Promoting Health and Safety of Children

Promoting Health and Safety of Children
Unit 4 Parenting Mrs. Loggins Curriculum Frameworks

Curriculum Frameworks
FW 4.1: Define terms related to promoting health and safety of children. 4.1.1: Apply terms in correct context. FW 4.2: List general guidelines for childproofing the home. (N.S. 4.4) (C.P.- HMC 06), (C.P.-HMC ) 4.2.1: Identify potential hazards within various scenarios. (C.P. HMC 06.01) FW 4.3: Name common childhood illnesses. 4.3.1: Explain care required for common childhood illnesses including the common cold, fever, ear infection, influenza, sore throat, diarrhea, asthma, allergies. FW 4.

FW 4.4: Describe medical checkups and immunizations.
4.4.1: Chart a schedule of routine checkups and immunizations from birth to age 18. FW 4.5: Designate appropriate care for injuries. 4.5.1: Demonstrate first aid for minor injuries. 4.5.2: Explain first aid for medical emergencies. FW 4.6: Explain car seat safety guidelines for children of various ages. 4.6.1: Research child vehicle safety restraint laws. FW 4.7: Describe child abuse and neglect. (N.S ) 4.7.1: List causes of child abuse and neglect. 4.7.2: List symptoms of child abuse and neglect. (N.S ) 4.7.3: Outline procedure for reporting suspected abuse or neglect. (N.S ) Curriculum Frameworks Continued… FW 4.

Unit 4 Vocabulary Allergies: oversensitivity to one or more common substances. Artificial Respiration: a procedure for forcing air into the lungs of a person whose breathing has stopped. Asthma: a condition affecting the lungs in which air passages tighten, making it difficult to breathe. Child Abuse: physical, emotional, or sexual violence against children. Child Neglect: failure to meet the child’s physical or emotional needs. Communicable Diseases: illnesses that are easily passed from one person to another. FW 4.

Fracture: a break or crack in the bone.
Contagious: the ability to be spread from one person to another. The period during which a communicable disease can be spread to another person. Convulsion: a seizure or a period of unconsciousness with uncontrolled jerking of muscles. Cardiopulmonary Resuscitation (CPR): first aid technique that tries to restore breathing and heartbeat to persons who show no signs of breathing or pulse. Fracture: a break or crack in the bone. Heimlich Maneuver: procedure that removes food or other obstacles from a choking person’s airway. Vocabulary Continued… FW 4.

Immunization: to protect a person from disease, usually by means of a vaccine.
Poison Control Center: a special unit that gives advice for and treats victims of poisoning. Shaken Baby Syndrome: a serious type of physical abuse that occurs when a baby is violently shaken. Sprain: an injury caused by sudden, violent stretching of a joint or muscle. Vaccine: a small amount of disease-carrying germs introduced to the body on purpose so that the body can build resistance to that disease. Wellness: the process of acquiring and maintaining physical, mental, emotional, and social health. Vocabulary Continued… FW 4.

Childproofing the Home
Accidents are the leading cause of death for children over 1 year old. Provisions to the home need to be made as soon as the child begins to crawl. Make the home safe from the child’s point of view. Get down on the ground and look around. Check for small parts or pocket change that may be on the floor. FW 4.2 and 4.2.1

Cover all electrical outlets with caps or shields. Keep electric fans and heaters out of reach. Lock up dangerous items. Guns Ammunition Power Tools To prevent poisoning, store household chemicals in a securely locked cabinet. Typically the higher cabinets are better. FW 4.2 and 4.2.1

Use childproof latches to keep children out of low cabinets. Close the cover on the washer/dryer when not in use. Use window guards Windows cannot be opened more than 6 inches. Ensure furniture cannot be tipped over. Cushion edges on tables with foam pads. Use baby gates Especially in staircases! Get rid of poisonous houseplants or move them out of reach of young children. FW 4.2 and 4.2.1 FW 4.

FW 4.2 and 4.2.1 FW 4.

In the Kitchen: Pan handles turned toward the back of the range. Use rear burners when possible. Sharp Objects/Glass can be hazardous. Keep knives and other sharp utensils off countertops. Try to limit glass items when children are at the table. Avoid tablecloths that hang over the edge of the table. Unplug and hide the cords of appliances that could be pulled off of a table or counter. FW 4.2 and 4.2.1

In the Bathroom: Children can drown in the toilet. Install a latch on the toilet lid. Make sure all OTC and prescription medications are stored in high cabinets with safety latches or locks. Make sure water temperature is not too hot. Skid proof mats for bottom of tub. Never leave a child unattended! FW 4.2 and 4.2.1

Around Heat Sources: Keep children away from radiators, space heaters, and fireplaces. Install guards Guards should be used until children are old enough to understand about the risk of burns from heat sources. Keep matches and lighters out of the reach of children. FW 4.2 and 4.2.1

Common Childhood illnesses
Common cold Fever Ear infection Influenza Seasonal H1N1 Sore throat Diarrhea Asthma Allergies FW 4.3

Common Cold Congestion Saline Nose Drops can help thin mucus. Suction bulb can help remove mucus from the nose. Decongestant can be given as directed on package label. Humidifier Blowing nose If the nose or cheeks become irritated, use petroleum jelly. Cough Keep well hydrated to help soothe cough. During rest time, elevate the head. Cough medicine as directed on package label. Sore Throat/Fever See a doctor to make sure it isn’t something more serious like strep throat. Fever indicates infection in the body. After the child has been seen by a physician, fever reducer such as Tylenol can be given to minimize pain and reduce fever. FW 4.3.1

Fever Occurs when the body's internal "thermostat" raises the body temperature above its normal level. Causes of Fever: Infection and children who recently vaccinated. Cause for concern: a temperature over 102 F Treat with a children’s fever reducer NEVER give a child ASPIRIN! FW 4.3.1

