4 Must-Know First Aid When Handling Kids

There may be numerous first aid skills to learn, but these 4 specific scenarios are overwhelmingly common when dealing with kids – falls, burns, bleeding, and choking. Learn how to deal with these 4 frequently encountered accidents with kids:

#1 First Aid for Falls

To start off, parents and babysitters should really be familiar with naughty and playful children who so frequently fall and injure themselves. Most of the time, these are minor falls and require nothing more than some comforting (or stern admonishment).

However, the appropriate first aid for falls come in truly handy when the fall is something more serious. Let us start step by step:

What to do:

STEP 1: Remove any hazards in the surrounding area first. Then, assess the severity of injuries. Call for ambulance or immediate medical attention in the event of:

• Trouble breathing or difficulty in talking, swallowing, seeing or hearing thing;
• Large wounds and major bleeding (see below for some first aid tips on bleeding too);
• Exposed bones, nerves, tendons, or internal organs;
• Abnormally shaped/sizes body parts that may signal a fracture or dislocation;
• Change in consciousness such as drowsiness or fainting;
• Severe headache and/or vomiting;
• Being inconsolable;
• Having abnormal fluid(s) coming out of nose or ear (eg. yellow, straw or bloody fluids);

STEP 2: If the injury is not serious, do not let your guard down just yet. Remember that whenever a fall happens, there could be more than one injury. Ask your child, observe carefully, and check for other injuries. Remove all clothings to examine.

STEP 3: Apply appropriate first aid to the injury. For burns, cuts, grazes, and bleeding – refer to our instructions below. Otherwise, for first aid to injuries to head, face, neck, back and spine, we recommend not deliberately moving the child and having a very low threshold to get immediate medical help. The exact detailed assessment, and prompt treatment for these more vulnerable areas are beyond the scope of this article but you may get tips from our local medical expert here.

STEP 4: Apply “RICE” – Rest, Ice (or Cold Packs), Compression (to relieve swellings, pain or bleeding), and Elevation (to above heart level). We elaborate further on these under our section on “first aid for bleeding” too. Finally, keep monitoring our child for abnormal behavior for the next few hours and days. Generally, 24-72 hours is a safe window before letting your guard down.

What not to do:

• Panic and forget about assessing for danger and severity – that is the first step that may determine life-and-death sometimes!
• Start carrying and moving your child around immediately – that would not be safe if your child sustained a neck, back or spine injury;
• Adopt an overly protective or overly punitive attitude – these may result in your child being immediately more distressed, and more prone to further falls or accidents in future;
• Brush away all concerns and forget that certain fall injuries may present themselves hours or days later (such as a brain concussion or slow internal bleeding);

#2 First Aid for Burns in Children

Often, we leave dangerous items around the house, resulting in a non-babyproof-ed place for kids. For instance, as they grow up, children start to reach for things on the table like a hot cup of coffee, soup or boiling water! Or, you may underestimate your kids’ reach and leave a cooling iron in a spot waiting for an accident to happen.

What to do:

So, what should you do if your kid accidentally gets scalded or burnt?

STEP 1: Basic first aid for burns starts with dousing the area copiously with clean and cool water. Do not use ice or other substances (such as toothpaste). Let the water run over the affected area for 10 to 20 minutes. You may use running tap water in Singapore.

STEP 2: Then, remove any loose particles carefully but do not use any force if there is something still stuck to the area (eg. clothing).

STEP 3: Cover with a sterile and loose gauze or bandage if available. If you are confident or experienced, you could also apply an antiseptic or burns ointment underneath the dressing. However, we highly recommend consulting a medical professional before this *. Two commonly used ointments for burns in kids are:

• Fucithalmic Ointment*
• Silver Sulfadiazine Cream* (ensure baby is >1 year old too)

Lastly, if the burnt area is a sensitive area such as the face, eyes, mouth, tongue or genital area, seek medical attention, as soon as possible whilst dousing it with clean and cool water. Do not attempt to apply any ointments.

What not to do:

• Use toothpaste, alcohol, coconut oil, or other creams or lotions;
• Apply ice;
• Use adhesive plasters or dressings;
• Prick or poke any blister or swelling (i.e. you should leave them to the medical professionals);

Common causes of burns in children:

• Hot water or fluids;
• Flames (direct or indirect);
• Electricity;

This may be out of the scope of the article, but HOW DO YOU PREVENT or REDUCE THE RISKS OF YOUR CHILDREN GETTING BURNS? We provide some tips and solutions here.

