Paediatric emergency - VTCT · Paediatric emergency first aid ... Assessment Principles for First Aid Qualifications. This can be downloaded from the Qualifications section of the

Learner name:

Learner number:

F/600/2036

VRQ

UV21569

Paediatric emergency first aid

By signing this statement of unit achievement you are confirming that all learning outcomes, assessment criteria and range statements have been achieved under specified conditions and that the evidence gathered is authentic.

This statement of unit achievement table must be completed prior to claiming certification.

Unit code Date achieved Learner signature Assessor initials

IV signature (if sampled)

Assessor name Assessor signature Assessors initials

Assessor number (optional)

Assessor tracking table

Statement of unit achievement

All assessors using this Record of Assessment book must complete this table. This is required for verification purposes.

VTCT is the specialist awarding organisation for the Hairdressing, Beauty Therapy, Complementary Therapy, Hospitality and Catering and Sport and Active Leisure sectors, with over 45 years of experience.

VTCT is an awarding body regulated by national organisations including Ofqual, SQA, DfES and CCEA.

VTCT is a registered charity investing in education and skills but also giving to good causes in the area of facial disfigurement.

UV21569Paediatric emergency first aid

The aim of this unit is to develop the knowledge, understanding and practical skills required to carry out paediatric first aid, including scene surveys and primary surveys of casualties.

You will learn the roles and responsibilities of a paediatric first aider and be able to assess, recognise and manage infant/child casualties with a range of injuries and symptoms. These will include infants/children who are unresponsive and not breathing normally, unresponsive and breathing normally, choking, in shock, suffering from external bleeding, minor injuries and anaphylactic shock.

UV21569_v7

Observation(s)

GLH

Credit value

Level

External paper(s)

1

10

1

2

0

On completion of this unit you will:

Learning outcomes Evidence requirements

UV21569

1. Be able to assess an emergency situation and act safely and effectively

2. Be able to provide first aid for an infant and a child who is unresponsive and breathing normally

3. Be able to provide first aid for an infant and a child who is unresponsive and not breathing normally

4. Be able to provide first aid for an infant and a child who has a foreign body airway obstruction

5. Be able to provide first aid to an infant and a child who is wounded and bleeding

6. Know how to provide first aid to an infant and a child who is suffering from shock

7. Understand the role of the paediatric first aider

1. Environment Evidence for this unit may be gathered within the workplace or realistic working environment (RWE).

2. Simulation Simulation may be used in this unit, where no naturally occurring evidence is available.

3. Observation outcomes Competent performance of Observation outcomes must be demonstrated on at least one occasion. Assessor observations, witness testimonies and products of work are likely to be the most appropriate sources of performance evidence. Professional discussion may be used as supplementary evidence for those criteria that do not naturally occur.

4. Knowledge outcomes There must be evidence that you possess all the knowledge and understanding listed in the Knowledge section of this unit. In most cases this can be done by professional discussion and/or oral questioning. Other methods, such as projects, assignments and/or reflective accounts may also be used.

5. Tutor/Assessor guidance You will be guided by your tutor/assessor on how to achieve learning outcomes in this unit. All outcomes must be achieved.

6. External paper There is no external paper requirement for this unit.

3

Paediatric emergency first aid

Achieving observation outcomes

Achieving range

Achieving observations and range

UV21569

Your assessor will observe your performance of practical tasks. The minimum number of competent observations required is indicated in the Evidence requirements section of this unit.

Criteria may not always naturally occur during a practical observation. In such instances you will be asked questions to demonstrate your competence in this area. Your assessor will document the criteria that have been achieved through professional discussion and/or oral questioning. This evidence will be recorded by your assessor in written form or by other appropriate means.

Your assessor will sign off a learning outcome when all criteria have been competently achieved.

There is no range section that applies to this unit.

4

You must adhere to Skills for Health’s Assessment Principles for First Aid Qualifications. This can be downloaded from the Qualifications section of the VTCT website http://www.vtct.org.uk.

Guidance for Assessors and Internal Quality Assurers

Learning outcome 1

Observations

You can:

UV21569

Observation 1 Optional OptionalCriteria questioned orally

Date achieved

Portfolio reference

Learner signature

Assessor initials

*May be assessed by supplementary evidence.

