Paediatric First Aid Course

Paediatric First Aid Course

Introduction to your course work book
A brief description to the class who FATE are and a little bit about what we do

House Rules Mobile phones switched off Toilets Break times
Start and finish times Mobile phones to be silenced during lectures, anyone needing to answer their phone for emergency only please leave the room Toilets point direction to class 15minute break half an hour for lunch 15 minute afternoon, please stick to the allocated break times. Course times 9.00/5.00 Any candidate who does not attend the full course will not be able to take the examination.

Competence assessment
CPR practical session Incident training Certificates

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

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 Course objectives

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 Ask the class to take a moment if they have ever been treated by someone for a injury that they may have sustained to the body. Now think how did that person react. Calm, confident, panicky, control,

First Aid and the Law

Acts and Regulations Health & Safety at Work Act 1974
Health & Safety (First Aid) Regulations 1981 Reporting of Injuries, Diseases & Dangerous Occurrences Regulations 1995 (RIDDOR) QUESTION TO THE CLASS WHAT THEIR UNDERSTANDING OF HEALTH AND SAFETY AT WORK AT IS? HOW DO YOUR EMPLOYEES DETERMINE HOW WE DECIDE HOW MANY FIRST AIDERS WE NEED? WHAT WOULD YOU CLASS AS A SERIOUS ACCIDENT ON SITE

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

The Aims of First Aid Preserve life Prevent the injury from worsening
Promote recovery

Role and Responsibilities
First Aider must always Assess Danger Prioritise Ask Treat/Transfer ASESS WHAT? DIAGNOSE, HOW TREAT TRANSFER? HOSPITAL, HOME WORK

Managing casualties

Aims and Objectives Understand how oxygen gets to the vital organs
State the priorities of life Triage a group of casualties Aims and Objectives P3

Your trainer will now explain how oxygen is transferred around the body
Transfer of oxygen P3

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

Who needs you first Screaming child Nose bleed Arterial bleed
Broken leg Asthma attack Shock Quiet child on the floor Choking Anaphylactic shock Who needs you first Workshop P3

Answers Quiet child on floor Choking Anaphylactic shock Asthma attack
Arterial bleed Nose bleed Broken leg Shock Screaming child Answers P3

Triage Breathing over Bleeding Burns Bones

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 Aims and objectives P3

Primary Assessment D: Danger R: Response A: Airway B: Breathing C: Circulation P3

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 Aims and Objectives P4

Cardio-Pulmonary Resuscitation
Adult Child Baby P4

Cardio Pulmonary Resuscitation
Danger Response Airway Breathing Compressions P4

In cases involving children and infants we should attempt one minutes CPR (3 cycles) before leaving the casualty to go and get help Child and baby P5

Adult A Flow chart for adult CPR, you can see it is amazingly simple, CPR should continue until normal breathing resumes or the casualty get up and says get off It is no longer necessary to teach a different protocol for Trauma/drowning and cardiac arrest, this has been taken out of FAW as it is very difficult for the lay person to identify the cause of cardiac arrest. Lifeguards will still be required to manage them differently # If they ask: Include 5 initial rescue breaths, CPR for one minute then get help P6

CPR Adult 30 compressions : 2 inflations 5 - 6cm depth of compression
2 Hands rate per minute CPR P6

Problems during resuscitation
Broken ribs Casualty vomits Stomach distension Not making a good seal Introduce two person operator to the class P9

Hygiene Considerations During Resuscitation
workshop P9

What is tetanus? Tetanus and Lock Jaw

Paediatric CPR It has been identified that many children and babies do not receive CPR purely because people are frightened of hurting them, there are no medical findings to support the idea that that is the case. The protocol is nearly the same encourage students learn it or include it in your course. Paediatric CPR Head tilt, chin lift as normal Breathing check is still look listen and feel for 10 seconds 5 initial rescue breaths, over one second Then 30 compressions, two hands, one third the depth of the chest, two fingers if under one year 3 cycles of 30 : 2 should equal approximately one minute, go for help Continue with 2 : 30 until something happens For paediatric courses where there are two or more rescuers with a duty to respond, these should learn 15:2 protocol Chest compressions can be one or two handed as long as the correct depth is achieved, so again in training it should be emphasised that two hands should be used especially as the rescuer tires. P10

CPR Child 30 compressions : 2 inflations 3 cycles of 30:2 = 1 minute
At least a 1/3rd depth of chest 1 hand 100 – 120 rate per minute P10

CPR Infant 30 compressions : 2 inflations 3 cycles of 30:2 = 1 minute
At least a 1/3rd depth of chest 2 fingers 100 – 120 rate per minute P12