Your child has a temperature if:
100.4° F (38° C) measured rectally (in the bottom) 99.5° F (37.5° C) measured orally (in the mouth) 99° F (37.2° C) measured in an axillary position (under the arm) Types of Thermometers: Digital Glass Mercury Thermometer Not recommended! Mercury is an environmental TOXIN! Electric Ear Thermometer Forehead Thermometer Pacifier Thermometer Plastic Strip Thermometer FW 4.3.1

Which thermometer do I use to take a child’s temperature?
For kids younger than 3 months, you'll get the most reliable reading by using a digital thermometer to take a rectal temperature. Electronic ear thermometers aren't recommended for infants younger than 3 months because their ear canals are usually too small. For kids between 3 months to 4 years old, you can use a digital thermometer to take a rectal temperature or an electronic ear thermometer to take the temperature inside the ear canal. You could also use a digital thermometer to take an axillary temperature, although this is a less accurate method. Axillary: area near the axilla. Axilla: underneath the arm; armpit area. For kids 4 years or older, you can usually use a digital thermometer to take an oral temperature if your child will cooperate. However, kids who have frequent coughs or are breathing through their mouths because of stuffy noses might not be able to keep their mouths closed long enough for an accurate oral reading. In these cases, you can use the tympanic method (with an electronic ear thermometer) or axillary method (with a digital thermometer). Wait 20 to 30 minutes after a child eats or drinks when taking temperature orally. This ensures that you receive an accurate reading. FW 4.3.1

Ear Infection Causes: The most common cause of acute ear infections is an upper respiratory infection that spreads to the ears. Inflammation from the infection causes the eustachian tube to swell shut, and traps bacteria in the middle ear cavity. FYI: In 1/3 of all acute ear problems, have no bacteria present. FW 4.3.1

Ear Infection “Glue Ear” occurs when the middle ear fills with a sticky, glue-like fluid instead of air. This fluid dampens the vibrations made by sound waves as they travel through the eardrum and ossicles. The cochlea in turn receives dampened vibrations, and so the 'volume' of hearing is essentially 'turned down'. This is why glue ear children display symptoms such as dulled or apparent ‘selective hearing’. FW 4.3.1

Ear Infection Signs and Symptoms Fever Tugging at the Ear Complaining about pain in the ear Crankiness Crying more than usual Having difficulty sleeping Having difficulty hearing Headache Drainage from the ear FW 4.3.1

Ruptured Eardrum Ear Infection
is a hole or tear in your eardrum, the thin drum-like tissue that separates your ear canal from your middle ear. A ruptured eardrum can result in hearing loss and make your middle ear vulnerable to infections or other injury. A ruptured eardrum usually heals within a few weeks without treatment. Sometimes, you may need a procedure to promote healing of a ruptured eardrum, or need surgical repair for a ruptured eardrum. Signs and Symptoms of a Ruptured Eardrum: Sharp, sudden ear pain that usually goes away quickly Clear, pus-filled or bloody drainage from your ear Hearing loss Ringing in your ear (tinnitus) Spinning sensation (vertigo) that usually goes away quickly Nausea or vomiting that can result from vertigo FW 4.3.1

Ear Infection: Treatment: Antibiotics Over using antibiotics or prescribing the wrong type of antibiotics will cause strands of bacteria to become more stubborn. Makes treating ear infections more difficult. Treatment of allergies Removal of adenoids Usually not an effective in treating build up of fluid in the ear. Tubes May cause scarring of the eardrums in ½ of patients who have them put in. Usually children outgrow ear infections Approximately by age 7. FW 4.3.1

Pictures of Tubes Used for the Treatment of Chronic Ear Infections
FW 4.3.1

Ear Infection: Prevention: Breastfeeding helps to pass along immunities to a child that may prevent ear infections. The position the child is in while breastfeeding is better than the usual bottle-feeding position for optimal eustachian tube function. If a child must be bottle-fed, it is best to hold the infant rather than allow him or her to lie down with the bottle. Because multiple upper respiratory infections may increase the risk for acute otitis media, reducing the exposure to large groups of children, particularly in daycare centers, may reduce the incidence. Children should also be kept away from environmental irritants such as secondhand tobacco smoke. FW 4.3.1

Influenza Children 0-5 years old and those with other health conditions are at greater risk of being hospitalized with complications from the flu. Symptoms: Fever (usually high) Headache Tiredness (can be extreme) Cough Sore throat Runny or stuffy nose Body aches Diarrhea and vomiting (more common among children than adults) FW 4.3.1

How to care for a child with the flu? Hydration Water, restore electrolytes. Pedialyte in liquid or popsicle form Gatorade Liquid should be taken in small sips frequently. Keep fever down by using a fever reducer for children. Lots of Rest Dress your child in layers They can add or remove clothing based on current temperature (chills/sweating) FW 4.3.1

Emergency Signs of the Flu In children Fast breathing or trouble breathing Bluish skin color Not drinking enough fluids Not waking up or not interacting Being so irritable that the child does not want to be held Flu-like symptoms improve but then return with fever and worse cough FW 4.3.1

Sore Throat (Also known as “pharyngitis“) If running a temperature see doctor to test for strep throat. Antibiotics will be needed if tested positive for strep. Treatment: Plenty of Fluids Rest Soft Foods Pain/Fever Reducer if needed FW 4.3.1

Diarrhea loose, watery stools occurring more than three times in one day – is a common problem that usually lasts a day or two and goes away on its own without any special treatment. Prolonged diarrhea can be a sign of other problems. Diarrhea can cause dehydration. You should see the doctor if: You have diarrhea for more than 3 days. You have severe pain in the abdomen or rectum. You have a fever of 102 degrees Fahrenheit or higher. You see blood in your stool or have black, tarry stools. Treatment: Hydrate the child Over the Counter Medication can be used to slow/stop diarrhea. Consult doctor before use Not usually recommended-stopping the diarrhea traps the organism in the body. Cause intense abdominal cramping. FW 4.3.1