Be able to assess an emergency situation and act safely and effectively

5

a. Demonstrate how to conduct a scene survey

b. Demonstrate how to conduct a primary survey on an infant and a child

c. Identify when and how to call for help*

Learning outcome 2

You can:

UV21569


Date achieved

Portfolio reference

Learner signature

Assessor initials

a. Demonstrate how to place an infant and a child into the appropriate recovery position

Be able to provide first aid for an infant and a child who is unresponsive and breathing normally

6


Learning outcome 3

You can:

UV21569


Date achieved

Portfolio reference

Learner signature

Assessor initials

a. Demonstrate how to administer CPR using an infant and a child manikin

Be able to provide first aid for an infant and a child who is unresponsive and not breathing normally

7


Learning outcome 4

You can:

UV21569


Date achieved

Portfolio reference

Learner signature

Assessor initials

a. Demonstrate how to treat an infant and a child who is choking*

Be able to provide first aid for an infant and a child who has a foreign body airway obstruction

8


Learning outcome 5

You can:

UV21569


Date achieved

Portfolio reference

Learner signature

Assessor initials

a. Demonstrate the safe and effective management for the control of minor and major external bleeding*

Be able to provide first aid to an infant and a child who is wounded and bleeding

9


Achieving knowledge outcomes

Developing knowledge

You will be guided by your tutor and assessor on the evidence that needs to be produced. Your knowledge and understanding will be assessed using the assessment methods listed below*:

• Projects• Observed work• Witness statements• Audio-visual media • Evidence of prior learning or attainment• Written questions• Oral questions• Assignments• Case studies• Professional discussion

Where applicable your assessor will integrate knowledge outcomes into practical observations through professional discussion and/or oral questioning.

When a criterion has been orally questioned and achieved, your assessor will record this evidence in written form or by other appropriate means. There is no need for you to produce additional evidence as this criterion has already been achieved.

Some knowledge and understanding outcomes may require you to show that you know and understand how to do something. If you have practical evidence from your own work that meets knowledge criteria, then there is no requirement for you to be questioned again on the same topic.

*This is not an exhaustive list.

UV2156910

Knowledge

UV21569 11

Learning outcome 2

Be able to provide first aid for an infant and a child who is unresponsive and breathing normally

You can: Portfolio reference

b. Describe how to continually assess and monitor an infant and a child whilst in your care

UV2156912

Learning outcome 3

Be able to provide first aid for an infant and a child who is unresponsive and not breathing normally


b. Identify when to administer CPR to an unresponsive infant and an unresponsive child who is not breathing normally

c. Describe how to deal with an infant and a child who is experiencing a seizure

UV21569 13

Learning outcome 4

Be able to provide first aid for an infant and a child who has a foreign body airway obstruction


a. Differentiate between a mild and a severe airway obstruction

b. Describe the procedure to be followed after administering the treatment for choking

UV2156914

Learning outcome 5

Be able to provide first aid to an infant and a child who is wounded and bleeding


b. Describe common types of wounds

c. Describe the types and severity of bleeding and the affect that it has on an infant and a child

d. Describe how to administer first aid for minor injuries

UV21569 15

Learning outcome 6

Know how to provide first aid to an infant and a child who is suffering from shock


a. Describe how to recognise and manage an infant and a child who is suffering from shock

b. Describe how to recognise and manage an infant and a child who is suffering from anaphylactic shock

UV2156916

Learning outcome 7

Understand the role of the paediatric first aider


a. Identify the responsibilities of a paediatric first aider

b. Describe how to minimise the risk of infection to self and others

c. Describe suitable first aid equipment, including personal protection, and how it is used appropriately

d. Identify what information needs to be included in an accident report/incident record, and how to record it

e. Define an infant and a child for the purposes of first aid treatment

Outcome 1: Be able to assess an emergency situation and act safely and effectively

Unit content

This section provides guidance on the recommended knowledge and skills required to enable you to achieve each of the learning outcomes in this unit. Your tutor/assessor will ensure you have the opportunity to cover all of the unit content.

UV21569 17

Conduct a scene survey: Assessment of scene (type of incident), assess for danger, safe approach to assess casualties, factors involved in the incident, number of casualties, mechanism of injuries, ages of those involved, potential injuries, specialist help required.

Conduct primary survey on infant/child: Initial/rapid assessment of casualty, establish/treat conditions immediate threat to life, assess for and remove danger, check response (call child or infant’s name), use of AVPU scale (Alert, response to Voice, response to Pain, Unresponsive), unconscious casualties take priority, child (gently tap their shoulder), infant (tap the sole of foot), check airway (open and clear), if unconscious (use head tilt and chin lift method), shout for help, check for breathing (look, listen and feel for up to 10 seconds).

