First Aid
Knowing how to treat an infection, scrape, or other injury is very important. If an injury is severe, go directly to the nearest emergency room. If the injury is one that you can handle, here are some tips to tell you what to do and when. Follow up with your doctor if you aren't sure, or if there is any change in the injury.


First Aid Kit for your homeIt's a good idea to keep a first aid kit in your home and in your car, in case of emergencies. Here are some items that should be kept inside:
Sterile adhesive bandages
Gauze pads
Ace bandage
Antiseptics
Scissors
Non-prescription drugs (ie: aspirin)
Thermometer
Soap & moistened towelettes
Safety pins
Band-aids
Latex gloves
Sunscreen
Any other items needed for family members (ie: special medications)


First Aid for skin injuries
*Small Cuts - Wash cut with fresh soap and water. Apply a clean bandage.
*Large Cuts - Press down on cut with clean bandage to stop bleeding. If bleeding doesn't stop, tie a tourniquet to control it. Seek medical help as soon as possible.
*Scrapes: Press lightly with wet sterile gauze and soap to clean; then apply clean sterile bandage.
*Bruises: Rest injured limb. Wrap ice in a washcloth and apply to injury. Consult your doctor if you have any doubt or questions.
*Puncture Wounds: Wrap in clean bandage and consult your doctor.
*Splinters: Wash the area around and including the splinter, then remove it with tweezers. Wash area after removal. Consult your doctor if you have any problems or questions.


First Aid for burns
Sunburns:
***First Degree - causes skin to turn red. Be extra cautious when young children acquire a sunburn...there could be serious damage. A good treatment is to massage aloe vera on the inflamed area every hour; this increases moisture and relief (Avoid products with alcohol, mineral oil, paraffin waxes or coloring).
***Second Degree - cause skin to turn red and develop blisters. For relief, dissolve one pound of baking soda into a tub of cool water and soak in it for about 1/2 hour. Eat high-protein foods to help repair tissue damage, and drink plenty of fluids to prevent dehydration. Consult your doctor if you need pain relief (and stay out of the sun!).
***Third Degree - cause cell damage and breaks in the skin where infection can develop. This type of burn requires the immediate attention of a doctor!


Third Degree Burns: Keep injured person relaxed and remove their clothing around burned area (do not pull attached clothing from skin). Apply cool wet compresses to one area at a time. Get to a doctor immediately.


Electrical Burns: Move injured person away from power source (use wood or cloth; not bare hands); turn power source off. Ascertain injury and consult a doctor immediately.


First Aid for fractures
A fracture is a break in a bone. It is closed or simple when the skin stays intact, and open or compound when the bone breaks through the skin. First thing to do is to put a splint on the fractured area. If the skin is broken apply pressure first to control the bleeding. Do not move injured person if a neck or back injury is suspected...call for help immediately!


First Aid for strains and sprains
A strained muscle is one that is stressed or used beyond its ability. A sprain happens when the ligaments connecting bone to muscle is stretched beyond its ability and the ligament tears. The soft tissue surrounding the joint may be sore and swollen. Rest and elevate the injury. Apply cold compresses and consult a doctor if injury is severe (pain and swelling).


First Aid for seizures
The symptoms of a seizure may range from a loss of consciousness; an inability to speak; headaches; confusion; stiffening of the body for up to 20 seconds; to involuntary rhythmic jerking movements of different parts of the body. You should notify the doctor when any seizure-type episode occurs that you do not know how to control (ie: if you know you have epilepsy and know how to respond to it from a previous experience. Lay person on his/her side with their head lower than their hips. If the person appears to choke, pull forward on their chin to bring the tongue forward and open the airway. Do not put anything in their mouth. If the seizure is in a child who has a high fever, loosen their clothes and sponge them with warm water to help reduce their fever. Call a doctor immediately!


First Aid for shock
Shock can be caused by a variety of problems, including a severe allergic reaction; major blood loss; severe dehydration, serious infection; and can occur in a person with diabetes (If you or someone else has a history of allergic reactions, ask your doctor to prescribe an emergency kit of injectible epinephrine (Epipen or Ana-Kit), and learn how to administer it correctly). Symptoms include nausea, vomiting, weakness, cold and clammy skin, pale skin color; dizziness; a cold sweat; increased breathing and heart rate; and other unusual behavior. Call for emergency medical help immediately! While waiting, lay the person on his/her back and wrap them in warm blankets. Raise their feet about a foot off the ground to keep them at a higher level than their heart (this decreases stress on their heart). If person is vomiting, turn them on their side. If they are conscious and able to swallow, just give them water. If they are bleeding, follow actions to control it. If person is not breathing, begin CPR at once (see below).


