The following recommendations will help you care for your child's minor emergencies and provide first aid for your child's
major emergencies while you are waiting for medical assistance. Also, take a first aid course. You can't learn CPR (cardiopulmonary
resuscitation) just by reading.
Animal bites
Immediately wash the bite with lots of soap and water for 10 minutes.
Many dog bites can be prevented by teaching a child not to pet strange dogs, not to tease dogs, and not to go near his own
dog when the dog is eating or fighting. Also, teach your child not to pick up sick or injured wild animals.
Bee stings (Note: Yellow jackets and wasps don't leave stingers)
Carefully remove the stinger by scraping it off without squeezing it. Use the edge of a knife blade or credit card. Then put
a few drops of water on the area of the sting, sprinkle on meat tenderizer, and massage the solution into the skin for 10
minutes. Don't use meat tenderizer near the eye. Putting an ice cube on the area will also relieve pain.
Call your child's physician if your child develops hives or has difficulty breathing.
Tick bites
The simplest and quickest way to remove a tick is to pull it off. Use tweezers to grasp the tick as close to the skin as possible.
Pull steadily upward until the tick releases its grip. Do not twist the tick or squeeze the tweezers so much that you crush
the tick.
If you don't have tweezers, pull the tick off in the same way by using your fingers. If you remove the body but leave the
head in the skin, remove the head by using a sterile needle (in the same way you would remove a sliver). Wash the wound and
your hands with soap and water after you remove the tick.
A recent study showed that embedded ticks do not back out when covered with petroleum jelly, fingernail polish, or rubbing
alcohol. Applying a hot match to the tick also does not work. If you aren't successful in completely removing the tick, call
your child's physician. Most ticks do not cause disease. However, if your child develops fever, rash, or other symptoms during
the week after the bite, call your child's physician.
Bleeding, severe
Determine whether an artery or a vein has been cut. When an artery is cut, the blood pumps or spurts from the wound with each
heartbeat. When a major vein is cut, the blood runs out of the wound at a steady rate.
If an artery is cut and you know the arterial pressure points, apply strong pressure to the artery between the wound and the
heart until help arrives. If you do not know the arterial pressure points, place several sterile dressings or the first clean
cloth at hand (towels, sheets, or shirts) over the wound and apply direct pressure over the wound immediately. For arterial
bleeding, the pressure must be forceful and continuous, often applied with the palm of the hand. Act quickly because the ongoing
blood loss can cause shock.
If a vein is cut, place several sterile dressings or the first clean cloth at hand (towels, sheets, or shirts) over the wound
and apply direct pressure over the wound. After about 10 minutes of pressure, the dressings can often be bandaged in place
until the child arrives at an emergency room.
Breathing, stopped
Call for an ambulance (911) and begin mouth-to-mouth resuscitation.
Burns
Immediately (within 10 seconds of the burn) immerse the burn in cold tap water for at least 5 minutes. If this is impossible
(for example, if the burn is on the face and trunk), apply cool wet cloths or pour a pan of cold tap water over the burn.
This will lessen the depth of the burn and relieve pain.
Do not put butter or burn ointment on the burn. Do not break blisters.
After you have cooled the burn, call your child's physician for further instructions.
Choking
Most children occasionally choke on liquids that go down the windpipe instead of the esophagus. Your child's cough reflex
will clear the windpipe of the liquid within 10 to 30 seconds. It is best if you do nothing except reassure your child.
Sometimes a young child will suddenly choke on a peanut, raw carrot, or other piece of food. If your child is coughing and
able to breathe, encourage him to cough the material up by himself.
If your child can't breathe, cough, or make a sound, proceed with high abdominal thrusts, called the Heimlich maneuver. Grasp
your child from behind, just below the lower ribs but above the navel, in bear-hug fashion. Give a sudden, upward jerk at
a 45-degree angle to try to squeeze all the air out of his chest and pop the lodged object out of his windpipe. Repeat this
upward abdominal thrust 10 times in rapid succession. If your child is too heavy for you to suspend from your arms, lay him
on his back on the floor. Put your hands on both sides of his abdomen, just below the ribs, and apply sudden strong bursts
of upward pressure.
