Paediatric First Aid Course

1
Paediatric First Aid Course
2

• Introduction to your course work book

3
House Rules

• Mobile phones switched off
• Toilets
• Break times
• Start and finish times

4
Competence assessment

• CPR practical session
• Incident training
• Certificates

5
Paediatric First Aid

• Write down in your own words why you have chosen
  or asked by your employers to attend this course.
• From a personal point of view, what would you
  like to achieve / learn on the course

6
Course objectives

• Identify a range of illnesses and injuries
• Treat a range of illnesses and injuries
• Manage an unconscious casualty
• Manage the airway
• Perform effective Cardio pulmonary resuscitation
• Manage bleeding

7
What is First Aid?

• First Aid is the immediate assistance or
  treatment given to someone injured or suddenly
  taken ill before the arrival of a ambulance,
  doctor or other appropriately qualified person

8
First Aid and the Law
9
Acts and Regulations

• Health Safety at Work Act 1974
• Health Safety (First Aid) Regulations 1981
• Reporting of Injuries, Diseases Dangerous
  Occurrences Regulations 1995 (RIDDOR)

10
Risk assessment of First Aid needs

• To consider
• Workplace hazards and risks
• Size of the organization
• History of accidents
• Nature distribution of work force
• Remoteness for medical services
• Needs of travelling, lone or remote workers
• Working on shared or multi-occupied sites
• Annual leave and other absences of First Aiders

11
The Aims of First Aid

• Preserve life
• Prevent the injury from worsening
• Promote recovery

12
Role and Responsibilities

• First Aider must always
• Assess
• Danger
• Prioritise
• Ask
• Treat/Transfer

13
Managing casualties
14
Aims and Objectives

• Understand how oxygen gets to the vital organs
• State the priorities of life
• Triage a group of casualties

P3
15
Transfer of oxygen

• Your trainer will now explain how oxygen is
  transferred around the body

P3
16
Multiple casualties

• From the following list decide who needs your
  attention first.
• Remember you can only deal with one casualty at a
  time.
• Please give reasons for your answers.

P3
17
Who needs you first

• Screaming child
• Nose bleed
• Arterial bleed
• Broken leg
• Asthma attack

• Shock
• Quiet child on the floor
• Choking
• Anaphylactic shock

P3
18
Answers

• Quiet child on floor
• Choking
• Anaphylactic shock
• Asthma attack

• Arterial bleed
• Nose bleed
• Broken leg
• Shock
• Screaming child

P3
19
Triage

• Breathing
• over
• Bleeding
• over
• Burns
• over
• Bones

20
Aims and objectives

• Identify life threatening problems
• Perform the primary assessment
• Maintain an airway
• State which three sets of clues help make up a
  diagnosis
• Perform a secondary assessment
• Place a casualty in the recovery position

P3
21
Primary Assessment

• D Danger
• R Response
• A Airway
• B Breathing
• C Circulation

P3
22
Aims and Objectives

• Perform effective CPR on the adult, child and
  baby
• Deal with problems that may occur during CPR
• Manage a range of scenarios

P4
23
Cardio-Pulmonary Resuscitation
Adult Child Baby
P4
24
Cardio Pulmonary Resuscitation

• Danger
• Response
• Airway
• Breathing
• Compressions

P4
25
Child and baby

• In cases involving children and infants we should
  attempt one minutes CPR (3 cycles) before leaving
  the casualty to go and get help

P5
26
Adult
P6
27
CPR

• Adult
• 30 compressions 2 inflations
• 5 - 6cm depth of compression
• 2 Hands
• 100 - 120 rate per minute

P6
28
Problems during resuscitation

• Broken ribs
• Casualty vomits
• Stomach distension
• Not making a good seal

P9
29
Hygiene ConsiderationsDuring Resuscitation
P9
30
Tetanus and Lock Jaw

• What is tetanus?

31
Paediatric CPR
P10
32
CPR

• Child
• 30 compressions 2 inflations
• 3 cycles of 302 1 minute
• At least a 1/3rd depth of chest
• 1 hand
• 100 120 rate per minute

P10
33
CPR

• Infant
• 30 compressions 2 inflations
• 3 cycles of 302 1 minute
• At least a 1/3rd depth of chest
• 2 fingers
• 100 120 rate per minute

P12
34
(No Transcript)
35
Assessing casualties

• Primary assessment
• Secondary assessment
• Recovery position
• A practical session

36
Secondary Assessment
P14
37
Secondary Assessment

• History
• Signs
• Symptoms
• Remember children
• babies may not be able to
• clearly explain how they feel
• what has happened

