1. Unit MPII 002 Managing paediatric illness and injury (Part 2)

2. MPII 002 Managing paediatric illness and injury
This part of the unit looks at first aid for infants and children:
who might experience the effects of extreme heat and cold
who may sustain an electric shock
who might have burns or scalds
who have been poisoned
who have been bitten or stung.

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4. Extreme cold
Lists the sign and symptoms of extreme cold on a baby and a child?
Is any there any difference?

5. Effects of extreme cold (1) 5.1
Signs and symptoms in a baby
Baby may be unusually quiet and refusing to feed.
Baby may not necessarily change colour.
Signs and symptoms in a child
Shivering.
Cold, pale, dry skin.
Listlessness or confusion.
Weakening pulse.
Failing consciousness.
Slow, shallow breathing.

6. Treatment for extreme cold
Discuss with the person sitting beside you treatment for extreme cold?
Remember treatment for a baby and child may vary.

7. Effects of extreme cold (2)
Treatment for a baby
Call a doctor.
Warm baby gradually by wrapping in a blanket.
Cuddle to transfer your body warmth to baby.
Treatment for a child
Give the child a warm bath. When skin colour has returned to normal, help out of the bath and quickly wrap in warm towels or blankets.
Dress the child warmly (including a hat) and put to bed, covered with plenty of blankets.
Ensure that the room is warm and give warm drinks.
Stay with them until temperature has returned to normal.
If the body temperature does not return to normal, get the child to hospital as soon as possible.

8. Extreme heat – heat exhaustion (1) 5.2
Signs and symptoms
The child may have:
fatigue
weakness
clammy skin
headache
nausea and/or vomiting
hyperventilation (rapid breathing).

9. Extreme heat – heat exhaustion (1)
Treatment
Bring the child indoors or into the shade.
Undress and lie child down in a cool, airy room, if possible with a fan.
Raise legs to improve blood flow.
Help the child to sit up and sip as much cool water as s/he can manage. Later give chilled water or diluted fruit juice to replace the salts lost from the body.
Call the doctor for further advice. If the child is too exhausted or ill to eat or drink, intravenous (IV) fluids may be necessary.
If left untreated, heat exhaustion may escalate into heatstroke, which can be fatal.

10. Extreme heat – heatstroke (1) 5.2
Signs and symptoms
The child may have:
sudden headache
dizziness and confusion
hot, flushed and dry skin
rapid deterioration in level of response
high temperature (40˚C/104˚F)
loss of consciousness.

11. Extreme heat – heatstroke (2)
Treatment
Call for emergency medical help if the child has been outside in the sun exercising for a long time and shows any of the symptoms above.
While waiting for help:
get the child indoors or into the shade
undress the child and sponge with tepid water
do not give fluids unless the child is alert.

12. Accidents involving electricity (1) 6.1 & 6.2
Signs and symptoms
The child may:
become unconscious
have burns
have problems breathing.

13. Accidents involving electricity (2)
Treatment
Do not touch the child if they are still in contact with the current.
Switch off the current at the mains or, if you cannot turn off the mains, stand on some dry insulation material and use something made of non-conductive material to push the electrical source away from the child.
Make sure that your hands are dry and that you are not standing on anything that is wet or made of metal.
Check the child’s breathing and for signs of life. Be prepared to begin rescue breaths if needed.
Put a child who is unconscious but breathing into the recovery position.
If the child has burns, treat these while you are waiting for help.

14. Burns and scalds
What is the difference between Burns and scalds?

15. Burns and scalds (1)
Burns occur when the skin is exposed to direct heat or to chemicals, for example fire, sunburn, friction, acid, bleach or garden chemicals.
Scalds occur when the skin is exposed to hot fluids, for example boiling water, steam or hot fat.

16. Burns and scalds (2)
First-degree or minor burns are superficial and affect only the outer layer of the skin, making it red and sore.
Second-degree or partial thickness burns extend below the surface of the skin. The skin looks raw, and blisters form.
Third-degree or full thickness burns damage the entire layer of the skin and underlying tissues to affect nerves, muscle and fat. The skin looks pale, waxy and charred.
First-degree burns can be treated at home and usually heal in seven to ten days. Second- and third-degree burns are much more serious and require medical attention as there is a risk of infection and shock developing.

17. How to treat burns and scalds (1) 7.2
Severe burns and scalds
The priority is to cool the injury but this should not delay taking the child to hospital.
Call for an ambulance immediately.
Bathe the area in cold water for at least ten minutes.
While cooling the burn, check the child’s breathing and level of consciousness and be prepared to resuscitate.