Asthma Constriction and inflammation of the airways. Signs and Symptoms: Difficulty Breathing, Wheezing, Coughing, Tightness of the Chest. Treatment: Inhalers Daily medication taken orally Allergy Shots FW 4.3.1

The Anatomy of Asthma FW 4.3.1

Allergies Common Allergens: Indoor Mold, Animals, Cockroaches, Dust Mites How to Treat: Over the Counter Allergen Reducers Dust/Clean/Vacuum Frequently Vacuum Needs to have a HEPA filter. Change bedding and other household linens frequently. HEPA Filter for child’s bedroom Allergy Testing Allergy Shots (Immunotherapy) FW 4.3.1

Food Allergens Symptoms: skin: itchy red bumps (hives); eczema; redness and swelling of the face or extremities; itching and swelling of the lips, tongue, or mouth (skin reactions are the most common type of reaction) gastrointestinal tract: abdominal pain, nausea, vomiting, or diarrhea respiratory tract: runny or stuffy nose, sneezing, coughing, wheezing, shortness of breath cardiovascular system: lightheadedness or fainting Any food can cause an allergy. FW 4.3.1

Food Allergies Continued… 90% of allergic reactions come from these foods: Milk, Eggs, Peanuts, Fish, Shellfish, Soy, Wheat Some allergies can be so severe that the food item may not even be able to be in the home. Treatment: Avoid eating trigger foods, two epinephrine auto injectors (commonly called EpiPens) After your child receives epinephrine, you should go immediately to a hospital emergency room so additional treatment can be given, if needed. Also, they'll observe your child for at least 4 hours to watch for signs of a second wave of symptoms (called a biphasic reaction) that occurs in many cases FW 4.3.1

Why should I not give a child aspirin?
Reye Syndrome Reye syndrome is linked to the use of aspirin and some viral illnesses. Cause is unknown. Is NOT contagious Disease mostly effects those who have just had an illness like the flu or chicken pox and taken aspirin. Prevention: Those under 20 should not consume aspirin. Unless prescribed by a doctor. FW 4.3.1

Why should I not give a child aspirin?
Reye Syndrome Symptoms: Sudden onset of retching or vomiting that is not clearly due to stomach flu. Sluggishness, lack of energy, and loss of interest in surroundings. Strange behavior, such as staring, irritability, personality change, and slurred speech. Drowsiness that may lead to severe sleepiness (stupor). As brain damage progresses, other symptoms may develop, including: Confusion and inability to identify whereabouts or family members or to answer simple questions (disorientation). Rapid, deep breathing (hyperventilation). Aggressive behavior, such as hitting others without reason (combativeness). Seizures and abnormal body positioning, and coma. If Reye syndrome is not recognized and treated promptly, death can occur. FW 4.3.1

Treatment of Reye’s Syndrome
If a child has symptoms of Reye syndrome, get medical care immediately. Early treatment increases the chance for full recovery. If the disease is diagnosed early, most children recover from Reye syndrome in a few weeks. But some children develop permanent brain damage. The goal of treatment is to stop damage to the brain and liver and to prevent complications. All children with Reye syndrome are treated in a hospital intensive care unit. FW 4.3.1

Medical Checkups These are needed to ensure that the child is growing and developing properly. Adequate growth usually indicates the child is healthy. An infant should see the doctor at age:12, 15, 18, and 24 months. They will see the doctor for vaccinations in between those times during baby’s 1st year of life. 2 year olds-6 year olds: once every year. Check ups at 8 and 10 year olds and as needed. FW 4.4

What is a vaccine? When germs enter the body, the immune system recognizes them as foreign substances (antigens). The immune system then produces the right antibodies to fight the antigens. Vaccines contain antigens that cause diseases. However, the antigens in vaccines are weakened or killed. This means they cannot produce the signs or symptoms of the disease, but they do stimulate the immune system to create antibodies. These antibodies help protect you if you are exposed to the disease in the future. Vaccines not only help keep your child healthy, they help all children by stamping out serious childhood diseases. Immunization: to protect a person from disease, usually by means of a vaccine. FW 4.4.1

Charts courtesy of: www.cdc.gov
Immunizations Charts courtesy of: FW 4.4.1

Are vaccines safe? Vaccines are generally quite safe.
The protection provided by vaccines far outweighs the very small risk of serious problems. Vaccines have made many serious childhood diseases rare today. Questions about safety of vaccines and Autism. If parents are worried about Autism, the Family Doctor can space the immunizations further apart. FW 4.4.1

Do vaccines have side effects?
Some vaccines may cause mild temporary side effects: Fever, Soreness, lump under the skin at shot injection site. Your family doctor will talk to you about possible side effects with certain vaccines. Tip: Give a dose of children’s Tylenol 30 minutes prior to the visit to ease pain of shot and soreness after. FW 4.4.1

Are there any reasons my child should not be vaccinated?
In some special situations, children shouldn't be vaccinated. For example, some vaccines shouldn't be given to children who have certain types of cancer or certain diseases, or who are taking drugs that lower the body's ability to resist infection. If your child has had a serious reaction to the first shot in a series of shots, your family doctor will probably talk with you about the pros and cons of giving him or her the rest of the shots in the series. If you are concerned about how a shot may effect a child, you should speak to the doctor first. FW 4.4.1

What is the flu vaccine? The flu vaccine is available by shot or by nasal spray. The flu shot contains dead viruses. The nasal-spray vaccine contains live but weakened viruses. You cannot get the flu from the flu shot or the nasal-spray vaccine. The flu vaccine is given at the beginning of the flu season, usually in October or November. The flu shot is safe for children 6 months of age and older. The nasal spray vaccine is safe for children 2 years of age and older. Because flu viruses change from year to year, it is very important for your child to get the vaccine each year so that he or she will be protected. Children are more likely to have complications from the flu. FW 4.4.1