P14
38
Unconsciousness

• Causes
• Fainting
• Stroke
• Heart attack
• Shock
• Head injuries
• Hypoxia
• Poisoning
• Epilepsy
• Diabetes

P15
39
The AVPU Code

• To check response
• A Alert
• V Responds to Voice
• P Responds to Pain
• U Unresponsive

P15
40
The Recovery Position
P15
41
Choking
P16
42
Children babies Causes of airway obstruction

• Inhalation of vomit
• Foreign object e.g. toy, peanut
• Submersion in water
• Infection of the lungs or throat
• Injuries to the head, neck or chest
• Cot death

P16
43
Recognition of choking

• Often stand up very quickly
• clutching throat
• Congested face, veins
• prominent in face and neck
• Coughing
• Difficulty breathing
• May have been eating

P16
44
Choking Adult Treatment
45
Adult choking

• Encourage the casualty to cough
• Up to 5 sharp back slaps
• Up to 5 abdominal thrusts
• Repeat cycle
• Unconscious CPR

46
Choking Paediatric Treatment
Chest for infants/abdominal for child gt 1
P16
47
Child Choking

• Encourage to cough
• Up to 5 sharp back slaps
• Up to 5 abdominal thrusts
• Unconscious CPR

P16
48
Baby Choking

• Up to 5 sharp back slaps
• Up to 5 chest thrusts
• Unconscious CPR

P17
49

• Obtaining medical assistance

In pairs write a list of information the 999
operator may ask you for
50

• Conditions that affect the breathing

51
Causes of breathing problems
Workshop
Make a list of all of the conditions that could
affect your casualties breathing
52
Hypoxia

• Blockage Suffocation
• Febrile convulsions Gas/smoke
• Sickle cell anemia Paralysis
• Lack of O² Electrical injury
• Poisoning Carbon monoxide
• Compression of chest Fits

53
Anaphylactic Shock
P19
54
Anaphylactic shock

• Major allergic reaction
• Bee stings
• Peanuts, foods
• Drugs

P19
55
Anaphylactic shock

• Anxiety
• Red blotchy skin
• Swelling of the face and neck
• Puffiness around the eyes
• Impaired breathing
• A rapid pulse

P19
56
Anaphylactic shock

• Treatment
• Calm and reassure
• Get help
• Help the casualty to sit up if conscious
• Recovery position if unconscious
• Help them to take their Epipen

P19
57
Asthma

• Where the air passages to the lungs go into spasm
  causing the lining of the airways to swell.
• The casualty then finds it difficult to breathe
• Causes of attack
• Pollen / Dust / Cigarette smoke
• Allergens such as pet hair
• Exercise

P20
58
Asthma recognition

• Difficulty breathing
• Wheezing
• Distress and anxiety
• Difficulty in speaking
• Grey blue skin
• Dry, tickly cough
• May become exhausted

P20
59
Asthma treatment

• Calm and reassure casualty
• Sit them down, leaning forward supported
• Plenty of fresh air
• Allow him to use medication
• If attack is prolonged or medication does not
  relieve attack, seek medical help

P20
60
Conditions that affect the circulation
P22
61
Aims and objectives

• List the different types of
• blood vessel
• Treat bleeding
• Apply a dressing
• Identify different types of injury
• Recognise and treat various conditions affecting
  circulation

P22
62
Section 7

• What sudden illnesses or conditions can affect
  the circulatory system?

P22
63
Shock

• What is it?
• Causes

P22
64
Causes of shock

• Severe bleeding
• Loss of body fluids
• Loss of serum
• Severe pain
• Acute heart attack
• Abdominal emergencies

P22
65
Shock Recognition

• Pale or grey skin
• Cold, clammy skin
• Feel faint or giddy
• Feels sick or may vomit
• Feels thirsty
• Anxious or restless
• Yawn or gasp for air
• Rapid, weak pulse
• Shallow, rapid breathing
• May lose consciousness

P22
66
Shock Treatment

• Deal with the injury or cause
• Lay casualty down, raise legs if possible
• Head low and turned to one side
• Loosen tight clothing
• Moisten lips if thirsty
• Keep casualty warm
• Transfer to hospital

P22
67
Wounds and bleeding

• Incised
• Laceration
• Puncture
• Contusion
• Abrasion

68
Blood Vessels

• Arteries
• Veins
• Capillaries

P22
69
Types of bleeding

• Arterial
• Severe. Bright red oxygenated blood spurts from
  wound with each heartbeat
• Venous
• Dark red. Blood may escape from the body as
  quickly as an arterial bleed, may gush profusely
• Capillary
• Oozing occurs at the site of all wounds, blood
  loss is usually slight

