The following recommendations will help you care for your child’s minor emergencies and provide first aid for your child’s major emergencies while you are waiting for medical assistance. Also, take a first aid course. You can’t learn CPR (cardiopulmonary resuscitation) just by reading.
- Animal bites
Immediately wash the bite with lots of soap and water for 10 minutes to prevent wound infections. Call your healthcare provider about all animal bites. Most animal bites need treatment in an emergency department.
- Bee stings (Note: Yellow jackets and wasps don’t leave stingers.)
Carefully remove the stinger by scraping it off without squeezing it. Use the edge of a knife blade or credit card. Then put a few drops of water on the area of the sting, sprinkle on meat tenderizer, and massage the solution into the skin for 10 minutes. Don’t use meat tenderizer near the eye. Putting an ice cube on the area will also relieve pain.
Call your child’s healthcare provider if your child develops hives or has trouble breathing.
- Tick bites
The simplest and quickest way to remove a tick is to pull it off. Use tweezers to grasp the tick as close to the skin as possible. Pull steadily upward until the tick releases its grip. Do not twist the tick or squeeze the tweezers so much that you crush the tick.
If you don’t have tweezers, pull the tick off in the same way by using your fingers. If you remove the body but leave the head in the skin, remove the head by using a sterile needle (in the same way you would remove a sliver). Wash the wound and your hands with soap and water after you remove the tick. Put on antibiotic ointment once.
Embedded ticks do not back out when covered with petroleum jelly, fingernail polish, or rubbing alcohol. Applying a hot match to the tick also does not work. If you cannot completely remove the tick, call your child’s provider.
- Bleeding, severe
Determine whether an artery or a vein has been cut. When an artery is cut, the blood pumps or spurts from the wound with each heartbeat. Call 911 immediately. When a major vein is cut, the blood runs out of the wound at a steady rate.
If an artery is cut, place several sterile dressings or a clean cloth (towels, sheets, or shirts) over the wound and apply direct pressure over the wound immediately. For arterial bleeding, the pressure must be forceful and continuous, often applied with the palm of the hand. Act quickly because the ongoing blood loss can cause shock.
If a vein is cut, place several sterile dressings or the first clean cloth at hand (towels, sheets, or shirts) over the wound and apply direct pressure over the wound. After about 10 minutes of pressure, the dressings can often be bandaged in place until the child arrives at an emergency room.
- Breathing, stopped
Call the rescue squad (911) and begin mouth-to-mouth resuscitation, also called rescue breathing.
Immediately immerse the burn in cold tap water for at least 5 minutes. If this is impossible (for example, if the burn is on the face and trunk), apply cool wet cloths or pour a pan of cold tap water over the burn. Do not use ice. Cold water will lessen the depth of the burn and relieve pain.
Do not put butter or burn ointment on the burn. Do not break blisters.
After you have cooled the burn, cover it with a clean cloth or gauze bandage to reduce pain, then call your child’s provider for further instructions.
Most children occasionally choke on liquids that go down the windpipe instead of the esophagus. Your child’s cough reflex will clear the windpipe of the liquid within 10 to 30 seconds. It is best if you do nothing except reassure your child.
Sometimes a young child will suddenly choke on a peanut, raw carrot, or other piece of food. If your child is coughing and able to breathe, encourage him to cough the material up by himself.
If your child can’t breathe, cough, or make a sound, proceed with high abdominal thrusts. Grasp your child from behind, just below the lower ribs but above the navel, in bear-hug fashion. Give a sudden, upward jerk at a 45-degree angle to try to squeeze all the air out of his chest and pop the lodged object out of his windpipe. Repeat this upward abdominal thrust 10 times in rapid succession. If your child is too heavy for you to suspend from your arms, lay him on his back on the floor. Put your hands on both sides of his abdomen, just below the ribs, and apply sudden strong bursts of upward pressure.
