Are you prepared for a possible emergency mamas? Infinity Clinic’s Dr. Rania Hawayek shares the first aid tips we should all know.
On a day to day basis, we find ourselves dealing with minor injuries or medical situations with our kids, and wondering whether or not to rush them to a doctor or an emergency room. These can range from simple head injuries to small cuts, minor burns and even allergic reactions. Most of these are best dealt with quickly and at home, and this may even help you avoid the need for a hospital visit and long wait to see a doctor. Here are four common conditions that several of my patients and myself, as a parent have had to deal with.
Burns can range from minor to major, caused by a few drops of hot tea to a faulty electrical socket. They are categorised as follows:
1st degree (superficial burns)
These affect only the outer layer of the skin and cause redness, pain and some swelling. These do not cause blistering. Sunburn is a good example of this. First aid treatment can deal with these.
2nd degree (partial thickness burns)
These involve some of the outer layers of the skin and result in red and white patches on the skin with blistering, redness, swelling and pain. First aid treatment should be carried out first, followed by medical treatment where needed.
3rd degree (full thickness burns)
These are much more serious and involve all the layers of the skin, and can sometimes include muscle and bone. These require emergency medical treatment straight away. There may be little or no pain. They can cause difficulty breathing and are sometimes associated with smoke inhalation, depending on the cause.
4th degree burns (usually electrical burns)
These involve skin, muscle and bone and can be misleading in that they appear simpler and less serious than they really are. These also need immediate medical attention.
For minor burns (first degree burns and some second degree burns), a few first aid tips can help soothe the pain from the burn and improve healing and outcome.
- First and foremost, remember to try and stay calm and not scare your child further. They’re most likely crying, terrified and in pain when this happens and need reassurance and coaxing to allow you to carry out first aid.
- Cool the burned area to soothe the pain. This is best done under cool running water for a few minutes. Do not apply ice.
- Remove any tight items such as jewellery and any burned clothing, before any swelling begins.
- Do not break any small blisters as this may increase the risk of infection.
- After cooling the burned area, cover it loosely with a dry clean cloth or dressing.
- Consider pain relief such as a dose of paracetamol
For all electrical burns, or those involving the face, hand, foot, groin area or involve a joint, you must seek medical attention immediately, due to the increased risk of complications and need for more specialised dressings or treatment.
The fear of a child choking is one of the things a parent worries about the most and this worry starts at the time of weaning our baby onto solids. I find myself frequently trying to reassure parents and convince them to start giving their baby more chunky purees and finger foods.
Choking is definitely scary, but is less common than we think. The following simple tips will hopefully help you feel better equipped to manage it if it does occur. The approach to a choking child differs slightly, depending on the child’s age.
For children under 1 year old:
- If conscious and coughing, allow them to continue coughing as this is the most effective way to dislodge the cause of choking.
- If conscious, but unable to cough, not crying and having difficulty breathing, you must begin by administering back blows. While you do this, get someone to call for help (999). This best position for back blows is to have the baby lying on your forearm, facing down with his head supported by your hand. Your hand can rest on your thigh, so that the baby’s head is lower than his chest. With the heel of you hand, give 5 firm back blows between the baby’s shoulder blades.
- Turn the baby over carefully and if he is still not breathing well and not coughing, you now have to do chest thrusts. Also lower your hand so the baby’s head is lower than his chest. Using 2 to 3 fingers, push down firmly on the baby’s chest (in the centre of an imaginary line connecting the nipples) around 2 to 4 cm. Do this 5 times.
- Keep repeating 5 black blows and 5 chest thrusts until the object is dislodged, the baby starts coughing strongly and/or crying.
For children older than 1 year:
- Follow the same approach, but instead of carrying the child against your forearm, lean or stand behind the child and have them lean forward against your arm.
- Deliver 5 black blows in the same method as above.
- For chest thrusts, lean or stand behind the child and put both your arms around them. Make a fist with one hand and hold it with your other hand. Thrust into the child’s body in the area above the navel and below the chest bone. Do this 5 times.
- Repeat back blows and chest thrusts as above.
If the baby or child is unconscious at first, or becomes unconscious during this process, this becomes an even more serious medical emergency and CPR must be administered.
Despite the sombre and frankly terrifying prospect of having to do this, learning these steps is extremely important and will help keep you calm and handle the situation well, in the unlikely event of significant choking. Most children experience very minor choking episodes as they get used to the texture of some foods, but a few coughs usually help resolve the situation.
Allergic reactions can occur as a result of eating certain foods, ingesting medications, insect bites and exposure to other allergens such as pollen or dust.
A significant allergic reaction, causing anaphylaxis – such as one resulting from an insect bite or for some children, the ingestion of certain foods such as nuts or shellfish amongst others, is one of the most dangerous medical emergencies to deal with. However, this rarely happens. Most allergic reactions are mild and can be easily dealt with at home.
A mild allergic reaction is characterised by some of the following symptoms: redness, some skin swelling, itchiness, a runny nose or nasal congestion, sneezing, eyes that are itchy and watery and hives (raised red rash). If your child experiences any of these symptoms, as a result of exposure to an allergen, you can give them a dose of antihistamine. If the symptoms resolve without any further consequences, then there’s no need for concern. If, however, the symptoms return after a few hours or on another occasion, you should give your child another dose of antihistamine and arrange an appointment with your paediatrician for assessment and investigation.
Signs of a severe allergic reaction are swelling of the mouth or tongue, difficulty swallowing or speaking, an audible wheeze or obvious breathing difficulty (usually preceded by coughing), nausea, vomiting and abdominal pain and dizziness (or even fainting). If your child experiences any of these symptoms, he or she will require immediate medical attention (call 999). If your child has a known allergy and has been prescribed and epipen (adrenaline pen) and develops some of these symptoms, now is the time to use it. For others, and while waiting for an ambulance or on the way to an emergency department, giving your child a dose of antihistamine can help, but should not delay emergency medical care.
Head injury is another extremely common (and often repeated) childhood occurrence which causes parents endless stress and worry. One of the most common stories I hear from my patients is about the baby falling off the bed/changing table/sofa, crying immediately, with no other symptoms. In this situation, the baby is often absolutely fine, with a distraught and tearful mama.
There are some cases, however, where the fall is a little more worrisome and the head injury a little more severe, with some consequences that warrant a little more observation or investigation.
Signs of a minor head injury:
- Cried immediately
- Remained conscious throughout
- Vomited up to twice
- back to normal self
- Mechanism of injury mild (although this is sometimes difficult to assess)
Signs of a more severe head injury:
- Lost consciousness during or after fall/head injury
- Vomited several times
- Quiet, subdued and sleepy
- Appears confused
- Not behaving normally
Of course, some of these signs can be confusing, in cases such as a minor head injury occurring near bedtime: that child will understandably be sleepy afterwards and that does not necessarily point to this being a major head injury. Also, it’s common for many young children to vomit when they’ve been upset and crying and again this confuses parents and worries them into thinking that something could be wrong internally. Following some head injuries, some older children complain of blurred vision and headaches, up to a few days later (signs of concussion) and this is expected in some cases.
If your child has had a minor fall without obvious bruising, cried immediately, had one or no episodes of vomiting and then fell asleep, there’s no need to keep them awake. You can check on them every hour or two to make sure they’re responding normally.
If your child has any of the signs of a severe head injury, you should seek medical help immediately. There may be a need for investigation such as a CT scan and/or observation. If your child has signs of a minor head injury and you’re concerned, or mixed signs of both, it’s best to also seek medical advice to be safe.