P22
70
External bleeding

• Pale skin with cold clammy skin
• Rapid weak pulse
• Shallow fast breathing
• Feels sick or may vomit
• Feels cold and thirsty
• Confused/distressed
• Obvious injury

P23
71
Internal bleeding

• Recognition
• Cold, clammy skin
• Rapid, weak pulse
• Pain
• Thirst
• Confusion, restlessness
• Possible collapse
• Pattern bruising
• Bleeding from orifices

P23
72
Treatment of severe bleeding

• Direct pressure
• Elevate the injury
• Apply a sterile dressing
• Transfer to hospital

P23
73
Treatment for Bleeding

• Practical
• Dressings and Bandages

P24
74
Hygiene considerations during first aid

• Wash your hands
• Wear protective gloves
• Wash the affected area
• Dont talk or cough
• Clean up after

75
Foreign Objects

• Eyes
• Irrigate the eye with eye wash, dress if the
  object wont come out
• Ears Nose
• Do not insert anything into the ear to remove the
  object, seek medical attention

P25
76
Bites and Stings

• Animal bites and stings can be extremely painful
  and distressing, bites are susceptible to
  infection, stings can lead to anaphylactic shock

P27
77
Treatment

• Seek medical assistance where the child or infant
  suffers an allergic reaction
• Scrape the sting out of the skin using a credit
  card or similar
• Apply a cold compress to relieve pain
• Wash bites with soap and water and dress any open
  injuries

P27
78
Poisons

• A poison is a substance which, if taken into the
  body in sufficient quantity, may cause temporary
  or permanent damage

P28
79
Workshop

• In small groups compile a list of things which
  could poison children and infants.
• Think carefully about your work place.

P28
80
Poisons

• How can a poison enter the body?
• Ingested
• Inhaled
• Instilled
• Injected
• Absorbed

P28
81
Poisons

• The affects of poisons
• Cause confusion, fits and unconsciousness
• Burn lips, mouth and food passages
• Affect the normal action of the heart
• Cause vomiting diarrhea
• Damage blood preventing oxygen reaching the
  tissues
• Inhaled poisons can cause severe respiratory
  distress

P28
82
Burns and Scalds
P30
83
Burns and Scalds

• What sort of things cause burns and scalds?
• What could cause a burn to a child or infant in
  the care environment?

P30
84
Burns and Scalds

• Causes
• Friction
• Dry heat
• Electric current
• Acids and alkalis
• Intense cold
• Radiation
• Scalds are caused by moist heat, water, steam

P30
85
Classification of Burns

• Superficial Redness, swelling, tenderness
• Partial thickness rawness of skin and blisters
• Full thickness scorching, damage to nerves, fat
  tissue and muscles

P30
86
Treatment of Burns and Scalds

• Burns
• Scalds
• Chemical burns
• Chemicals to the eye
• And Foreign objects in the eye

P30
87
Medical Attention

• Must be sought for
• Full thickness burns
• Burns to face, hands, feet or genital area
• Burns that extend all around a limb
• Partial thickness burns greater than
• 1 of body surface palm of casualties hand

P30
88
Electricity
P31
89
Electricity in the Workplace

• Where in the work place could the children and
  infants in your care receive an electric shock?

P31
90
Domestic Voltage Shocks

• Isolate the appliance
• Once safe D.R.A.B.
• If not breathing start CPR
• Treat any burns
• Monitor and record condition
• Recovery position if unconscious

P31
91
High Voltage Injuries
P31
92
Fractures
P32
93
Aims and Objectives

• Recognise fractures
• Manage the treatment of fractures
• Recognise and treat injuries to muscles and joints

P32
94
Causes of Fractures

• Direct force
• Indirect force
• Can you think of some examples of incidents or
  accidents that may cause a fracture to a bone?

P32
95
Open Fracture

• Fractured ends of the bone protrude through the
  skin

P32
96
Closed Fracture
When the skin is not broken
P32
97
Complicated Fracture

• Leads to further damage and injury to major
  organs or blood vessels.

