Cut away clothing to expose the wound
2. Apply pressure with a clean cloth or dressing. Don’t use any medication or ointment on the wound till the doctor has seen it
3. If there is glass or any other object sticking out of the wound, do not remove it. Apply pressure on either side
4. Lay your child down and raise the wounded area above the level of the heart, if possible. For an arm wound, raise the arm above the head. For a leg wound, lay your child down and raise the leg
5. If blood seeps through the dressing, put another dressing on top and provide more pressure to stop the bleeding
6. Keep your child warm and calm. If the blood us spurting rhythmically, in time to the heartbeat, and is a bright red colour, an artery may have been cut. Apply direct pressure and
elevate the affected are. Call the emergency services as heavy bleeding can be life-threatening, particularly for a young child.

• NOSEBLEEDS

1. Have the child lean forward while sitting or standing

2. Put firm pressure on his nose by squeezing the lower half of the bridge just above the cartilage. Do not block the nostrils.

3. Keep squeezing for 10 minutes and then release your hold and see if the nose is still bleeding

4. If the bleeding hasn’t stopped, apply pressure for another 10 minutes

5. If the nosebleed still hasn’t stopped, consult your doctor

6. If a nosebleed follows a head injury, seek urgent medical attention

• INTERNAL BLEEDING

WHAT TO LOOK FOR?

1. Bleeding from the nose, ears, mouth or vagina
2. A bruise in the shape of an object that crushed against the body

WHAT TO DO?

If you suspect internal bleeding, call an ambulance and treat the child for shock.
Lay the child down, keep him quiet and cover him with a blanket.