Management of Injuries and Acute Illness

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Chapter 10
Management of Injuries and Acute Illness
2
Program Planning

• Every program should develop policies and
  response procedures to follow in the event of an
  illness or serious emergency.
• Plans should be reviewed and updated frequently.
• Staff should be familiar with these plans and
  know how they are to be implemented.

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Program Planning (continued)

• Staff members should be trained in basic first
  aid and CPR.
• First-aid supplies should be available and
  accessible.
• Families should also be informed of program
  emergency response policies and procedures.

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Basic Principles

• Remain with the child at all times.
• Do not move unless there is danger of further
  injury.
• Do not give fluids or medications unless
  prescribed.
• Call for medical assistance.
• Notify the childs family.
• Record all information about the event.

5
Absence of Breathing

• Establish that a victim is not breathing.
• Position (head tilt-chin lift) and give two small
  breaths.
• Begin CPR
• Continue until the victim begins breathing or
  emergency medical assistance arrives.

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Airway Obstruction

• Children under five years are at highest risk.
• Why?
• What other groups of children are at high risk
  for choking?
• What items do children choke on most often?

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Airway Obstruction (continued)

• Use the Heimlich maneuver to dislodge an item in
  the childs airway. Know how this technique is
  applied differently for
• Infants
• Toddlers
• Older children and adults
• Stop compressions and begin CPR at once if the
  child stops breathing.

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Heimlich Maneuver
Infant
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Heimlich Maneuver
10
Shock

• Shock is life-threatening and can occur with many
  different types of injuries.
• The victim may appear pale, weak, and confused.
• Help the victim to lie down elevate feet 8 to 10
  inches and observe closely for breathing.
• Call for emergency medical assistance.

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Asthma Attacks

• Asthma attacks are caused by swelling and
  narrowing of the air passages.
• Severity of attacks varies from mild coughing and
  wheezing to life-threatening.  
• Boys are diagnosed more often than girls.
• Children 5 to 17 years of age missed 14.7 million
  school days due to asthma (CDC, 2005).

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Asthma Attacks (continued)

• Encourage the child to relax.
• Administer prescribed medications (inhaler).
• Monitor the childs breathing.
• Call for emergency medical assistance if the
  attack is prolonged or the child becomes fatigued
  and is struggling to breathe.
• Notify the childs family.

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Bleeding

• Call for emergency medical assistance if bleeding
  comes in spurts or cannot be controlled.
• Follow Universal Precautions.
• Apply direct pressure elevate if possible.
• Notify the childs family.

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Diabetes

• Approximately 15,000 children are diagnosed with
  type 1 diabetes every year.
• Type 2 diabetes is linked to obesity and is being
  diagnosed at an alarming rate among young
  children.
• Diabetes is the fifth leading cause of death.

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Diabetes (continued)

• The risk of developing type 2 diabetes is highest
  for African Americans, Hispanic/Latino Americans,
  American Indians, some Asian Americans and Native
  Hawaiians or other Pacific Islanders.

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Diabetes (continued)

• Teachers must work closely with the families of
  children who have been diagnosed with diabetes.
• Emergency management requires
• Recognizing symptoms of hypoglycemia and
  hyperglycemia (Table 10-5)
• Administering treatment and calling for emergency
  medical assistance if needed

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Drowning

• Drowning is the leading cause of death among
  young children.
• Prevention is the desired approach.
• Administer CPR if the child is not breathing.
• Call for emergency medical assistance.
• Contact the childs family.

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Head Injuries

• Every head injury should be considered
  potentially serious.
• Observe the child carefully for 48 hours.
• Become familiar with developing signs of serious
  complications.

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Poisoning

• Why are young children at high risk for
  accidental poisoning?
• What signs might indicate a potential poisoning?
• Know how to distinguish different categories of
  ingested substances (Table 10-6).

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Carolinas Poison Center

• (in Charlotte) 355-4000
• (out of Charlotte)
• toll free
• 1-800-848-6946

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SIGNS TO WATCH FORIN CASE OF POISONING

• drowsiness
• coma
• slow, shallow breathing
• slow pulse rate
• vomiting
• ringing in the ears
• severe burns to lips, mouth
• convulsions
• dehydration
• Whenever any of these signs appear
• call your doctor or nearest Poison
• Control Center.
• Do not delay! Death may only be a matter of time
  if you hesitate.