If your child is less than 1 year old, first use back blows. Place him face down at a 60-degree angle over your knees. (Gravity
may help propel the object out.) Deliver 5 hard blows with the heel of your hand to the area between your child's shoulder
blades. If this is not successful, lay him on his back and give 5 rapid chest compressions over the lower sternum (breast
bone) using two fingers. If he still hasn't started breathing, begin mouth-to-mouth resuscitation and call for an ambulance
(911).
Convulsions with fever
Bringing your child's fever down as quickly as possible will shorten the seizure. Remove most of your child's clothing and
apply cold washcloths to his forehead and neck. Sponge his body with cool water. (Do not use rubbing alcohol.) As the water
evaporates, your child's temperature will fall.
When the seizure is over and your child is awake, give him an appropriate dose of acetaminophen or ibuprofen and encourage
him to drink cool fluids. If your child starts to vomit, place him on his side or abdomen. If his breathing becomes noisy,
pull his jaw and chin forward by placing a finger behind the corner of her jaw on each side. Don't put anything into his mouth.
Have someone call your physician.
Drowning
Begin mouth-to-mouth breathing as soon as possible, in a boat, a life preserver, or at the latest, when the rescuer reaches
shallow water. Continue rescue breathing until the child reaches a medical facility. Some children have survived long submersions,
especially in cold water.
If there is any possibility of a neck injury (for example, a diving accident), protect the neck from any bending or twisting.
Eye, chemical in
Most chemicals such as alcohol or hydrocarbons (for example, gasoline or lighter fluid) cause only temporary stinging and
superficial irritation. However, acids and alkalis splashed into the eye can severely damage the cornea. When any chemical
is accidentally splashed into your child's eye, treat is as an emergency until your local Poison Information Centre expert,
or your child's physician tells you otherwise.
Immediate and thorough irrigation of the eye with lukewarm tap water is essential to prevent damage to the cornea. This irrigation
should be performed at home and as quickly as possible. Either hold your child's face up under a gently running water tap
or have your child lie down and continuously pour lukewarm water into the eye from a pitcher or a glass. You may find it easier
to simply step into the shower with your child while directing lukewarm shower water towards your child's eye. For most chemicals,
the eye should be irrigated for 10 - 20 minutes. Call your local Poison Information Centre or your child's physician immediately
after irrigating the eye.
Eye, foreign body in
If the particle is in the corner of your child's eye, try to remove it with the corner of a clean cloth or a moistened cotton
swab. If the particle is under your child's eyelid, try to remove it by opening and closing his eye several times while his
eye is submerged in a cup of water. If the object stays on the lid and you can see it, try to remove it with a moistened cotton
swab. If you can't see the particle or remove it, call your child's physician.
Fracture, suspected
If you think your child has broken a bone, take him in for a medical exam and an x-ray. Don't let your child put weight or
pressure on the bone. Put a splint on the suspected fracture before you move your child so the edges of the fracture won't
damage blood vessels.
Shoulder or arm:
Use a sling made of a triangular piece of cloth to support the forearm at an 80° to 90° angle to the upper arm. If you can't
make a sling, at least support the injured part with the other hand.
Leg:
After placing a towel between the legs for padding, use the uninjured leg as a splint by binding the thighs and legs together
with straps. If you can't do this, at least carry your child and don't permit him to put any weight on the injured leg.
Neck:
Protect the neck from any turning or bending. Do not move your child until a neck brace or spine board has been applied. Call
an ambulance (911) for transportation.
Sprained ankle or knee
Remember the acronym RICE for treatment of most sports injuries: rest, ice, compression, and elevation.
Apply continuous compression by wrapping a wet elastic bandage around the ankle or knee. Numbness, tingling, or increased
pain means the bandage is too tight. Keep the bandage on for 24 to 48 hours.
Put a plastic bag of crushed ice on the ankle or knee. Do this 20 minutes of every hour while your child is awake for the
first 1 or 2 days after the injury. Ice and compression reduce bleeding, swelling, and pain.