If your child is less than 1 year old, first use back blows. Place him face down at a 60-degree angle over your knees. (Gravity may help get the object out.) Deliver 5 hard blows with the heel of your hand to the area between your child’s shoulder blades. If this is not successful, lay him on his back and give 5 rapid chest compressions over the lower sternum (breast bone) using two fingers. If he still hasn’t started breathing, begin mouth-to-mouth resuscitation and call the rescue squad (911).
- Seizures with fever
Place your child on the ground or floor in a safe area. Do not try to open your child’s mouth or place an object between the teeth. Do not try to restrain the child’s movements. If your child starts to vomit, place her on her side or abdomen. If her breathing becomes noisy, pull her jaw and chin forward by placing a finger behind the corner of her jaw on each side.
Bringing your child’s fever down as quickly as possible may shorten the seizure. Remove most of your child’s clothing and apply cold washcloths to her forehead and neck. Sponge her body with cool water. (Do not use rubbing alcohol.) As the water evaporates, your child’s temperature will fall.
When the seizure is over and your child is awake, give her an appropriate dose of acetaminophen or ibuprofen and encourage her to drink cool fluids. If the seizure lasts more than 10 minutes, call 911. Have someone call your child’s healthcare provider.
Begin mouth-to-mouth breathing as soon as possible, in a boat, or at the latest, when the rescuer reaches shallow water. Call 911. Continue rescue breathing until the child reaches a medical facility. Some children have survived long submersions, especially in cold water.
If there is any possibility of a neck injury (for example, a diving accident), protect the neck from any bending or twisting.
- Eye, chemical in
Most chemicals such as alcohol or hydrocarbons (for example, gasoline or lighter fluid) cause only temporary stinging and irritation. However, acids and alkalis such as drain cleaner or toilet bowl cleanser splashed into the eye can severely damage the cornea. When any chemical is accidentally splashed into your child’s eye, treat it as an emergency until your provider or a Poison Control Center expert tells you otherwise.
Immediate and thorough irrigation of the eye with tap water is essential to prevent damage to the cornea. Hold your child’s face up under gently running tap water. Or have your child lie down while you continuously pour lukewarm water from a pitcher or glass into his eye. It is very important to try to hold your child’s eyelids open during this process. For most chemicals, you should flush the eye for 5 minutes; for acids, 10 minutes; and for alkalis, 20 minutes. Then call your healthcare provider.
- Eye, foreign body in
If the particle is in the corner of your child’s eye, try to remove it with the corner of a clean cloth or a moistened cotton swab. If the particle is under your child’s eyelid, try to remove it by opening and closing her eye several times while her eye is submerged in a cup of water. If the object stays on the lid and you can see it, try to remove it with a moistened cotton swab. If you can’t see the particle, try flushing the eye with water. If you can’t remove the particle, call your child’s provider.
- Fracture, suspected
If you think your child has broken a bone, take him in for a medical exam and an X-ray. Don’t let your child put weight or pressure on the bone. Put a splint on the suspected fracture before you move your child so the edges of the fracture won’t damage blood vessels.
- Shoulder or arm: Use a sling made of a triangular piece of cloth to support the forearm at an 80° to 90° angle to the upper arm. If you can’t make a sling, at least support the injured part with the other hand.
- Leg: After placing a towel between the legs for padding, use the uninjured leg as a splint by binding the thighs and legs together with straps. If you can’t do this, at least carry your child and don’t permit him to put any weight on the injured leg.
- Neck: Protect the neck from any turning or bending. Do not move your child until a neck brace or spine board has been applied. Call a rescue squad (911) for transportation.
- Sprained ankle or knee
Remember the acronym RICE for treatment of most sports injuries: rest, ice, compression, and elevation.
Apply continuous compression by wrapping an elastic bandage around the ankle or knee. Numbness, tingling, or increased pain means the bandage is too tight. Keep the bandage on for 24 to 48 hours.