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Non-Life-Threatening Conditions

• Teachers should know how to care for children who
  experience a variety of injuries and acute
  illnesses, including
• Scrapes and cuts
• Bites
• Blisters
• Burns
• Eye injuries

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Non-Life-Threatening Conditions (continued)

• Fractures
• Frostbite
• Heat stroke
• Nosebleeds
• Seizures
• Splinters
• Tooth emergencies

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Fractures

• Fractures are breaks, cracks, or chips in a bone.
  
• A fractured bone that pierces through the skin is
  called an open fracture.
• Because of bleeding and the risk of infection,
  open fractures are potentially the most
  dangerous.
• Fortunately, closed fractures, which do not break
  the skin, are the most common kind.
• A dislocation occurs when the bone slips out of
  its normal place in the joint.
• The telltale symptoms of a fracture are
• Acute pain
• Tenderness
• Swelling (may be severe or mild)
• Limited range of movement

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First Aid for Fractures

• Immobilize the injured area. Don't try to realign
  the bone, but if you've been trained in how to
  splint and professional help isn't readily
  available, apply a splint to the area.
• Apply ice packs to limit swelling and help
  relieve pain until emergency personnel arrive.
  Don't apply ice directly to the skin wrap the
  ice in a towel, piece of cloth or some other
  material.

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First Aid for Nosebleeds

• Stay calm and reassure the child.
• With the child upright in a chair or in your lap,
  tilt his or her head slightly forward.
• Gently pinch the nose (just below the bony ridge)
  with a tissue or clean washcloth.
• Keep pressure on the nose for about 10 minutes
  if you stop too soon, bleeding may start again.
  It may also help to apply ice wrapped in a paper
  towel.

• Do not have the child lean back. This may cause
  blood to flow down the back of the throat, which
  tastes bad and may cause gagging, coughing, or
  vomiting.
• Have the child to rest for a while after a
  nosebleed. Discourage nose-blowing, picking, or
  rubbing, and any rough play.

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First Aid for Seizures

• Get the child away from anything that could cause
  harm -- out of the tub, away from stoves or
  heaters, away from tables and shelves where items
  may fall off and cause an injury.
• Roll the child on his or her side, as a seizure
  victim may vomit and could choke if lying on his
  or her back.
• If you can, tilt the child's chin forward,
  CPR-style, to help open the breathing passage.
• Do not put anything in the child's mouth. A
  tongue cannot be swallowed this is a myth. If
  you put your hand in the child's mouth, you may
  end up being bitten, because a seizure victim
  will often clamp down uncontrollably. A spoon or
  other object thrust into the child's mouth will
  not help breathing, but may result in injury to
  the mouth and teeth.
• Once the convulsive component of the seizure is
  over and the child then is sleepy, groggy, or not
  very responsive, the emergency component is
  essentially over.
• The child should be taken calmly, at normal
  driving speed, to the emergency room for
  evaluation and care.

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FIRST AID FOR BRUISES

• Apply ice packs for 15-minute periods at least
  several times a day during the first 48 hours to
  reduce swelling.
• A zip-lock bag filled with ice cubes and water or
  a partially thawed package of frozen peas may be
  useful if an ice pack isn't available.
• Elevating the bruised area also lessens swelling.
  
• Instruct the child to avoid physical exercise for
  the time being, especially if the bruise is on an
  arm or leg, since physical activity can delay
  healing.
• Call your pediatrician if the child has banged
  his or her head and has a bruise behind the ear.
  This may be a sign of skull fracture.

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Tooth Emergencies

• Knocked Out ToothHold the tooth by the crown and
  rinse off the root of the tooth in water if its
  dirty (Avoid touching the root end). Do not scrub
  it or remove any attached tissue fragments. If
  possible, gently insert and hold the tooth in its
  socket. If that isnt possible, put the tooth in
  a cup of milk and get to the dentist as quickly
  as possible. Remember to take the tooth with you!
• Broken ToothRinse the mouth with warm water to
  clean the area. Use cold compresses on the area
  to keep any swelling down. Call the dentist
  immediately.