What is the DTaP vaccine?
The DTaP vaccine is 3 vaccines in 1 shot. It protects against diphtheria, tetanus and pertussis. It's given as a series of 5 shots. Diphtheria is a disease that attacks the throat and heart. It can lead to heart failure and death. Tetanus is also called "lockjaw." It can lead to severe muscle spasms and death. Pertussis (also called "whooping cough") causes severe coughing that makes it hard to breathe, eat and drink. It can lead to pneumonia, convulsions, brain damage and death. Having your child immunized when they are young protects your child against these diseases for about 10 years. After this time, your child will need booster shots. FW 4.4.1

What is the Td vaccine? The Td vaccine is used as a booster to the DTaP vaccine. It helps prevent tetanus and diphtheria. It's given when your child is 11 years old or older and every 10 years throughout life. FW 4.4.1

What is the IPV vaccine? The IPV (inactivated poliovirus) vaccine helps prevent polio. It's given 4 times as a shot. It has replaced the older oral polio vaccine. Polio can cause muscle pain and paralysis of one or both legs or arms. It may also paralyze the muscles used to breathe and swallow. It can lead to death. FW

What is the MMR vaccine? The MMR vaccine protects against the measles, mumps and rubella. It's given as 2 shots. Measles causes fever, rash, cough, runny nose and watery eyes. It can also cause ear infections and pneumonia. Measles can also lead to more serious problems, such as brain swelling and even death. Mumps causes fever, headache and painful swelling of one or both of the major saliva glands. Mumps can lead to meningitis (infection of the coverings of the brain and spinal cord) and, very rarely, to brain swelling. Rarely, it can cause the testicles of boys or men to swell, which can make them unable to have children. Rubella is also called the German measles. It causes slight fever, a rash and swelling of the glands in the neck. Rubella can also cause brain swelling or a problem with bleeding. If a pregnant woman catches rubella, it can cause her to lose her baby or have a baby who is blind or deaf, or has trouble learning. Some people have suggested that the MMR vaccine causes autism. However, good research has shown that there is no link between autism and childhood vaccinations. FW 4.4.1

What is the varicella vaccine?
What is the Hib vaccine? What is the varicella vaccine? The Hib vaccine helps prevent Haemophilus influenza type b, a leading cause of serious illness in children. It can lead to meningitis, pneumonia and a severe throat infection that can cause choking. The Hib vaccine is given as a series of 3 or 4 shots. The varicella vaccine helps prevent chickenpox. It is given to children once after they are 12 months old or to older children if they have never had chickenpox or been vaccinated. The varicella vaccine is given as a series of 2 shots. FW 4.4.1

What is the pneumococcal conjugate vaccine?
What is the HBV vaccine? What is the pneumococcal conjugate vaccine? The HBV vaccine helps prevent hepatitis B virus (HBV), an infection of the liver that can lead to liver cancer and death. The vaccine is given as a series of 3 or 4 shots. The HBV vaccine and Hib vaccine can also be given together in the same shot. The pneumococcal conjugate vaccine (PCV) protects against a type of bacteria that is a common cause of ear infections. This bacteria can also cause more serious illnesses, such as meningitis and bacteremia (infection in the blood stream). Infants and toddlers are given 4 doses of the vaccine. The vaccine may also be used in older children who are at risk for pneumococcal infection. FW 4.4.1

What is the meningococcal conjugate vaccine?
The meningococcal conjugate vaccine (MCV4) protects against 4 strains ("types") of bacterial meningitis caused by the bacteria N. meningitidis. Bacterial meningitis is an infection of the fluid around the brain and spinal cord. It is a serious illness that can cause high fever, headache, stiff neck and confusion. It can also cause more serious complications, such as brain damage, hearing loss or blindness. Children should get the MCV4 vaccine at 11 to 12 years of age. Children older than 12 who have not received the vaccine should receive it before starting high school. FW 4.4.1

1st Aid Care for Children
All homes should have a 1st aid kit. Items to include: (Reference: The American Red Cross) 2 absorbent compress dressings 25 adhesive bandages (assorted sizes) 1 adhesive cloth tape 5 antibiotic ointment packets 5 antiseptic wipe packets 2 packets of aspirin 1 blanket (space blanket) 1 breathing barrier (with one-way valve) 1 instant cold compress 2 pair of non-latex gloves (size: large) 2 hydrocortisone ointment packets Scissors 1 roller bandage 5 sterile gauze pads Oral thermometer (non-mercury/non-glass) 2 triangular bandages Tweezers First aid instruction booklet FW 4.5 and 4.5.2

Minor Cuts and Scrapes Need to be cared for properly in order to prevent infection or other complications. Stop the bleeding Minor cuts and scrapes usually stop bleeding on their own. If they don't, apply gentle pressure with a clean cloth or bandage. Hold the pressure continuously for 20 to 30 minutes and if possible elevate the wound. Don't keep checking to see if the bleeding has stopped because this may damage or dislodge the clot that's forming and cause bleeding to resume. If blood spurts or continues flowing after continuous pressure, seek medical assistance. Clean the wound Rinse out the wound with clear water. Soap can irritate the wound, so try to keep it out of the actual wound. If dirt or debris remains in the wound after washing, use tweezers cleaned with alcohol to remove the particles. If debris still remains, see your doctor. Thorough cleaning reduces the risk of infection and tetanus. To clean the area around the wound, use soap and a washcloth. There's no need to use hydrogen peroxide, iodine or an iodine- containing cleanser. FW 4.5 and 4.5.2