Put a cold pack or plastic bag of crushed ice on the ankle or knee. Do this 20 minutes of every hour for the first 4 hours after the injury. Ice and compression reduce bleeding, swelling, and pain.
Keep the injured ankle or knee elevated and at rest for 24 hours. Give acetaminophen or ibuprofen as needed for pain.
Call your child’s provider for further instructions.
If your child has swallowed something poisonous, first sweep any pills or solid poisons out of your child’s mouth with your finger. Then, if your child swallowed a chemical, immediately give her one glass of water or milk to rinse her esophagus to prevent damage. Rinsing the esophagus is not necessary if your child swallowed a medicine. Call the National Poison Center Hotline at 1-800-222-1222 for advice. Do not induce vomiting.
Pinch the soft parts of the nose against the center wall for 10 minutes. Tell your child to breathe through his mouth during this time. If blood continues to come out of the nose while it is pinched, you may not be pressing on the right spot.
If the nosebleed hasn’t stopped after 10 minutes, insert a piece of gauze covered with petroleum jelly or water-based K-Y jelly into the nostril. Squeeze again for 10 minutes.
If bleeding persists, call your child’s healthcare provider but continue applying pressure in the meantime.
- Skin injuries
Call your child’s provider immediately if you have any trouble stopping the bleeding, if the wound is caused by a dirty object, if there is any chance that a foreign body is in the wound, or if the skin is split and will need stitches.
- Scrapes or superficial cuts
Wash abrasions or superficial cuts for 5 minutes with soap and water; then rinse well. Put on an antibiotic ointment and Band-Aid or sterile gauze dressing and change it daily.
- Puncture wounds (as from stepping on a nail)
Soak the area in hot water and soap for 15 minutes. Try to make the puncture wound bleed some more. If there is any chance that an object has broken off inside the puncture wound or if your child has not had a tetanus booster in the last 5 years, call your child’s healthcare provider.
Put a cold pack or ice bag on the bruise for 20 minutes. No other treatment should be necessary.
- Slivers and splinters
Most slivers can be removed with a needle and tweezers. Before you use them, sterilize the needle and tweezers with alcohol. Also clean the skin surrounding the sliver with alcohol before you try to remove the sliver. Grasp the sliver firmly with tweezers and pull it out at the same angle it went in. Call your child’s healthcare provider if you can’t remove a sliver.
- Scrapes or superficial cuts
- Head injuries
- Observation and rest
Observe your child closely for the first 2 hours after the injury. Encourage your child to lie down and rest. It is all right for your child to sleep. Trying to keep him awake continuously is unnecessary. Have your child sleep near you so you can periodically check on him. Call your healthcare provider immediately if you don’t think your child is acting normally (for example, if he develops symptoms such as confusion or trouble walking).
Give your child only clear fluids (ones you can see through) and no solid food until he has gone 6 hours without vomiting. Vomiting is common after head injuries.
- Pain medicines
Give your child acetaminophen or ibuprofen for headache or other pain. (Exception: avoid until your child has gone 2 hours from the time of the injury without vomiting).
- Special precautions and awakening
- Although your child is probably fine, watch him or her closely for 48 hours after the injury. Sleep in the same room with him for the first 2 nights after the injury. That way, if he develops any symptoms, you will be nearby. Awakening him to check the ability to walk and talk is optional, unless his breathing or sleep pattern becomes abnormal.
- Checking pupils is unnecessary. Some healthcare providers may ask you to check your child’s pupils (the black centers of the eyes) to make sure they are equal in size and become smaller when you shine a flashlight on them. Unequal pupils are never seen before other symptoms like confusion and unsteady walking. In general, pupil checks are necessary only for a hospitalized child with a severe head injury.
- Observation and rest
Written by Barton D. Schmitt, MD, author of “My Child Is Sick”, American Academy of Pediatrics Books. Published by RelayHealth.
Last modified: 2010-06-14
Last reviewed: 2011-06-06 This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional. Pediatric Advisor 2011.4 Index
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