P32
98
Green Stick Fracture

• A partial fracture or hairline fracture
• where the bone does not break in two
• are quite common in children and infants where
  bones are still quite flexible

P32
99
Fractures

• Recognition features
• Casualty may hear the bone snap
• Pain
• Tenderness
• Swelling, bruising
• Loss of power
• Grating sound on movement
• Deformity

P32
100
Practical Treatment of Fractures

• A practical session
• Collarbone
• Upper arm
• Lower arm / wrist
• Hand / fingers
• Thigh
• Lower leg / ankle

P32
101
Bones, Muscles and Joints

• Provides support, protects vital organs and
  allows movement

102
Sprains, Strains Dislocations

• Sprain is an injury to a ligament at a joint
• Strain is an injury to a muscle or tendon
• Dislocation is the dislodging of a bone head at a
  ball and socket joint

P33
103
Treatment

• Rest
• Ice
• Comfortable Position
• Elevation

P33
104

• Disorders of the Brain

P34
105
Aims and Objectives

• Identify the various levels of consciousness
• Recognise a range of head injuries and describe
  the treatment for them
• Recognise and manage epilepsy

P34
106
The AVPU Code

• To check response
• A Alert
• V Responds to Voice
• P Responds to Pain
• U Unresponsive

107
Concussion

• History of blow to the head
• Brief or partial loss of
  consciousness
• Dizziness or nausea
• Loss of memory
• Mild headache
• Monitor and sent to hospital

P34
108
Compression

• May be disorientated, confused, unconscious or
  weeping
• Progressive loss of consciousness
• Strong pulse
• Weakness or paralysis of mouth, face and one
  side of the body
• Flushed face with hot, dry skin
• Pupils unevenly dilated

P34
109
Treatment

• Monitor and record levels of response
• Calm and reassure
• Ensure privacy
• Carry out the general management and treatment
  for unconsciousness
• Arrange for urgent transfer to hospital

P34
110
Skull fracture
P34
111
Skull fracture

• Could lead to compression
• A wound or bruise to the head
• A soft area or depression of the scalp
• Deterioration in level of response
• Clear fluid or watery blood coming form the nose
  or ears
• Blood in white of the eye
• Distortion of the face or head
• Monitor seek medical attention

P34
112
Treatment

• Monitor and record levels of response
• Calm and reassure
• Ensure privacy
• Carry out the general management and treatment
  for unconsciousness
• Arrange for urgent transfer to hospital

P34
113
Observation of head injuries

• Eyes
• Skin
• Breathing
• Consciousness
• Pulse

P35
114
The Spinal Column
Spinal injuries are rare in children and infants
but we should still have an awareness of the
recognition features
P36
115
Spinal Injuries

• Recognition features
• Damage to spinal bones
• Pain at injury site
• Step or twist in spine
• Tenderness
• Damage to the cord
• Loss of control or one or more limbs
• Abnormal sensations, tingling
• Disorientation or bewilderment
• Difficulty in breathing

P36
116
How should we manage a suspected spinal injury?
P36
117
Spine Cord Injury Management skills

• Management using two people
• Head tilt and chin lift

P36
118
Other Medical Conditions

• Diabetes
• Affects of heat and cold
• Poisoning
• Foreign bodies
• Electrical injuries
• Bites and stings
• Febrile convulsions
• Sickle cell
• Meningitis

P37
119
Aims and Objectives

• Recognise a range of injuries
• Manage a range of illnesses
• Treat a range of injuries

P37
120
Sickle Cell Anaemia

• A serious condition where the red blood cells
  become sickle shaped instead of the normal
  doughnut shape. This prevents oxygen moving
  around the body causes severe pain and organ
  damage.
• Is common in families from Africa, Caribbean,
  eastern Mediterranean, the Middle East and Asia.

P37
121
Sickle Cell Anaemia

• Recognition features
• Severe abdominal pain
• Treatment
• Keep the child comfortable and transport to
  hospital

P37
122
Meningitis

• Viral and aseptic meningitis are both relatively
  mild.
• Bacterial meningitis is far more serious.
• Infection attacks the fluid that surrounds the
  brain and spinal cord.

P38
123
Meningitis

• Caused by a viral or bacterial infection, this
  can be spread by discharge from the nose and
  throat of the infected person

P38
124
Recognition Features

• Newborns and infants
• Inactivity
• Irritability
• Vomiting
• Poor feeding and high pitched cry
• Fever, headache and neck stiffness

P38
125
Recognition Features

• Over two years old
• High fever (101 106f or 38.3 41.1c)
• Headache, stiff neck developing between 1 2
  days
• Nausea, vomiting
• Back pain, fuzziness
• Red or purple skin rash
• Loss of appetite

P38
126
Treatment

• Seek urgent medical assistance
• Be aware not all sufferers develop all the
  recognition features