Minor cuts and scrapes (continued) Apply an antibiotic. After you clean the wound, apply a thin layer of an antibiotic cream or ointment (Neosporin) to help keep the surface moist. The products don't make the wound heal faster, but they can discourage infection and help your body's natural healing process. Certain ingredients in some ointments can cause a mild rash in some people. If a rash appears, stop using the ointment. Cover the wound. Bandages can help keep the wound clean and keep harmful bacteria out. After the wound has healed enough to make infection unlikely, exposure to the air will speed wound healing. FW 4.5 and 4.5.2

Minor cuts and scrapes (continued) Change the dressing Change the dressing at least daily or whenever it becomes wet or dirty. If you're allergic to the adhesive used in most bandages, switch to adhesive-free dressings or sterile gauze held in place with paper tape, gauze roll or a loosely applied elastic bandage. Watch for signs of infection See your doctor if the wound isn't healing or you notice any redness, increasing pain, drainage, warmth or swelling. FW 4.5 and 4.5.2

How can I tell if the wound requires stitches?
Get stitches for deep wounds. A wound that is more than 1/4-inch (6 millimeters) deep or is gaping or jagged edged and has fat or muscle protruding usually requires stitches. Adhesive strips or butterfly tape may hold a minor cut together, but if you can't easily close the wound, see your doctor as soon as possible. Proper closure within a few hours reduces the risk of infection. FW 4.5 and 4.5.2

Does my wound require a tetanus shot?
If your wound is deep or dirty and your last shot was more than five years ago, your doctor may recommend a tetanus shot booster. Get the booster as soon as possible after the injury Doctors recommend you get a tetanus shot every 10 years. FW 4.5 and 4.5.2

Nosebleeds Most often are not a medical problem, but can be. Most nosebleeds stem from the septum just inside the nose. Septum separates your nasal chambers. For frequent nosebleeds If you experience frequent nosebleeds, make an appointment with your doctor. You may need a blood vessel cauterized. Cautery is a technique in which the blood vessel is burned with electric current, silver nitrate or a laser. Sometimes your doctor may pack your nose with special gauze or an inflatable latex balloon to put pressure on the blood vessel and stop the bleeding. Also call your doctor if you are experiencing nasal bleeding and are taking blood thinners. Using supplemental oxygen administered with a nasal tube may increase your risk of nosebleeds. Apply a water-based lubricant to your nostrils and increase the humidity in your home to help relieve nasal bleeding. FW 4.5 and 4.5.2

Caring for a nosebleed: Sit upright and lean forward By remaining upright, you reduce blood pressure in the veins of your nose. This discourages further bleeding. Sitting forward will help you avoid swallowing blood, which can irritate your stomach. Pinch your nose Use your thumb and index finger to pinch your nostrils shut. Breathe through your mouth. Continue to pinch for five to 10 minutes. This maneuver sends pressure to the bleeding point on the nasal septum and often stops the flow of blood. To prevent re-bleeding after bleeding has stopped Don't pick or blow your nose and don't bend down until several hours after the bleeding episode. Keep your head higher than the level of your heart. If re-bleeding occurs Blow out forcefully to clear your nose of blood clots and spray both sides of your nose with a decongestant nasal spray containing oxymetazoline Example: Afrin Pinch your nose in the technique described above and call your doctor. FW 4.5 and 4.5.2

When should I seek medical help for a nose bleed?
If: The bleeding lasts for more than 20 minutes The nosebleed follows an accident, a fall or an injury to your head, including a punch in the face that may have broken your nose FW 4.5 and 4.5.2

Human Bites Human bites can be as dangerous as or even more dangerous than animal bites because of the types of bacteria and viruses contained in the human mouth. If someone cuts his or her knuckles on another person's teeth, as might happen in a fight, this is also considered a human bite. If you sustain a human bite that breaks the skin: Stop the bleeding by applying pressure. Wash the wound thoroughly with soap and water. Apply an antibiotic cream to prevent infection. Apply a clean bandage. If the bite is bleeding, apply pressure directly on the wound, using a sterile bandage or clean cloth, until the bleeding stops. Seek emergency medical care. Make sure the person has had an updated tetanus shot. FW 4.5 and 4.5.2

Animal Bites For minor wounds If the bite barely breaks the skin and there is no danger of rabies, treat it as a minor wound. Wash the wound thoroughly with soap and water. Apply an antibiotic cream to prevent infection and cover the bite with a clean bandage. For deep wounds If the animal bite creates a deep puncture of the skin or the skin is badly torn and bleeding, apply pressure with a clean, dry cloth to stop the bleeding and see your doctor. For infection If you notice signs of infection, such as swelling, redness, increased pain or oozing, see your doctor immediately. For suspected rabies If you suspect the bite was caused by an animal that might carry rabies — including any wild or domestic animal of unknown immunization status — see your doctor immediately. Make sure the victim has an updated tetanus shot. FW 4.5 and 4.5.2

Insect Bites and Stings For mild reactions: Move to a safe area To avoid more stings. Remove the stinger Especially if it's stuck in your skin. This will prevent the release of more venom. Wash area with soap and water. Apply a cold pack or cloth filled with ice to reduce pain and swelling. Apply hydrocortisone cream (0.5 percent or 1 percent), calamine lotion or a baking soda paste — with a ratio of 3 teaspoons) baking soda to 1 teaspoon water — to the bite or sting several times a day until symptoms subside. Take an antihistamine (Benadryl) Allergic reactions may include mild nausea and intestinal cramps, diarrhea, or swelling larger than 2 inches (5 centimeters) in diameter at the site. See your doctor promptly if you experience any of these signs and symptoms. FW 4.5 and 4.5.2

Insect Bites and Stings For severe reactions: Severe reactions may progress rapidly. Call 911 or emergency medical assistance if the following signs or symptoms occur: Difficulty breathing Swelling of the lips or throat Faintness Dizziness Confusion Rapid heartbeat Hives Nausea, cramps and vomiting FW 4.5 and 4.5.2

