First aid for children - with St John

It’s a fact of life that children will, at some time or another, have an accident and suffer an injury. Workers in formal child care services are required to hold current first aid qualifications, but it is also important for parents and others who have children in their care to take a first aid course and have a first aid kit accessible, in case of emergencies. Knowing what to do gives you confidence in an emergency. 

St John DRABC (“Doctor ABC”) Action Plan

This Action Plan is a vital to help the first aider in assessing whether the child has any life-threatening conditions and if any immediate first aid is necessary.

D - check for Danger

• to you
• to others
• to child

R - check Response

• is child conscious?
• is child unconscious?

A - check Airway

• is airway clear of objects?
• is airway open?

B - check for Breathing

• is chest rising and falling?
• can you hear child's breathing?
• can you feel the breath on your cheek?

C - check for Circulation

• can you feel a pulse?
• can you see any obvious signs of life?

Recovery Position

• kneel beside the child
• lift nearer leg at knee so it is fully bent upwards
• place nearer arm across chest
• place farther arm at right angles to body
• roll child away from you onto side
• keep leg at right angles with knee touching ground to prevent child rolling onto face.

Allergic Reactions

An allergic reaction can occur when a substance enters the body. The allergy may be caused by an insect sting or bite, drugs, medication, food or chemicals.  Allergic reactions vary considerably in severity, and swift action may make all the difference.  

Management of Severe Allergic Reaction

1. Follow DRABC.
2. Call 000 for an ambulance.
3. Observe and record pulse and breathing.
4. If the child is carrying medication for the allergy, it should be taken at once.
5. If conscious, help child to sit in position that most relieves breathing difficulty.
6. If unconscious, check ABC (Airway, Breathing, Circulation) and prepare to resuscitate if necessary.

Poisoning

The most common cause of poisoning in young children is swallowing medication or household products that have not been safely stored.

In an emergency
Ring 13 11 26 24 hours a day, 7 days a week, Australia-wide.
    
If the victim has collapsed, stopped breathing, is fitting or is suffering an anaphylactic reaction, ring 000 for an ambulance. Do NOT ring the Poisons Information Centre.

Otherwise for the management of poisoning

1. Call the Poisons Information Centre – 131126.
2. In the case of liquid or pills, locate the container and take it to the phone.
3. DO NOT make the child vomit – this can cause further harm.
4. If the child does vomit, keep vomitus to show the doctor.
5. DO NOT give fluids – this will dissolve the drugs and hasten absorption.
6. Reassure your child.
7. Seek medical aid.

If the child is unconscious:

1. Open the child’s mouth and check for pills - hook out with a finger any tablets you can see.
2. Place child in recovery position and check ABC, while waiting for an ambulance.

The best treatment for poisoning is constantly changing. Advice you may have received in the past may not be the recommended treatment anymore, considering current knowledge.

Also, many books and antidote charts are out of date and incorrect. Well-meaning friends and relatives may advise you about treating poisoning incidents, but their information may also be out of date. Inducing vomiting was once the main treatment for swallowed poisons but we now know that it does not reliably remove poisons from the body and is often dangerous.

If you ring the Poisons Information Centre you will receive the most up-to-date advice as information databases are updated many times each year.

Source: Victorian Poisons Information Centre

Sprains and Strains

The pain from a sprain may be quite intense and the child’s ability to move the joint will be restricted. There will be swelling around the joint and bruising will develop quickly. 

Management of Sprains and Strains - RICE

1. Rest the child and the injured part.
2. Icepacks wrapped in a cloth may be applied to the injury – for 15 minutes every 2 hours for 24 hours, then for 15 minutes every 4 hours for 24 hours.
3. Compression Bandages, such as elastic bandages, should be firmly applied to extend well beyond the injury.
4. Elevate the injured part.
5. Seek medical attention.

Splinter Removal

1. Clean the area around the splinter with soap and water.
2. If the splinter end protrudes from the skin – grasp the splinter with cleaned tweezers and remove the splinter at the angle it went in.
3. If the splinter end is not protruding, expose the splinter using a disposable sterile splinter probe and then remove as in Step 2.
4. Clean the area and apply a transparent or adhesive dressing.
5. Seek medical advice if:

• Splinter area becomes more painful, reddened and swollen, or
• Splinter breaks or does not come out easily.

This first aid information is not a substitute for taking a first aid course. St John recommends that one person in every Australian household have a current first aid certificate.

For more information on first aid training and kits visit St John or call 1300 360 455.

The information provided in this article is intended as a guide only. Always consult your doctor if you or your child is suffering any medical complaint. Any websites referred to by Australian Family contain information moderated by government and medical institutions or organisations.

This article was first published in Australian Family Magazine, May 2002. Updated July 2009.