P38
127
Diabetes

• This condition is caused when the body can no
  longer regulate the levels of sugar in the blood
• The pancreas fails to produce the hormone insulin
  
• Hypoglycaemia
• Hyperglycaemia

P39
128
Diabetes

• Recognition of Hypoglycemia
• Pallor of skin
• Profuse sweating
• Casualties pulse is rapid
• Breathing is shallow
• Limbs may tremble
• Confused or abnormally aggressive, can be
  mistaken for someone who is drunk
• Faintness or unconsciousness

P39
129
Treatment of Hypoglycemia

• Conscious casualty
• Give a sweetened drink with 2 or tablespoons
• of sugar, or other sweet substance
• If the casualty improves dramatically ensure
• he gets more sugar, as the problem was an
• excess of insulin
• Unconscious casualty
• Place into recovery position
• Ensure open airway
• Sent to hospital

P39
130
Diabetes

• Recognition of Hyperglycemia
• Hot red face
• Dry skin
• Acetone smell on the breath
• May be wearing a medic alert bracelet
• May be carrying a testing kit
• Confused or abnormally aggressive, can be
  mistaken for someone who is drunk
• Faintness or unconsciousness

P39
131
Diabetes

• Treatment of Hyperglycemia
• Calm and reassure
• Loosen tight clothing
• Advise to seek medical assistance
• Place into recovery position if unconscious

P39
132
Major epilepsy

• Disturbance in the normal electrical activity
• of the brain
• May have an Aura or warning period
• Sudden loss of consciousness, falls to the floor
  and becomes rigid
• Flushed or livid face and neck
• Commences convulsions, may lose control of
  bladder or bowel
• Relaxes and becomes unconscious
• Recovers after a few minutes

P40
133
Treatment

• Try to support or ease the fall of the casualty,
  lay him down
• Clear the space around the casualty
• Loosen tight clothing, put something soft under
  the head
• DO NOT move, restrain, try to wake or put
  anything in the casualties mouth
• When convulsion has finished place into the
  recovery position, check for other injuries
• Advise casualty to see a doctor

P40
134
Effects of heat and cold

• Heat exhaustion
• Caused by a loss of salt and water from excessive
  sweating
• Hypothermia
• Body temperature falls below 35C
• Heat stroke
• A failure of the thermostat in the brain causes
  this condition

P41
135
Febrile Convulsions

• Associated with high temperature caused by ear,
  nose and throat infections. Occasionally seen
  after MMR vaccination

P42
136
Febrile Convulsions

• Unconsciousness
• Violent muscle spasms
• Fever, hot flushed skin
• Breath holding, red puffy face and neck
• Convulsions lasting no more than four minutes

P42
137
Febrile Convulsions

• Prevent injury by padding around the body during
  seizure
• Supply cool fresh air
• Sponge the skin with tepid water to assist
  cooling
• Maintain airway, place into the recovery position

P42
138
How to recognise Heat Exhaustion

• May have a head ache
• Be profusely sweating or has stopped sweating
• Be hot to the touch
• Become pale with cold clammy skin
• Suffer from cramp
• Become confused

P43
139
Treatment for Heat Exhaustion

• Move the casualty to a cool place
• Allow to sip cool water
• Arrange for medical assistance if they dont
  recover quickly

P43
140
Heat stroke

• Keep the casualty comfortable and send to
  hospital urgently

P43
141
Hypothermia

• Hypothermia is where the body's core temperature
  drops below 35c

P44
142
How to recognise Hypothermia

• May have very cold skin which feels like marble
• Have white skin and blue extremities
• Be shivering uncontrollably
• Have slow breathing
• Have a slow pulse
• Become confused and very slow to react

P44
143
Infants with Hypothermia

• Infants may not shiver and as such cannot warm
  themselves in this way

P44
144
The Aftermath

• Report to the HSE
• Record in the accident book
• Replenish first aid supplies

P47
145
Accident details

• Name of casualty
• Home address
• Name of person writing the report
• When the accident happened
• Where the accident happened
• What happened
• Treatment given
• Method of disposal

P47
146
First Aid containers

• Workshop

P48
147
First Aid Containers

• Think about the type of injuries and illnesses
  you see in your workplace.
• What do you need in your first aid kit?

P48
148
First Aid Containers

• Contents
• Disposable gloves
• Guidance card
• 20 individually wrapped sterile dressings
• 2 sterile eye pads
• 4 individually wrapped triangular bandages
• 6 safety pins
• 6 medium sized individually wrapped sterile
  dressings
• 2 large sized individually wrapped sterile
  dressings

P48
149
Question and Answer Session