Insect Bites and Stings For severe reactions: Take these actions immediately while waiting with an affected person for medical help: Check for medications that the person might be carrying to treat an allergic attack, such as an auto-injector of epinephrine (for example, EpiPen). Administer the drug as directed — usually by pressing the auto-injector against the person's thigh and holding it in place for several seconds. Massage the injection site for 10 seconds to enhance absorption. Have the person take an antihistamine pill If they are able to do so without choking. Do this after administering epinephrine. Have the person lie still on back with feet higher than the head. Loosen tight clothing and cover the person with a blanket. Don't give anything to drink. Turn the person on his or her side to prevent choking if there's vomiting or bleeding from the mouth. Begin CPR if there are no signs of circulation, such as breathing, coughing or movement. If the doctor has prescribed an auto-injector of epinephrine, read the instructions before a problem develops and also have your household members read them. FW 4.5 and 4.5.2

Poisoning Many conditions mimic the signs and symptoms of poisoning, including seizures, alcohol intoxication, stroke and insulin reaction. If you suspect poisoning, call your regional poison control center or, in the United States, the National Poison Control Center at before giving anything to the affected person. Signs and symptoms of poisoning: Burns or redness around the mouth and lips, from drinking certain poisons Breath that smells like chemicals, such as gasoline or paint thinner Burns, stains and odors on the person, on his or her clothing, or on the furniture, floor, rugs or other objects in the surrounding area Empty medication bottles or scattered pills Vomiting, difficulty breathing, sleepiness, confusion or other unexpected signs FW 4.5 and 4.5.2

Poisoning When to call for help: Call 911 or your local emergency number immediately if the person is: Drowsy or unconscious Having difficulty breathing or has stopped breathing Uncontrollably restless or agitated Having seizures FW 4.5 and 4.5.2

Poisoning What to do: If the person has been exposed to poisonous fumes, such as carbon monoxide, get him or her into fresh air immediately. If the person swallowed the poison, remove anything remaining in the mouth. If the suspected poison is a household cleaner or other chemical, read the label and follow instructions for accidental poisoning. If the product is toxic, the label will likely advise you to call the poison control Follow treatment directions that are given by the poison control center. If the poison spilled on the person's clothing, skin or eyes, remove the clothing. Flush the skin or eyes with cool or lukewarm water, such as by using a shower for 20 minutes or until help arrives. Make sure the person is breathing. If not, start rescue breathing and CPR. Take the poison container (or any pill bottles) with you to the hospital. FW 4.5 and 4.5.2

What NOT to do: Don't give ipecac syrup or do anything to induce vomiting. The American Academy of Pediatrics advises discarding ipecac in the home, saying there's no good evidence of effectiveness and that it can do more harm than good. 1st Aid Care for Children FW 4.5 and 4.5.2

Signs and symptoms of sunburn usually appear within a few hours of exposure, bringing pain, redness, swelling and occasional blistering. Because exposure often affects a large area of your skin, sunburn can cause headache, fever and fatigue. If you have a sunburn: Take a cool bath or shower. You can also apply a clean towel dampened with cool water. Apply an aloe vera or moisturizing lotion several times a day. Leave blisters intact to speed healing and avoid infection. If they burst on their own, apply an antibacterial ointment on the open areas. If needed, take an over-the-counter pain reliever. Don't use petroleum jelly, butter or other home remedies on your sunburn. They can prevent or delay healing. If your sunburn begins to blister or if you experience immediate complications, such as rash, itching or fever, see your doctor. FW 4.5 and 4.5.2

Your ligaments are tough, elastic-like bands that connect bone to bone and hold your joints in place. A sprain is an injury to a ligament caused by excessive stretching. The ligament can have a partial tear, or it can be completely torn apart. Of all sprains, ankle and knee sprains occur most often. Sprained ligaments swell rapidly and are painful. Generally, the greater the pain, the more severe the injury is. For most minor sprains, you probably can treat the injury yourself. FW 4.5 and 4.5.2

Sprain Follow the instructions for P.R.I.C.E. Protect The injured limb from further injury by not using the joint. You can do this using anything from splints to crutches. Rest The injured limb. But don't avoid all activity. Even with an ankle sprain, you can usually still exercise other muscles to minimize deconditioning. Ice Use a cold pack, a slush bath or a compression sleeve filled with cold water to help limit swelling after an injury. Try to ice the area as soon as possible after the injury and continue to ice it for 10 to 15 minutes four times a day for 48 hours. If you use ice, be careful not to use it too long, as this could cause tissue damage. Compress the area with an elastic wrap or bandage. Compressive wraps or sleeves made from elastic or neoprene are best. Elevate the injured limb above your heart whenever possible to help prevent or limit swelling. After two days, gently begin using the injured area. You should feel a gradual, progressive improvement. Over-the-counter pain relievers may be helpful to manage pain during the healing process. See your doctor if your sprain isn't improving after two or three days. FW 4.5 and 4.5.2

Get emergency medical assistance for your sprain: You're unable to bear weight on the injured leg, the joint feels unstable or you can't use the joint. This may mean the ligament was completely torn. On the way to the doctor, apply a cold pack. You have a fever higher than 100 F (37.8 C), and the area is red and hot. You may have an infection. You have a severe sprain. Inadequate or delayed treatment may cause long- term joint instability or chronic pain. 1st Aid Care for Children FW 4.5 and 4.5.2

Motion Sickness You may escape motion sickness by planning ahead. If you're traveling, reserve seats where motion is felt least: By ship, request a cabin in the front or middle of the ship, or on the upper deck. By plane, ask for a seat over the front edge of a wing. Once aboard, direct the air vent flow to your face. By train, take a seat near the front and next to a window. Face forward. By automobile, drive or sit in the front passenger's seat. If you're susceptible to motion sickness: Focus on the horizon or on a distant, stationary object. Don't read. Keep your head still, while resting against a seat back. Don't smoke or sit near smokers. Avoid spicy and greasy foods and alcohol. Don't overeat. Take an over-the-counter Dramamine Expect drowsiness as a side effect. Consider scopolamine available in a prescription adhesive patch. Several hours before you plan to travel, apply the patch behind your ear for 72-hour protection. Talk to your doctor before using the medication if you have health problems such as asthma, glaucoma or urine retention. Eat dry crackers or drink a carbonated beverage to help settle your stomach if you become ill. FW 4.5 and 4.5.2