If breathing – check circulation (signs of severe bleeding and control).

If not breathing and alone – commence CPR for one minute (5 rescue breaths followed by 30 compressions), call 999/112.

When to call for help: Life-saving priorities, casualty not breathing, difficulty breathing, unconsciousness, severe burns or blood loss, allergic reaction (anaphylaxis), heart attack, stroke, poisoning, fractured lower limbs, spinal injury, meningitis, severe hypothermia, heat stroke, febrile convulsions, repeated seizures.

How to call for help – call 999/112, use of bystanders.

Outcome 2: Be able to provide first aid for an infant and a child who is unresponsive and breathing normally

UV2156918

Place infant/child into recovery position: Carry out following secondary survey, kneel on floor to one side of casualty, remove spectacles/any bulky objects in pockets, place casualty’s arm nearest you at right angle to their body (bent at elbow with hand pointing upwards), take their other hand with your palm against theirs (palm to palm), place back of their hand onto their opposite cheek (keep your hand there to guide and support head as you roll them), use your other arm to reach across to the casualty’s knee (furthest away from you), pull up on knee so that leg is bent, foot flat onto floor, gently pull knee towards you (so that they roll over onto side facing you), keep spine in line (pubic bone, sternum, chin), move bent top leg in front of their body (resting on floor), head positioned to maintain open airway, check breathing, monitor vital signs.

Continually assess and monitor: Monitor and record vital signs, do so until emergency services arrive and take over.

Outcome 3: Be able to provide first aid for an infant and a child who is unresponsive and not breathing normally

UV21569 19

Administer CPR: Ask helper to call 999/112, ask a helper to bring an automated external defibrillator (AED) if one is available, commence CPR, if you are alone, commence CPR (five rescue breaths and 30 compressions), perform CPR for one minute – then go/call for help, 999/112, if unable or unwilling chest compressions only may be given.

Administer CPR using infant manikin: Kneel beside casualty, ensure a firm flat surface, give five rescue breaths, followed by CPR, followed by two rescue breaths, continue cycle till emergency help arrives and takes over, casualty starts to breathe normally, become too exhausted to carry on.

CPR – hand position/technique (two fingers, apply pressure in centre of chest, press down vertically on breastbone, 1/3rd of depth, release pressure (without removing fingers), administer 30 compressions, rate of 100-120 compressions per minute), combine with rescue breaths.

Rescue breaths – gently open airway (using head tilt and chin lift method), seal infants mouth and nostrils (with your mouth), administer a breath, maintain good seal, blow steadily into infant/child’s mouth until chest rises, remove your mouth (keeping airway open), look to see the infant/child’s chest fall, provide second rescue breath.

Deal with infant/child experiencing seizure: Try to ease their fall, protect the casualty, make space around them safe, protect their head (surround with soft padding), loosen tight clothing, do not restrain infant/child, ask bystanders to

move away, note time/duration of seizure, open infant/child’s airway when seizures have ceased, check breathing, recovery position if breathing, monitor vital signs, call 999/112 if infant/child’s first seizure, if lasts more than five minutes, if it occurs in water, if the casualty is having repeated seizures, if they remain unconscious for more than 10 minutes after the seizure, if they are injured.

Outcome 4: Be able to provide first aid for an infant and a child who has a foreign body airway obstruction

UV2156920

Treat an infant/child who is choking: If breathing (encourage to cough, remove obvious obstructions from the mouth), infants (lie face down on forearm, keep infant’s head low, support neck and back).

Commence with up to 5 back blows – infant has difficulty crying, if casualty cannot speak, has difficulty making any other noise, is distressed, stops coughing or breathing.

Carry out back blows – upper body supported, casualty leaning forward, up to five sharp blows, between shoulder blades, use heel of hand, stop if obstruction clears and check mouth.

If back blows fail to clear obstruction (infant) – turn infant onto their back, chest uppermost, give up to five chest thrusts (similar to chest compressions but sharper in nature), using two fingers pushing inwards and upwards on the breastbone (rate of one every three seconds), check after each one, if not cleared continue the cycle three times, if still obstructed take the infant with you to call 999/112, continue until help arrives, if infant becomes unconscious (place infant onto a firm surface and start CPR), never perform abdominal thrusts on a baby.