18. How to treat burns and scalds (2)
Minor burns and scalds
Cool down the area by running it under cool water or soak in cold water for ten minutes. This will prevent the burn from getting worse. 
Gently remove any constricting articles from the injured area before it begins to swell.
Lightly cover the burned area with a sterile dressing.
Stay calm and watch for any signs of shock. If the child loses consciousness, open the airway, check his/her breathing and be prepared to begin rescue breaths.

19. How poisons enter the body 8.1
Poisons can enter the body in a number of ways.
Once in the body, poisons can enter the bloodstream and be carried to organs and tissues.
Swallowed: foods, alcohol, medication, household and garden items, and certain plants.
Absorbed through the skin: from plants such as poison ivy, fertilizers or pesticides.
Inhaled: gases, like carbon monoxide from car exhaust, carbon dioxide from sewers, and chlorine from a pool, or fumes from household products such as glue, paint, cleaners, or drugs.
Injected: bites or stings of insects, spiders, marine life, snakes, and other animals, or medications injected with a hypodermic needle.

20. Common poisonous substances – signs and symptoms 8.2
If poison is swallowed, the child may:
be red around the mouth
have stomach pain
have the smell of the poison on their breath (for example, alcohol)
be nauseous or vomiting
be unusually drowsy and possibly become unconscious
have blistering or burns around the mouth and a burning sensation in the throat if a chemical has been swallowed.
If poison is inhaled, the child may:
be breathing noisily
have a headache.
Strong poisons can cause seizures or loss of consciousness and coma. The heart and breathing might also stop.

21. Common poisonous substances – what to do 8.2
Get medical attention immediately.
Try to identify what the poison was. Try to find out what time the child took it and how much was consumed.
Check inside the child’s mouth and encourage spitting out any berries or bits of leaf in the mouth. If possible, collect a sample to show the doctor.
Check the child’s circulation and breathing while waiting for the ambulance. Reassure.
If the child is unconscious but breathing, put in the recovery position.
Important: never try to make the child vomit if they have swallowed poison. Vomiting can make the condition worse by damaging the stomach and the tubes that carry the food to the stomach.

22. Information about poisonous substances 8.3
Many poisonous products offer specific advice on the label about how to treat accidental swallowing of the contents, and some have a phone number which you can call for advice.
The National Poisons Information Service (NPIS) is approved by the Department of Health, and commissioned by the Health Protection Agency. It provides expert advice on all aspects of acute and chronic poisoning.

23. Severity of bites and stings 9.1
Animal bites
Any animal bite is hazardous and requires immediate attention.
Due to children’s smaller size, most bites are to their face and usually involve their lips, nose or cheek. Animal bites often occur as a result of a child becoming over-boisterous with a household pet – usually a dog or a cat.
Toddlers often bite each other when playing together, but the resulting injuries are usually minor and do not normally pose a serious risk to their health.
Insect stings
The most common insect stings are from wasps, bees and hornets. Other insects, such as mosquitoes and gnats, bite rather than sting and they do not require any specific first aid treatment. Bee and wasp stings are painful but rarely serious, unless the child has an extreme allergic reaction, also known as anaphylactic shock.

24. Treatment of bites (1) 9.2 For a minor bite wound, do the following:
Calm and reassure the child, who may be very frightened.
Wash the wound using warm water and soap, and rinse under running water for at least five minutes.
Dry the wound carefully but gently with a clean gauze pad or tissue.
Apply a plaster or sterile dressing.
Check with the doctor as soon as possible to ensure that the bite is not infected or serious enough to carry the risk of tetanus.

25. Treatment of bites (2)
For a serious and deep bite wound, you need to do the following:
Call an ambulance immediately or take the child to the hospital.
Calm and reassure the child.
Cover the wound with a clean dressing or pad and apply pressure with your hand to stop the bleeding. If possible, raise the affected part above the level of the child’s heart.

26. Recognition and treatment of stings (1) 9.2
Insect stings
The following are signs and symptoms of an insect sting:
child crying: stings from bees and wasps are painful and it is usually obvious that a baby or child has been stung as they will cry as a result of the pain
a raised white area on an inflamed, reddened area of skin at the site of the sting 
itchiness
there may be a sting left in the skin – sometimes so small it is not visible to the naked eye.

27. Recognition and treatment of stings (2)
What to do
Calm the child down.
If you can see a sting, scrape it off using a flat object such as a credit card or your fingernail.
Once the sting has been removed apply a cold compress to reduce the pain, swelling and itchiness.
Leave the cold compress in place for up to ten minutes and reassure the child.
Important: If the child has a severe allergic reaction to a sting, call an ambulance immediately.

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