First-degree burn The least serious burns are those in which only the outer layer of skin is burned, but not all the way through. The skin is usually red, with swelling, and pain sometimes is present. Treat a first-degree burn as a minor burn unless it involves substantial portions of the hands, feet, face, groin or buttocks, or a major joint, which requires emergency medical attention. Second-degree burn When the first layer of skin has been burned through and the second layer of skin (dermis) also is burned. Blisters develop and the skin takes on an intensely reddened, splotchy appearance. Second-degree burns produce severe pain and swelling. If the second-degree burn is no larger than 3 inches in diameter, treat it as a minor burn. If the burned area is larger or if the burn is on the hands, feet, face, groin or buttocks, or over a major joint, treat it as a major burn and get medical help immediately. FW 4.5 and 4.5.2

Third-degree burn The most serious burns involve all layers of the skin and cause permanent tissue damage. Fat, muscle and even bone may be affected. Areas may be charred black or appear dry and white. Difficulty inhaling and exhaling, carbon monoxide poisoning, or other toxic effects may occur if smoke inhalation accompanies the burn. For major burns, call 911 or emergency medical help. Until an emergency unit arrives, follow these steps: Don't remove burned clothing. However, do make sure the victim is no longer in contact with smoldering materials or exposed to smoke or heat. Don't immerse large severe burns in cold water. Doing so could cause a drop in body temperature (hypothermia) and deterioration of blood pressure and circulation (shock). Check for signs of circulation (breathing, coughing or movement). If there is no breathing or other sign of circulation, begin CPR. Elevate the burned body part or parts. Raise above heart level, when possible. Cover the area of the burn. Use a cool, moist, sterile bandage; clean, moist cloth; or moist towels. FW 4.5 and 4.5.2

For minor burns Cool the burn. Hold the burned area under cool (not cold) running water for 10 or 15 minutes or until the pain subsides. If this is impractical, immerse the burn in cool water or cool it with cold compresses. Cooling the burn reduces swelling by conducting heat away from the skin. Don't put ice on the burn. Cover the burn with a sterile gauze bandage. Don't use fluffy cotton, or other material that may get lint in the wound. Wrap the gauze loosely to avoid putting pressure on burned skin. Bandaging keeps air off the burn, reduces pain and protects blistered skin. Take an over-the-counter pain reliever. Minor burns usually heal without further treatment. They may heal with pigment changes, meaning the healed area may be a different color from the surrounding skin. Watch for signs of infection, such as increased pain, redness, fever, swelling or oozing. If infection develops, seek medical help. Avoid re-injuring or tanning if the burns are less than a year old — doing so may cause more extensive pigmentation changes. Use sunscreen on the area for at least a year. Caution Don't use ice. Putting ice directly on a burn can cause a burn victim's body to become too cold and cause further damage to the wound. Don't apply butter or ointments to the burn. This could cause infection. Don't break blisters. Broken blisters are more vulnerable to infection. FW 4.5 and 4.5.2

Choking The universal sign for choking is hands clutched to the throat. If the person doesn't give the signal, look for these indications: Inability to talk Difficulty breathing or noisy breathing Inability to cough forcefully Skin, lips and nails turning blue or dusky Loss of consciousness FW 4.5 and 4.5.2

If choking is occurring, the Red Cross recommends a "five-and-five" approach to delivering first aid: First, deliver five back blows between the person's shoulder blades with the heel of your hand. Next, perform five abdominal thrusts (also known as the Heimlich maneuver). Heimlich Maneuver: procedure that removes food or other obstacles from a choking person’s airway. Alternate between five back blows and five abdominal thrusts until the blockage is dislodged. FW 4.5 and 4.5.2

To perform Heimlich maneuver on someone else: Stand behind the person. Wrap your arms around the waist. Tip the person forward slightly. Make a fist with one hand. Position it slightly above the person's navel. Grasp the fist with the other hand. Press hard into the abdomen with a quick, upward thrust — as if trying to lift the person up. Perform a total of five abdominal thrusts, if needed. If the blockage still isn't dislodged, repeat the five-and-five cycle. FW 4.5 and 4.5.2

Heimlich Maneuver FW 4.5 and 4.5.2

For other cases of severe bleeding, follow these steps: Have the injured person lie down and cover the person to prevent loss of body heat. If possible, position the person's head slightly lower than the trunk or elevate the legs. This position reduces the risk of fainting by increasing blood flow to the brain. If possible, elevate the site of bleeding. While wearing gloves, remove any obvious dirt or debris from the wound. Don't remove any large or more deeply embedded objects. Don't probe the wound or attempt to clean it at this point. Your principal concern is to stop the bleeding. Apply pressure directly on the wound until the bleeding stops. Use a sterile bandage or clean cloth and hold continuous pressure for at least 20 minutes without looking to see if the bleeding has stopped. Maintain pressure by binding the wound tightly with a bandage and adhesive tape. Use your hands if nothing else is available. If possible, wear rubber or latex gloves or use a clean plastic bag for protection. FW 4.5 and 4.5.2

Don't remove the gauze or bandage. If the bleeding continues and seeps through the gauze or other material you are holding on the wound, don't remove it. Instead, add more absorbent material on top of it. Squeeze a main artery if necessary. If the bleeding doesn't stop with direct pressure, apply pressure to the artery delivering blood to the area of the wound. Pressure points of the arm are on the inside of the arm just above the elbow and just below the armpit. Pressure points of the leg are just behind the knee and in the groin. Squeeze the main artery in these areas against the bone. Keep your fingers flat. With your other hand, continue to exert pressure on the wound itself. Immobilize the injured body part once the bleeding has stopped. Leave the bandages in place and get the injured person to the emergency room as soon as possible. FW 4.5 and 4.5.2

