chapter 9 management of injuries and acute illness

Chapter 9

Management of Injuries and Acute Illness

Responding to An Emergency

An emergency involves an unexpected event or condition that requires a prompt response.

Program Planning

• Every program should develop policies and response procedures to follow in the event of an illness or serious emergency.– Plans should be reviewed and updated

frequently.– Staff should be familiar with these plans and

know how they are to be implemented.

Program Planning (continued)

• Staff members should be trained in basic first aid and CPR.

• First-aid supplies should be available and accessible.

• Families should also be informed of program emergency response policies and procedures.

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Basic Principles

• Remain with the child at all times.

• Do not move unless there is danger of further injury.

• Do not give fluids or medications unless prescribed.

• Call for medical assistance.

• Notify the child’s family.

• Record all information about the event.


Evaluating a Victim

• Assess the child

• Alert another adult

• Attend to the victim

• Record all observations and treatments

• And, never attempt to diagnose or give medical advice


Absence of Breathing

• Establish that a victim is not breathing.

• Position (head tilt-chin lift) and give two small breaths.

• Begin CPR (using a compression-to-ventilation rate of 30:2 for persons of all ages except newborns).

• Continue until the victim begins breathing or emergency medical assistance arrives.


CPR

• View a quick demonstration of CPR techniques by clicking on the links:– http://depts.washington.edu/learncpr/videode

mo/infant-cpr-video.html

– http://depts.washington.edu/learncpr/videodemo/child-cpr-video.html

http://depts.washington.edu/learncpr/videodemo/infant-cpr-video.html

http://depts.washington.edu/learncpr/videodemo/infant-cpr-video.html


Airway Obstruction

• Children under five years are at highest risk.– Why?– What other groups of children are at high risk

for choking?– What items do children choke on most often?


Airway Obstruction (continued)

• Use the Heimlich maneuver to dislodge an item in the child’s airway. Know how this technique is applied differently for:– Infants – Toddlers– Older children and adults

• Stop compressions and begin CPR at once if the child stops breathing

Heimlich Maneuver

Infant

Heimlich Maneuver


Shock

• Shock is life-threatening and can occur with many different types of injuries.

• The victim may appear pale, weak, and confused.

• Help the victim to lie down; elevate feet 8 to 10 inches and observe closely for breathing.

• Call for emergency medical assistance.


Asthma Attacks

• Encourage the child to relax.• Administer prescribed medications

(inhaler).• Monitor the child’s breathing.• Call for emergency medical assistance if

the attack is prolonged or the child becomes fatigued and is struggling to breathe.



Bleeding

• Call for emergency medical assistance if bleeding comes in spurts or cannot be controlled.

• Follow Universal Precautions.

• Apply direct pressure; elevate if possible.



Diabetes (continued)

• Teachers must work closely with the families of children who have been diagnosed with diabetes.

• Emergency management requires:– Recognizing symptoms of hypoglycemia and

hyperglycemia (Table 9-6)– Administering treatment and calling for

emergency medical assistance if needed


Drowning

• Drowning is the leading cause of death among young children under 14 years.

• Prevention is essential!– What precautions must be taken to protect

children from accidental drowning?

• Administer CPR if the child is not breathing.

• Call for emergency medical assistance and contact the child’s family.


Head Injury

• Every head injury should be considered potentially serious.

• Observe the child carefully for 48 hours.– What signs should you observe a child for?

• Become familiar with developing signs of serious complications.


Poisoning

• Why are young children at high risk for unintentional poisoning?

• What signs might indicate a potential poisoning?

• Know how to distinguish different categories of ingested substances

(Table 9-7).

Carolinas Poison Center

(in Charlotte) 355-4000

(out of Charlotte)

toll free:

1-800-848-6946

SIGNS TO WATCH FORIN CASE OF POISONING

• drowsiness

• coma

• slow, shallow breathing

• slow pulse rate

• vomiting

• ringing in the ears

• severe burns to lips, mouth

• convulsions

• dehydration

Whenever any of these signs appear

call your doctor or nearest Poison

Control Center.

Do not delay! Death may only be a matter of time if you hesitate.


Non-Life-Threatening Conditions

• Teachers should know how to care for children who experience a variety of injuries and acute illnesses.

• How would you respond to each of the following conditions?– Scrapes and cuts– Bites – Blisters– Burns– Eye injuries

Non-Life-Threatening Conditions (continued)

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

Fractures

• Fractures are breaks, cracks, or chips in a bone. • A fractured bone that pierces through the skin is called an open

fracture. – Because of bleeding and the risk of infection, open fractures are potentially the most

dangerous. – Fortunately, closed fractures, which do not break the skin, are the most common kind.– A dislocation occurs when the bone slips out of its normal place in the joint.

The telltale symptoms of a fracture are:• Acute pain • Tenderness • Swelling (may be severe or mild) • Limited range of movement

First Aid for Fractures

• Immobilize the injured area. Don't try to realign the bone, but if you've been trained in how to splint and professional help isn't readily available, apply a splint to the area.

• Apply ice packs to limit swelling and help relieve pain until emergency personnel arrive. Don't apply ice directly to the skin — wrap the ice in a towel, piece of cloth or some other material.

First Aid for Nosebleeds• Stay calm and reassure the

child.

• With the child upright in a chair or in your lap, tilt his or her head slightly forward.

• Gently pinch the nose (just below the bony ridge) with a tissue or clean washcloth.

• Keep pressure on the nose for about 10 minutes; if you stop too soon, bleeding may start again. It may also help to apply ice wrapped in a paper towel.

• Do not have the child lean back. This may cause blood to flow down the back of the throat, which tastes bad and may cause gagging, coughing, or vomiting.

• Have the child to rest for a while after a nosebleed. Discourage nose-blowing, picking, or rubbing, and any rough play.

First Aid for Seizures• Get the child away from anything that could cause harm -- out of the

tub, away from stoves or heaters, away from tables and shelves where items may fall off and cause an injury.

• Roll the child on his or her side, as a seizure victim may vomit and could choke if lying on his or her back.

• If you can, tilt the child's chin forward, CPR-style, to help open the breathing passage.

• Do not put anything in the child's mouth. – A tongue cannot be swallowed; this is a myth.

• Once the convulsive component [of the seizure] is over and the child then is sleepy, groggy, or not very responsive, the emergency component is essentially over.

• The child should be taken calmly, at normal driving speed, to the emergency room for evaluation and care.

FIRST AID FOR BRUISES:

• Apply ice packs for 15-minute periods at least several times a day during the first 48 hours to reduce swelling.

• A zip-lock bag filled with ice cubes and water or a partially thawed package of frozen peas may be useful if an ice pack isn't available.

• Elevating the bruised area also lessens swelling.

• Instruct the child to avoid physical exercise for the time being, especially if the bruise is on an arm or leg, since physical activity can delay healing.

• Call your pediatrician if the child has banged his or her head and has a bruise behind the ear. This may be a sign of skull fracture.

Tooth Emergencies

• Knocked Out ToothHold the tooth by the crown and rinse off the root of the tooth in water if it’s dirty (Avoid touching the root end). Do not scrub it or remove any attached tissue fragments. If possible, gently insert and hold the tooth in its socket. If that isn’t possible, put the tooth in a cup of milk and get to the dentist as quickly as possible. Remember to take the tooth with you!

• Broken ToothRinse the mouth with warm water to clean the area. Use cold compresses on the area to keep any swelling down. Call the dentist immediately.

chapter 9 management of injuries and acute illness

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serious emergency

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