First Aid for choking

If a person is able to speak or cough forcefully, you do not need to intervene (this means air is getting through the windpipe). However, if the person is unable to speak; makes gasps for air; turns blue; or clutches at his/her throat, act fast with the Heimlich maneuver. These particular foods pose a choking hazard and are dangerous for children under four years old: thick, sticky candies, hard candies, raw carrots, celery, grapes and raisins, hot dogs, chunks of meat, peanut butter, popcorn, and nuts. Every parent or person who cares for children should know how to do the Heimlich maneuver and CPR (see below).


***In children under 1 year old: Have someone call for emergency help and then immediately perform the Heimlich maneuver. Hold your infant resting face down on your forearm; keep his/her head lower than his trunk (Rest your forearm on your thigh). With the heel of your hand give five quick blows between your infant's shoulder blades. If he/she still isn't breathing, turn infant over to face you. With your fingers, give five quick compressions to the breastbone just blow the nipple line. Check for foreign matter in the infant's mouth. If you see anything remove it with your finger. Keep repeating the five back blows and five chest blows until the foreign object is expelled. If the child loses consiousness at any time during this procedure, stop the back blows and chest thrusts and begin CPR (see below).


***In children over 1 year old: Stand or kneel behind the child, and wrap your arms around his/her waist. Place the heel of one hand (thumb side) against child's abdomen, just above the navel and below the rib cage. Deliver a quick, forceful, upward push of your fist into the child's abdomen to force air up through the windpipe. Keep repeating until foreign object is expelled. If the child loses consiousness at any time during this procedure, stop the back blows and chest thrusts and begin CPR (see below).


***In older children and adults: Wrap your arms around the choking person with your hands on their abdomen. Deliver quick, forceful thrusts into their abdomen (in an upward motion), until the foreign object is expelled.


***First Aid for CPR (Cardiopulmonary Resuscitation)CPR can sustain life if a person's breathing and/or heart have stopped. When respiration stops, the body begins to be deprived of oxygen, which can cause serious damage. The following directions are not meant to teach you how to do CPR in times of crisis, but are meant to be used to refresh your memory after you have learned to properly do CPR from completing a course on emergency first aid that includes CPR training. Before you begin performing any CPR, immediately call for emergency help and then begin CPR!


Remember the basic ABCs of CPR:

A = Airway: Open the airway; take care for spinal injuries.

B = Breathing: Check for breathing; if person is not breathing, give 2 slow, full breaths.

C = Circulation: Check for a pulse; Carotid artery in adults (side of neck), and Brachial in infants (inside of arm just above elbow).



More detailed CPR instructions:
If there is a heartbeat & pulse, but person is not conscious and/or not breathing: Place person flat on their back. Lift head up (unless there is a neck injury) and lift jaw to open airway. Check for a pulse. If you feel a pulse, DO NOT do chest compressions on anyone with a heartbeat. Pinch the person's nose closed and blow a steady breath into their mouth (in infants: fully cover their nose and mouth with your mouth). Breathe at least 15 breaths per minute (infants: 20 breaths per minute); use only enough air to move the person's chest up and down. Continue until person begins breathing. If your breaths do not cause the person's chest to rise and fall, check their mouth for foreign matter and give two more puffs of air. If there is still no movement of their chest, perform the Heimlich maneuver (see above).


If there is no heartbeat or pulse: Lay person flat on their back. Check for a pulse.


For infants: place two or three fingers on the infant's chest just below the nipple line. For each compression, push the infant's breastbone down with your fingers straight down (not diagonally). For older children and adults: use the heel of your hand. Do not rock your body. Perform alternate cycles of chest compressions (100 compressions per minute in infants and young children; 80-100 compressions per minute in adults) and respirations (20 breaths per minute; 1 breath every 3 seconds). The complete cycle consists of at least 5 chest compressions followed by 1 breath. Check for a pulse and breathing every few minutes.