If back blows fail to clear obstruction (child) – use abdominal thrusts, standing behind casualty, both arms around upper part of abdomen, casualty bending well forwards, clench fist and place it between the casualty’s navel and bottom of their breastbone, grasp fist firmly with other hand, pull sharply inwards and upwards up to five times, check mouth, if obstruction not cleared then repeat back blows and abdominal thrusts up to three times,

checking the mouth after each step, if not cleared call 999/112, continue until help arrives, if child casualty becomes unconscious place on firm surface and start CPR.

Mild and severe airway obstruction:

Mild obstruction – casualty should be able to cough, maybe in distress, difficulty speaking, making other noise, no loss of consciousness.

Severe airway obstruction – casualty unable to speak, cough or breathe, may be pointing to throat or grasping neck, eventual loss of consciousness.

Procedure after administering treatment for choking: Seek urgent medical attention, even after successful treatment, for any casualty (who has received abdominal thrusts, has difficulty swallowing, a persistent cough, or feeling that something is still stuck in the throat).

Outcome 5: Be able to provide first aid to an infant and a child who is wounded and bleeding

UV21569 21

Control of minor and major external bleeding:

SEEP – Sit or lay casualty down, Examine/Expose the wound (remove clothing if needed), Elevate above the level of the heart, Pressure applied.

Safe and effective management: Put on gloves if available, check to see if object embedded in wound, if minor bleeding clean wound and apply a plaster, if major bleeding apply direct pressure over wound, if embedded object apply pressure on either side of the embedded object, apply pressure with fingers using a sterile dressing or clean, non-fluffy pad, if no dressing get casualty to apply pressure themselves, raise/support injured limb above level of casualty’s heart to reduce blood loss, support in raised position sling/bandage, treat for signs/symptoms of shock, raise/support legs above level of heart (if possible), check circulation beyond bandage every ten minutes (if circulation is impaired, loosen the bandage and reapply), call 999/112 for emergency help, monitor and record vital signs.

If bleeding seeps through dressing – apply a second dressing on top of the first.

If blood seeps through second dressing – remove both dressings, apply a fresh one, ensuring pressure is applied at the point of bleeding.

Common types of wounds: Each type of wound carries specific risks, variable tissue damage, possible infection.

Laceration – ripping forces (e.g. barbed wire), may bleed less profusely than incised wounds, likely to have more tissue damage, risk of infection high.

Abrasion (graze) – top layer of skin being scraped off, result of fall/friction burn, often contains dirt which may cause infection.

Contusion (bruise) – bleeding under the skin, resulting from blunt blow, underlying damage (e.g. fractured bone).

Incised wound – sharp-edged object (e.g. blade or glass), blood vessels are cut straight across, bleeding may be profuse, other structures may be damaged (e.g. nerves, tendons, arteries).

Stab wound – long/bladed instrument (e.g. knife, screwdriver), may appear small in diameter, maybe damage to internal organs, maybe severe, internal/external bleeding.

Puncture wound – e.g. needle, being stabbed, standing on a nail, maybe deep yet appear small in diameter, maybe damage to internal organs, maybe severe internal/external bleeding.

Gunshot wound – bullet/other missile travelling at speed into the body, resulting neat entry wound and ragged exit wound, causing possible damage (internal organs, severe internal and external bleeding).

Nosebleed – ruptured blood vessels, result of object striking the nose, picking or blowing the nose.

Animal bite – may cause infection.

Amputation – traumatic injury, complete/partial severing of a body part (e.g. fingers in door).

Types and severity of bleeding: Classified by the type of blood vessel damaged, check for bleeding from body orifices (mouth, ear, nose, urethra or anus), quantity of blood in the body varies in

Outcome 5: Be able to provide first aid to an infant and a child who is wounded and bleeding (continued)

UV2156922

relation to size (e.g. infants around 80ml/kg, adults (50-70ml/kg blood volume)), as blood volume reduces, signs and symptoms of shock become apparent.

Arteries – carry oxygenated blood under pressure, if damaged will bleed profusely, spurting with heartbeat, bright red colour.

Veins – carry deoxygenated blood, under less pressure, darker red colour, vein walls can widen greatly causing blood to pool (varicose vein), damage to large or varicose vein (blood will gush out profusely).

Capillaries – bleeding occurs with any wound, blood loss usually slight, bruising is ruptured capillaries under the skin causing bleeding into tissues.