Assessing casualties Primary assessment Secondary assessment
Recovery position A practical session

Secondary Assessment P14

Secondary Assessment History Signs Symptoms Remember children &
babies may not be able to clearly explain how they feel & what has happened Secondary Assessment P14

Unconsciousness Causes Fainting Stroke Heart attack Shock
Head injuries Hypoxia Poisoning Epilepsy Diabetes P15

The AVPU Code A Alert V Responds to Voice P Responds to Pain
To check response: A Alert V Responds to Voice P Responds to Pain U Unresponsive 4 METHODS OF RESPONSE ALERT CAN HEAR AND RESPOND TO YOU RESPONDS ONLY TO YOUR VOICE RESPONDS TO GENTLE PAIN NOT RESPONDING AT ALL P15

The Recovery Position P15

Choking P16

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

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 Recognition of choking P16

Choking Adult Treatment
Choking sequence Again very easy

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

Choking Paediatric Treatment
Choking sequence Again very easy * Chest for infants/abdominal for child > 1 P16

Child Choking Encourage to cough Up to 5 sharp back slaps
Up to 5 abdominal thrusts Unconscious CPR Child Choking P16

Baby Choking Up to 5 sharp back slaps Up to 5 chest thrusts
Unconscious CPR Baby Choking P17

Obtaining medical assistance
In pairs write a list of information the 999 operator may ask you for

Conditions that affect the breathing

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

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

Anaphylactic Shock P19

Anaphylactic shock Major allergic reaction Bee stings Peanuts, foods
Drugs P19

Anaphylactic shock Anxiety Red blotchy skin
Swelling of the face and neck Puffiness around the eyes Impaired breathing A rapid pulse P19

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

The casualty then finds it difficult to breathe
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

Asthma recognition Difficulty breathing Wheezing Distress and anxiety Difficulty in speaking Grey blue skin Dry, tickly cough May become exhausted P20

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

Conditions that affect the circulation
P22

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 Aims and objectives P22

What sudden illnesses or conditions can affect the circulatory system?
Section 7 What sudden illnesses or conditions can affect the circulatory system? P22

Shock What is it? Causes P22

Causes of shock Severe bleeding Loss of body fluids Loss of serum
Severe pain Acute heart attack Abdominal emergencies P22

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

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

Incised Laceration Puncture Contusion Abrasion
Wounds and bleeding

Arteries Veins Capillaries Blood Vessels P22

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

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 External bleeding P23

Internal bleeding Recognition Cold, clammy skin Rapid, weak pulse Pain
Thirst Confusion, restlessness Possible collapse Pattern bruising Bleeding from orifices P23

Treatment of severe bleeding
Direct pressure Elevate the injury Apply a sterile dressing Transfer to hospital P23

Treatment for Bleeding
Practical Dressings and Bandages Treatment for Bleeding P24

Hygiene considerations during first aid
Wash your hands Wear protective gloves Wash the affected area Don’t talk or cough Clean up after Hygiene considerations during first aid

Eyes Irrigate the eye with eye wash, dress if the object won’t come out Ears & Nose Do not insert anything into the ear to remove the object, seek medical attention Foreign Objects P25

Animal bites and stings can be extremely painful and distressing, bites are susceptible to infection, stings can lead to anaphylactic shock Bites and Stings P27

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 Treatment P27

A poison is a substance which, if taken into the body in sufficient quantity, may cause temporary or permanent damage Poisons P28

Workshop In small groups compile a list of things which could poison children and infants. Think carefully about your work place. P28

How can a poison enter the body?
Poisons How can a poison enter the body? Ingested Inhaled Instilled Injected Absorbed P28

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

Burns and Scalds P30

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? Burns and Scalds P30

Burns and Scalds Causes Friction Dry heat Electric current
Acids and alkalis Intense cold Radiation Scalds are caused by moist heat, water, steam P30

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

Treatment of Burns and Scalds
Chemical burns Chemicals to the eye And: Foreign objects in the eye Treatment of Burns and Scalds P30

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

Electricity P31

Electricity in the Workplace
Where in the work place could the children and infants in your care receive an electric shock? Electricity in the Workplace P31

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 Domestic Voltage Shocks P31

High Voltage Injuries P31

Fractures P32

Aims and Objectives Recognise fractures
Manage the treatment of fractures Recognise and treat injuries to muscles and joints Aims and Objectives P32

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? Causes of Fractures P32

Fractured ends of the bone protrude through the skin
Open Fracture P32

When the skin is not broken
Closed Fracture When the skin is not broken P32

Complicated Fracture Leads to further damage and injury to major organs or blood vessels. P32