First-Aid Kit for Family Travel



By Peter JaretCONSUMER HEALTH INTERACTIVE
Below: • The essentials
Use this checklist to make sure you have adequate supplies for dealing with minor medical problems while traveling with children. You can pack the items in a small tote, a lunch box, or a zip-top bag -- whichever is easiest to stow.
It's also a good idea to check with your doctor to make sure you're up-to-date on all of your vaccinations. Your doctor can also tell you if you should take along antibiotics for malaria or traveler's diarrhea, or whether there are other medical issues to be concerned about in the country you're visiting.

The essentials
•Prescription and allergy medications. Carefully write down the prescriptions your kids use (exact drug names and dosages) and your physician's phone number, just in case. Place a copy of these notes somewhere accessible (like the glove compartment) and apart from the actual medicines. Keep in mind that some pharmacies accept only local prescriptions.
•Children's acetaminophen or ibuprofen. Either can lower fever and ease the pain of headache, sprains, and ear infections. If you use the liquid form, bring along a measuring spoon.
•Antihistamines. Benadryl and other antihistamines relieve hay fever, rashes, itchy insect bites, and stuffy noses. They may have a sedative effect, which is why some parents use them for kids who get carsick - giving a dose about 30 minutes before the drive begins. You could also use Dramamine (dimenhydrinate) for this, but try it on your child before the trip, since some kids become agitated rather than drowsy when they take it.
•Diaper rash ointment.
•Broad-spectrum sunscreen and lip balm with a sun protection factor of 15 or higher.
•Sterile adhesive bandages. Buy assorted sizes to cover a range of cuts and scrapes.
•Disinfectant. Include a small bottle of hydrogen peroxide or rubbing alcohol, and use it only for cleaning dirty cuts and scrapes (disinfectants are powerful enough to damage healthy tissue); otherwise just wash with soap and water.
•Cotton pads and balls to clean up scrapes.
•Antibiotic ointment, such as bacitracin. To ward off infection while cuts and scrapes heal.
•Cortisone cream. To soothe insect bites and rashes.
•Insect repellent. No stronger than 10 percent DEET for kids, 25 percent for adults.
•Thermometer. You'll need this to gauge how sick your child is. Use a rectal thermometer for kids under age one (don't forget some lubricating jelly), a digital thermometer in the armpit for kids ages one to three (add two degrees for a more accurate reading), and a digital oral one for older kids.
•Tweezers. For removing splinters or ticks.
•Cold pack. Buy one that doesn't need to be frozen; you squeeze this type to start the cooling reaction.
•Small scissors and moleskin. If your family will be doing a lot of walking, you'll want to protect your kids' feet against blisters.
•Small scissors and moleskin. If your family will be doing a lot of walking, you'll want to protect your kids' feet against blisters.


-- Peter Jaret is a medical writer and book author whose work has appeared in Health, National Geographic, and many other publications. He is the recipient of the 1992 American Medical Association award for medical reporting and the 1998 James Beard Award for journalism.


Further Resources
National Center for Infectious Diseases


Travelers' Health
http://www.cdc.gov/travel


References

Robert H. Pantell M.D., James F. Fries M.D., Donald M. Vickery M.D., Taking Care of Your Child: A Parent's Illustrated Guide to Complete Medical Care. Perseus Books Publishing, L.L.C.: 1999.



The American Red Cross First Aid and Safety Handbook, Kathleen Handal, MD, Little Brown & Co., 1992



Reviewed by Michael Potter, M.D., an attending physician and associate clinical professor at the University of California, San Francisco. He is board-certified in family practice.

Is it a Medical Emergency?

Even healthy kids get hurt and sick sometimes. In some cases, you may panic and want to head straight to the emergency room at the nearest hospital. In other cases, it’s more difficult to determine whether an injury or an illness needs the attention of a medical professional, or whether you can take care of it at home.