Internal bleeding – inside the body cavities, may occur following an injury (e.g. fracture, penetrating wound), suspect internal bleeding if the casualty develops shock without obvious blood loss.

Administer first aid for minor injuries: Small cuts and grazes, minor injuries, clean skin around wound, use running water or non-antiseptic wipe, dry wound, ensure casualty not allergic to adhesive dressing/plaster, cover wound with dressing/plaster.

Outcome 6: Know how to provide first aid to an infant and a child who is suffering from shock

UV21569 23

Recognise shock:

Initially – a rapid pulse, pale, cold, clammy and sweating skin.

As shock develops – rapid, shallow breathing, a weak ‘thready’ pulse which may disappear at the wrist, grey-blue skin or cyanosis, weakness and dizziness, thirst, nausea and possibly vomiting.

As brain’s oxygen supply weakens – restlessness and aggressiveness, yawning and gasping for air, unconsciousness, finally heart will stop.

Administer first aid casualty in shock: Help casualty to lie down, reassure casualty, treat possible causes of shock (e.g. severe bleeding or serious burns).

If injuries permit – raise/support casualty’s legs above level of heart (to improve blood supply to vital organs), prevent casualty from making unnecessary movements, loosen tight clothing at the neck, chest and waist, call 999/112, keep warm using coats or blankets, do not overheat, monitor and record vital signs.

Common triggers of anaphylactic shock:

Raw fruits – e.g. apples, apricots, pears, cherries, kiwi, mango, plums, peaches, nectarines, tomatoes.

Raw vegetables – e.g. carrots, celery and peppers.

Raw legumes – e.g. mange tout and raw peas.

Other triggers – e.g. certain spices, nuts, prawns, shellfish, eggs, wasp and bee stings, latex and medications.

Recognise anaphylactic shock: Symptoms usually occur immediately, common symptoms (redness, blotchy skin, swelling or itching of lips, tongue, inside of mouth, soft palate, eyes, ears, throat), watery eyes, occasionally symptoms in the oesophagus (gullet) or stomach (pain and discomfort, nausea and vomiting), difficulty breathing, wheezing and gasping for air, a feeling of terror, confusion and agitation, signs of shock, unconsciousness.

Managing anaphylactic shock: Call 999/112 for emergency help (advise suspected anaphylaxis and probable cause), assist with medication (identify type of auto-injector containing adrenaline/epinephrine, help casualty to use firmly against their thigh), make casualty comfortable, reassure, place in position that eases any breathing difficulties, monitor casualty’s vital signs, record level of response (AVPU).

Outcome 7: Understand the role of the paediatric first aider

UV2156924

Responsibilities of paediatric first aider: Assess situation (quickly and safely), summon appropriate help (call 999/112), protect casualties (and others at scene from possible danger), identify injury or illness, give early and appropriate treatment, prevent cross-infection, arrange casualty’s removal to hospital, report observations (to those taking over care of the casualty), complete accident/incident report, restock first aid kit.

Minimise risk of infection: Wash hands thoroughly with soap and water (if possible), use protective disposable gloves (if not available get casualty to dress own wounds if practicable), cover own cuts with waterproof plaster, wear protective apron/eye protection (when dealing with large quantities of body fluids), avoid touching wound or part of a dressing coming into contact with the wound, do not cough or sneeze over a wound, beware of needles/sharp objects (carried by casualty, embedded in wound), use face shield or pocket mask if available, ensure safe disposal of waste.

Suitable first aid equipment: No mandatory content list for paediatric first aid kit, seek advice for up-to-date guidance from appropriate agencies e.g. Pre-school Learning Alliance, National Child Minding Association, Health and Safety Executive,

Personal protective equipment (PPE): Protective disposable gloves, protective apron, eye protection, face shield or pocket mask, ensure appropriate use.

Accident report/incident record: Record information (as soon as practicable).

Minimum information to include – full name of casualty, time/date of incident,

nature of what happened, nature of injury, treatment provided (including medication e.g. asthma pump), medical help sought, witness details, description/sketch plan of incident, position of child, equipment, furniture, staff.

Definition of child/infant: For first aid purposes, infant (aged under 1 year), child aged 1-8 years (for paediatric/child care purposes), 1 to puberty for other first aid purposes.

Documents

Paediatric emergency - VTCT · Paediatric emergency first aid ... Assessment Principles for First Aid Qualifications. This can be downloaded from the Qualifications section of the