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 Green Stick Fracture P32

Fractures Recognition features Casualty may hear the bone snap Pain
Tenderness Swelling, bruising Loss of power Grating sound on movement Deformity P32

Practical Treatment of Fractures
A practical session Collarbone Upper arm Lower arm / wrist Hand / fingers Thigh Lower leg / ankle Practical Treatment of Fractures P32

Bones, Muscles and Joints
Provides support, protects vital organs and allows movement

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

Treatment Rest Ice Comfortable Position Elevation P33

Disorders of the Brain P34

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 Aims and Objectives P34

The AVPU Code A Alert V Responds to Voice P Responds to Pain
To check response: A Alert V Responds to Voice P Responds to Pain U Unresponsive 4 METHODS OF RESPONSE ALERT CAN HEAR AND RESPOND TO YOU RESPONDS ONLY TO YOUR VOICE RESPONDS TO GENTLE PAIN NOT RESPONDING AT ALL

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

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

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

Skull fracture P34

Could lead to compression
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

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

Observation of head injuries
Eyes Skin Breathing Consciousness Pulse P35

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

Spinal Injuries Damage to spinal bones: Damage to the cord:
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

How should we manage a suspected spinal injury?
10MIN TO DISCUSS P36

Spine Cord Injury Management skills
Management using two people Head tilt and chin lift P36

Other Medical Conditions
Diabetes Affects of heat and cold Poisoning Foreign bodies Electrical injuries Bites and stings Febrile convulsions Sickle cell Meningitis Other Medical Conditions P37

Aims and Objectives Recognise a range of injuries
Manage a range of illnesses Treat a range of injuries Aims and Objectives P37

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. Sickle Cell Anaemia P37

Sickle Cell Anaemia Recognition features: Treatment:
Severe abdominal pain Treatment: Keep the child comfortable and transport to hospital Sickle Cell Anaemia P37

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. Meningitis P38

Caused by a viral or bacterial infection, this can be spread by discharge from the nose and throat of the infected person Meningitis P38

Recognition Features Newborns and infants Inactivity Irritability
Vomiting Poor feeding and high pitched cry Fever, headache and neck stiffness Recognition Features P38

Recognition Features Over two years old
High fever (101 – 106f or – 41.1c) Headache, stiff neck developing between 1 – 2 days Nausea, vomiting Back pain, fuzziness Red or purple skin rash Loss of appetite Recognition Features P38

Seek urgent medical assistance Be aware not all sufferers develop all the recognition features
Treatment P38

The pancreas fails to produce the hormone insulin
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 Diabetes P39

Recognition of Hypoglycemia
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

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

Recognition of Hyperglycemia
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

Treatment of Hyperglycemia
Diabetes Treatment of Hyperglycemia Calm and reassure Loosen tight clothing Advise to seek medical assistance Place into recovery position if unconscious P39

Disturbance in the normal electrical activity
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

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

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

Associated with high temperature caused by ear, nose and throat infections. Occasionally seen after MMR vaccination Febrile Convulsions P42

Febrile Convulsions Unconsciousness Violent muscle spasms
Fever, hot flushed skin Breath holding, red “puffy” face and neck Convulsions lasting no more than four minutes Febrile Convulsions P42

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 Febrile Convulsions P42

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

Treatment for Heat Exhaustion
Move the casualty to a cool place Allow to sip cool water Arrange for medical assistance if they don’t recover quickly Treatment for Heat Exhaustion P43

Keep the casualty comfortable and send to hospital urgently
Heat stroke P43

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

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

Infants with Hypothermia
Infants may not shiver and as such cannot warm themselves in this way Infants with Hypothermia P44

The Aftermath Record in the accident book Replenish first aid supplies
Report to the HSE Record in the accident book Replenish first aid supplies P47

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 HANDOUTS TO THE CLASS THE INCIDENT REPORT FORMS AND GET THEM TO COMPLTETE THEM MAKING UP THEIR OWN INCIDENT. ( 18YEARS BEFORE YOU CAN MAKE A CLAIM) P47

First Aid containers Workshop P48

Think about the type of injuries and illnesses you see in your workplace. What do you need in your first aid kit? First Aid Containers P48

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 PLACE THE FIRST AID CONTAINERS IN FRONT OF THE CLASS AND ASK THE CLASS TO look at what is contained I a kit and how it could be used then run through list of contents FEED BACK TO THE CLASS YOUR FINDINGS (ANYTHING CAN GO IN A FIRST AID BOX) IF YOU CAN JUSTIFY IT by risk assessment. P48

Question and Answer Session

Paediatric First Aid Course

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