Ultimately, different problems require different levels of care. And when your child needs some sort of medical help, you have lots of options:

• Handle the problem at home. Many minor injuries and illnesses, including some cuts, poison ivy rashes, coughs, colds, scrapes, and bruises, can be handled with home care and over-the-counter (OTC) treatments.
• Call your doctor. This is a good option in most cases. If you’re unsure of the level of medical care your child needs, your child’s doctor — or a nurse who works in the office — can help you determine what steps to take and how to take them.
• Visit an urgent care center. An urgent care center can be a good option at night and on weekends when your child’s doctor may not be in the office, but it’s not necessarily a medical emergency. At these clinics, you can usually get things like x-rays, stitches, and care for other minor injuries that aren’t life threatening yet require medical attention on the same day.
• Visit a hospital emergency room. An ER — also called an emergency department (ED) — can handle a wide variety of serious problems, such as severe bleeding, head trauma, seizures, meningitis, breathing difficulties, dehydration, and bacterial infections.
• Call 911 for an ambulance. Some situations are so serious that you need the help of trained medical personnel on the way to the hospital. These might include if your child: has been in a car accident, has a head or neck injury, has ingested too much medication and is now hard to arouse, or is not breathing or is turning blue. In these cases it’s best to dial 911 for an ambulance.

As a parent, it’s hard to make these judgment calls if you don’t have a medical degree. You don’t want to rush to the ER if it’s really not an emergency and can wait until a doctor’s appointment. On the other hand, you don’t want to hesitate to get medical attention if your child needs treatment right away. If you have questions, the best thing you can do is call your child’s doctor. As your child grows — and inevitably runs into more sickness and calamities — you’ll learn to trust yourself to decide when it’s an emergency.

Remember that in cases when you know the problem is minor, it’s best to go to an urgent care center, see your doctor, or handle it at home because the more people who show up at the ER with non-emergencies, the longer everyone has to wait for care. When you can’t determine whether it's an emergency or not, call your child’s doctor.

Should I Go to the ER?

Here are some examples of when to go the ER:

• your child has some difficulty breathing or shortness of breath
• there’s a change in your child’s mental status, such as suddenly becoming unusually sleepy or difficult to arouse, disoriented, confused, not making sense
• your child has a cut or break in the skin that is bleeding and won’t stop
• your child has a stiff neck along with a fever
• your child has a rapid heartbeat that doesn’t slow down
• your child accidentally ingests a poisonous substance or too much medication
• your child has severe bleeding or head trauma

Other situations may seem alarming, but don’t require a trip to the ER. Call your child's doctor if your child has any of these symptoms:

• high fever (above 104° Fahrenheit, 40° Celsius)
• ear pain
• pain in the abdomen
• headache
• rash
• mild wheezing
• persistent cough

When in doubt, call your child’s doctor. Even if the doctor isn’t available, the office nurse should be able to talk with you and determine whether you should take your child to the ER. Even on weekends and evenings, doctors typically have answering services that allow them to get in touch with you once you leave a message.

Urgent Care Centers

There may be times when your child has an injury or an illness that’s not life threatening, but needs medical attention on the same day. If that’s the case, consider going to an urgent care center in your area.

Urgent care centers, also known as fast tracks, usually allow you to walk in without an appointment, just as you would to an emergency room. But they are equipped and staffed to treat minor, non life-threatening issues. Typically, your child will be seen by a doctor, and also may be able to get x-rays or blood drawn.

Most of these clinics offer extended hours on evenings and on weekends for patients to receive treatment when the family doctor is not available. Some are open 24 hours a day every day. Cases where you might take your child to an urgent care center include:

• cuts
• minor injuries
• vomiting or diarrhea
• severe ear pain
• sore throat
• infected bug bites
• mild allergic reactions
• suspected sprain or broken bone
• minor animal bites

The doctors who work at freestanding urgent care centers often are ER doctors or family physicians who focus on treating adult and pediatric diseases. Some urgent care centers are also staffed by nurse practitioners and physician assistants. In many children’s hospitals, the emergency rooms have special sections for treatment of minor injuries and illnesses that might be treated at an urgent care center.

Find out about the urgent care centers near you — before a situation comes up where you need to go to one. Your child’s doctor may be able to recommend facilities in the area. In general, you want to find a clinic that meets any state licensing requirements and is staffed by doctors who are board certified in their specialties, such as pediatrics, family medicine, or emergency medicine. Some of these clinics, in addition to accepting walk-in patients, allow you to call ahead to be seen. You might also want to ask if the center accepts your family’s insurance plan.

Talk with your child’s doctor before your child gets sick about how to handle emergencies and the doctor’s policy on addressing medical needs outside of office hours. Having that information ahead of time will mean one less thing to worry about when your child is sick!

Reviewed by: Kate M. Cronan, MD
Date reviewed: April 2006

Source: http://www.kidshealth.org/parent/growth/medical/emergencies.html