Keep the injured ankle or knee elevated and at rest for 24 hours.
Call your child's physician for further instructions.
Poisoning
If your child has swallowed something poisonous, first sweep any pills or solid poisons out of your child's mouth with your
finger. Then, if your child swallowed a chemical, immediately give him one glass of water or milk to rinse her esophagus;
this is not necessary if your child swallowed a medicine. Call your local Poison Information Centre or your child's physician
for advice.
Nosebleed
Pinch the soft parts of the nose against the centre wall for 10 minutes. Tell your child to breathe through his mouth during
this time. If blood continues to come out of the nose while it is pinched, you may not be pressing on the right spot.
If the nosebleed hasn't stopped after 10 minutes, insert a piece of gauze covered with vasoconstrictor nose drops (for example,
Neosynephrine) or petroleum jelly into the nostril. Squeeze again for 10 minutes.
If bleeding persists, call your child's physician but continue applying pressure in the meantime.
Skin injuries
Call your child's physician immediately if you have any difficulty stopping the bleeding, if the wound is caused by a dirty
object, if there is any chance that a foreign body is in the wound, or if the skin is split and will need stitches. Any deep
cut that needs stitches must be sutured within 12 hours. After 12 hours the wound is no longer clean enough to close with
stitches.
Abrasions or superficial cuts
Wash abrasions or superficial cuts for 5 minutes with soap and water; then rinse well. If the area of the cut may get dirty
(for example, the hand), put on an antibiotic ointment and Band-Aid or sterile gauze dressing and change it daily.
Puncture wounds (as from stepping on a nail):
Soak the area in hot water and soap for 15 minutes. Try to make the puncture wound bleed some more. If there is any chance
that an object has broken off inside the puncture wound or if your child has not had a tetanus booster in the last 5 years,
call your child's physician.
Blood blisters:
Do not open blood blisters. Opening them does not help them heal and increases the possibility of infection. They will peel
off and be replaced by new skin in about 2 weeks.
Bruises:
Put ice on the bruise for 20 to 30 minutes. No other treatment should be necessary.
Slivers and splinters:
Most slivers can be removed with a needle and tweezers. Before you use them, sterilize the needle and tweezers with alcohol.
Wash the skin surrounding the sliver with soap before you try to remove the sliver. Grasp the sliver firmly with tweezers
and pull it out at the same angle it went in. Call your child's physician if you can't remove a sliver.
Head injuries
Observation and rest:
Observe your child for the first 2 hours after the injury. Encourage your child to lie down and rest until he no longer has
symptoms. It is all right for your child to sleep; trying to keep him awake continuously is unnecessary. Have your child sleep
near you so you can periodically check on him.
Diet:
Give your child only clear fluids (ones you can see through) and no food until he has gone 6 hours without vomiting. Vomiting
is common after head injuries.
Avoid pain medicines:
Don't give your child acetaminophen, aspirin, or ibuprofen because your physician needs to know your child's reaction to the
injury. If your child's head hurts badly enough to need a pain reliever, your physician should check him.
Special precautions and awakening:
Although your child is probably fine, watching him for 48 hours will ensure that you don't miss any serious complication.
After 48 hours, however, your child should return to a normal routine and full activity. Awaken your child twice during the
night: once at your bedtime and once 4 hours later. (Awakening him every hour is unnecessary and next to impossible.) Arouse
him until he is walking and talking normally. Do this for 2 nights. If his breathing becomes abnormal or his sleep is otherwise
unusual, awaken him to be sure a coma is not developing. If you can't awaken your child, call your child's physician immediately.
Checking pupils is unnecessary. Some physicians may ask you to check your child's pupils (the black centres of the eyes) to
make sure they are equal in size and become smaller when you shine a flashlight on them. Unequal pupils are never seen before
other symptoms like confusion and unsteady walking. In general, pupil checks are necessary only for a hospitalized child with
a severe head injury.
Call your child's health care provider immediately if:
