Basic First AidSupplemental Pediatric First Aid Topics

1

Introduction

• Designed to be used with ASHI Basic First Aid and ASHI CPR and AED

• Materials cover child care topics required by most states

• Licensing requirements vary by state and may require additional topics

• Is consistent with Caring for Our Children: National Health and Safety Performance Standards; Guidelines for Early Care and Education Programs, 3rd Edition at http://nrckids.org/CFOC3.

2

Emergency Action Plans

• A must have for child care facilities

• Written plan dealing with:• Children• Staff • Volunteers

• Child care providers review plan:• When hired• Once per year from then on

3

Emergency Action Plan Contents

National Standards for Emergency Action Plans include:• Managing emergencies for children with special health

needs• When and how to notify of parent or guardian• Going with a child to an urgent care facility and staying

with the child until the parent or guardian gets there to take over

4

Emergency Action Plan Contents

• Getting emergency medical care and consent forms signed by the parent or guardian to medical personnel

• Managing other children during an emergency• Providing a backup caregiver, teacher, or substitute• Pre-planning what urgent care facility to use• Completion of a written incident or injury report• Inspection and restocking of first aid kits• Reviews of staff members’ ability to perform first aid• Staff supervision following an incident when a child is lost,

missing, or seriously injured

5

Talking to Children about the Emergency Action Plan

Preparing children for the possibility of a medical emergency:

– Do practice drills– Stress the importance of following

directions– Invite EMS and Fire personnel to work

with children– See "Listen, Protect, Connect" —

Psychological First Aid for Teachers and Schools; http://www.ready.gov/kids/downloads/PFA_SchoolCrisis.pdf

6

Incidents and Injury Reporting for Child Care Facilities

• State child care licensing offices require reporting of injuries

• Many states have forms that must be used

• All child care providers should be familiar with their state’s incident or injury report form

7

Incidents and Injury Reporting for Child Care Facilities

National standards recommend that report forms provide the following information:• Name, sex, and age of the injured person• Date and time of injury• Location where injury took place

8

Incidents and Injury Reporting for Child Care Facilities

• Description of how the injury occurred including: – Who saw the incident– What they reported– What was reported by the child

• Body parts involved• Description of any consumer product involved• Name and location of the staff member responsible

for supervising the child at the time of the injury• Actions taken by staff members

9

Incidents and Injury Reporting for Child Care Facilities

• Recommendations for actions to avoid future incidents

• Name of person who completed the report• Name, address, and phone number of the facility• Signature of the child’s parent or guardian or of

the adult injured• Documentation that the report was sent home the

day of the injury

10

Addressing Other Children’s Needs

• During a medical emergency, the needs of the other children still need to be met. Develop a plan that specifies:– Which staff member(s) will handle

the medical emergencies– How the supervision of the other

children will be handled

11

Addressing Other Children’s Needs

• In general:– Keep the other children

away from the emergency– Keep the other children safe – Answer their questions

simply and honestly– Maintain normal routines

12

Illness-related Emergencies

• Conditions and illnesses can trigger medical emergencies

• Suspect serious illness when child has:– Sudden onset of fever– Headache– Stiff neck– Blood-red or purple rash

13

Other Warning Signs

• Change in mental state• Breathing difficulty or

shortness of breath• Pain, severe pressure, or

discomfort in the chest• Severe abdominal pain

14

Early Warning Signs

• Catch• Take action• Improve overall outcome

15

Meningitis

• Caused by an infection of the fluid surrounding the:– Brain– Spinal cord

• Signs and symptoms:– Sudden fever– Vomiting– Headache– Stiff neck

16

Other Illness Considerations

Temperature – Rising temperature is body’s

defense against infection– Can be taken in the:

• Mouth• Rectum• Armpit• Ear

17

Other Illness Considerations

Fever Guidelines — • Immediate medical attention when a child under 4 months old

has a temperature of – 101°F rectally – 100°F in the armpit

• Medical attention within an hour for an infant under 2 months old with any fever

• Report fever in children older than 4 months to parent or guardian:– 101°F orally, – 102°F rectally– 100°F in armpit– and 101°F in ear

18

Other Illness Considerations

Vomiting — • Be sure the airway is clear• Vomiting more than once within 24 hours • Vomiting with a fever, stiff neck, or head injury• Vomit with a green or bloody appearance• Vomiting occurring with a lower urine output

19

Other Illness Considerations

Diarrhea —• Blood or mucus in stool• Abnormal color (very black or very pale)• Diarrhea with less urine output• Diarrhea with fever• Diarrhea with jaundice or a yellow coloring to skin or

eyes

20

Other Illness Considerations

Rash –• Can be an indicator of

illness• Refer to pages 5 - 6 in the

supplement for more information

21

Shaken Baby Syndrome– Dangerous due to larger

head vs. body– Injury may cause:

• Blindness• Seizures• Retardation• Paralysis• Death

22

Shaken Baby Syndrome

Shaken Baby Syndrome

23

Shaken Baby Syndrome– Crying is often the trigger

• Understand normal crying• Know when to call health care provider

– Caregivers• Know the dangers of shaking• Not overly stressed• No alcohol or drug abuse

Shaken Baby Syndrome

– Signs and Symptoms vary depending on force• Cranky• Listless• Tremors• Vomiting• Seizures• Coma• Death

24

Caring for Children with Special Health Needs

• Special needs:– Chronic condition– Requires health services – Often requires medical

equipment

25

Special Health Care Needs

• Children who have:– Seizures– Life-threatening or severe

allergic reactions – Diabetes – Asthma or other breathing

difficulties

26

Care Plan for Children with Special Needs

27

More information, including a Care Plan form, can be found in Caring for Our Children: National Health and Safety Performance Standards; Guidelines for Early Care and Education Programs, 3rd Edition at http://nrckids.org/CFOC3, Appendix BB.

Care Plan for Children with Special Needs

• Parent or guardian works with Health Care provider to create a care plan

• Care plan includes:• Child information• Routine care information• Needed accommodations• Special equipment/medical supplies• Emergency care• Suggested special training for staff• Parental notes• Signature

28

29

Care Plan for Children with Special Needs

Example from New Jersey Dept. of Health and Senior Services

Care Plan for Children with Special Needs

30

Example from New Jersey Dept. of Health and Senior Services

Care Plan for Children with Special Needs

31

Example from New Jersey Dept. of Health and Senior Services

Care Plan for Children with Special Needs

32

Example from New Jersey Dept. of Health and Senior Services

Care Plan for Children with Special Needs

33

Example from New Jersey Dept. of Health and Senior Services

First Aid for Children with Special Needs

• Secure the child’s safety:– Wheels locked when moving child from a wheel chair

to flat surface– Do not interfere with the child’s specialized medical

equipment• Follow initial steps described in the child’s Care

Plan while waiting for parent or EMS arrival • Additional condition-specific procedures may be

required

34