Child Seatbelt Laws Arkansas State Law:
Children 5 years or younger and those weighing less than 60 pounds should be in a child restraint. Children 5 years and younger or less than 60 pounds should sit in the rear seats of the vehicle. Adult Restraint Permitted for those who are over 6 years old and weigh over 60 pounds. Source: FW 4.6

Child Seatbelt Laws Infant Seats Rear Facing Infant Seats Front Facing
Younger than one or weighing 20 pounds or less. Make sure you put handle of infant seat down when driving in the car. Front Facing Those infants over 20 pounds. Booster Seat Useful for Toddlers FW 4.6

Source: http://www.cwla.org/advocacy/statefactsheets/2009/arkansas.htm
Child Abuse and Neglect Child Abuse: physical, emotional, or sexual violence against children. Child Neglect: failure to meet the child’s physical or emotional needs. Arkansas Statistics: In 2006, 9,180 children were substantiated or indicated as abused or neglected in Arkansas. In 2006, 19 children in Arkansas died as a result of abuse or neglect. Of these children, 5,194 were neglected. 1,729 were physically abused. 2,400 were sexually abused. Source: FW 4.7

Causes of Child Abuse and Neglect
Alcohol and Drug Abuse Anger Issues Lack of Parenting Skills Past History of Domestic Violence As an adult or child. Stress Lack of Support Untreated Mental Illness FW 4.7.1

Signs of Child Abuse and Neglect
Emotional Abuse Excessively withdrawn, fearful, or anxious about doing something wrong. Shows extremes in behavior (extremely compliant or extremely demanding; extremely passive or extremely aggressive). Doesn’t seem to be attached to the parent or caregiver. Acts either inappropriately adult (taking care of other children) or inappropriately infantile (rocking, thumb-sucking, tantruming). FW 4.7.2

Physical Abuse Frequent injuries or unexplained bruises, welts, or cuts. Is always watchful and “on alert,” as if waiting for something bad to happen. Injuries appear to have a pattern such as marks from a hand or belt. Shies away from touch, flinches at sudden movements, or seems afraid to go home. Wears inappropriate clothing to cover up injuries, such as long-sleeved shirts on hot days. FW 4.7.2

Sexual Abuse Trouble walking or sitting. Displays knowledge or interest in sexual acts inappropriate to his or her age, or even seductive behavior. Makes strong efforts to avoid a specific person, without an obvious reason. Doesn’t want to change clothes in front of others or participate in physical activities. An STD or pregnancy, especially under the age of 14. Runs away from home. FW 4.7.2

Clothes are ill-fitting, filthy, or inappropriate for the weather. Hygiene is consistently bad (unbathed, matted and unwashed hair, noticeable body odor). Untreated illnesses and physical injuries. Is frequently unsupervised or left alone or allowed to play in unsafe situations and environments. Is frequently late or missing from school. FW 4.7.2

Effects of Child Abuse and Neglect
Lack of trust and relationship difficulties. Abuse by a primary caregiver damages the most fundamental relationship as a child—that you will safely, reliably get your physical and emotional needs met by the person who is responsible for your care. Without this base, it is very difficult to learn to trust people or know who is trustworthy. This can lead to difficulty maintaining relationships due to fear of being controlled or abused. It can also lead to unhealthy relationships because the adult doesn’t know what a good relationship is. FW 4.7

Core feelings of being “worthless” or “damaged.” If you’ve been told over and over again as a child that you are stupid or no good, it is very difficult to overcome these core feelings. You may experience them as reality. Adults may not strive for more education, or settle for a job that may not pay enough, because they don’t believe they can do it or are worth more. Sexual abuse survivors, with the stigma and shame surrounding the abuse, often especially struggle with a feeling of being damaged. FW 4.7

Trouble regulating emotions. Abused children cannot express emotions safely. As a result, the emotions get stuffed down, coming out in unexpected ways. Adult survivors of child abuse can struggle with unexplained anxiety, depression, or anger. They may turn to alcohol or drugs to numb out the painful feelings. FW 4.7

Mandated Reporters of Child Abuse and Neglect
Any employee of residential and non- residential domestic violence programs Attorney Coroner Counselors Emergency Medical Personnel EMT Firefighters Hospital Employees Law Enforcement Officials Medical Personnel School Employees Social Service Workers FW 4.7.3

How to Report Child Abuse and Neglect
If abuse/neglect is suspected or known about report to: Child Abuse Hotline: To get help or report abuse, call the Childhelp National Child Abuse Hotline at A-CHILD ( ). Help for child sexual abuse: 1-888-PREVENT ( ) Stop It Now HOPE Rape, Abuse & Incest National Network (RAINN) FW 4.7.3

How to Prevent Yourself from Becoming an Abuser.
Learn what is age appropriate and what is not. Having realistic expectations of what children can handle at certain ages will help you avoid frustration and anger at normal child behavior. Develop new parenting skills. While learning to control your emotions is critical, you also need a game plan of what you are going to do instead. Start by learning appropriate discipline techniques and how to set clear boundaries for your children. Parenting classes, books, and seminars are a way to get this information. You can also turn to other parents for tips and advice. Take care of yourself. If you are not getting enough rest and support or you’re feeling overwhelmed, you are much more likely to succumb to anger. Sleep deprivation, common in parents of young children, adds to moodiness and irritability—exactly what you are trying to avoid. Get professional help. Seek counseling to deal with past issues. Seek educational parenting classes. Learn how you can get your emotions under control. Anger management classes. FW 4.7

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