Should you see a doctor for a burn?

In general, these affect the severity of a burn in your kid(s):

• The cause of the burn;
• The surface area affected;
• The degree/depth of burn;
• Health status of the individual;
• Other related injuries;

However, some burns can be more serious than you think. We recommend seeing a medical professional as soon as you can for burns in children.

#3 First Aid for Bleeding in Children

There can be many causes and circumstances resulting in bleeding in children. Hence, the point of this short section is to learn the basic first aid to deal with bleeding in children.

Generally, you can apply these skills, but do remember that this is just a broad suggestion and not meant to replace or substitute proper medical attention!

What to do:

STEP 1: Stay calm and assess the situation logically. This is of paramount importance because many laymen would start panicking and freaking out at the sight of blood. Because the presence of blood often means the presence of an open wound, it is crucial to assess the severity. If you are unsure, call the ambulance or seek medical attention immediately.

STEP 2: Wash the area with clean (preferably sterile) water or appropriate antiseptic solutions. Avoid using alcohol. Commonly available cleansing solutions include chlorhexidine, iodine (or povi-iodine), PP washes, or simple normal saline. If not, or if the area is near the eyes, nose or mouth, pure drinking water can be used too.

STEP 3: Once the area is toileted, try to achieve hemostasis. This is a medical term for reducing or halting the bleeding. You can do so via direct or indirect compression. Usually the simplest way is to press firmly over the bleeding area with a sterile gauze or bandage. Some pain is inevitable during this compression. As a general rule of thumb, a duration of 5 to 20 minutes is safe.

STEP 4: Elevate the bleeding area to a level above the heart level. This will help hemostasis too. If available, you can apply a cold pack to reduce bleeding.

What not to do:

• Contaminate the bleeding area with unhygienic hands or foreign objects or tools;
• Squeeze or move the area unnecessary (that will result in more bleeding);
• Attempt to remove foreign objects (eg. nails, glass shards) without proper medical advice;
• Keep wiping the area – this will increase risks of contamination and prevent the more-effective method of direct continuous compression;
• Apply unconventional solutions or medicines like coconut oil, aloe vera, turmeric, powders, etc;

Common Cause for Bleeding in Children:

• Falls, cuts, and injuries (see above for elaboration)
• Epistaxis (an entirely different topic, but thankfully usually self-limiting and non-deleterious)
• Ulcers
• Constipation
• Internal Bleeding (usually gastro-intestinal related and out of scope for this read)

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#4 What To Do If Your Kid is Choking

Choking is a common, yet often underestimated and hazardous situation, that you should be prepared for. Be it a toy ball, pencil lead, eraser, fishball, grapes, coin, or other minute object, children can easily choke on stuff. Whether you are playing unassumingly in a room, or having a joyous dinner, choking can happen suddenly and unexpectedly.

(8 STEPS TO TREAT A CHOKING CHILD) What to do :

First 3 Steps Regardless of Age:

STEP 1: Do NOT panic! Just like when faced with bleeds, many grown-ups fluster when faced with choking scenarios. Be aware that choking can happen in ANY situation and not just at the dining table.

STEP 2: Check if your child is really choking. Ask your child: “Are you choking?” If your child is still talking or crying, chances are they are NOT choking. Here are the signs that will tell you your child is choking:

• Inability to talk
• Difficulty breathing or noisy breathing
• Squeaky sounds when trying to breathe
• Cough, which may either be weak or forceful
• Skin, lips and nails turning blue or dusky
• Skin that is flushed, then turns pale or bluish in color
• Loss of consciousness
• Clutching neck area with hand(s)

Credits to: https://www.mayoclinic.org/first-aid/first-aid-choking/basics/art-20056637

STEP 3: Get emergency help. Call someone to call 995 (Singapore) or a relevant emergency medical helpline. If you are alone, call the emergency hotline ONLY if it takes you very few seconds or less to do so. (No fixed judgment, but we’d say 3-4 seconds is the maximum). Put the phone on loudspeaker mode. Otherwise, do not waste precious seconds and proceed to the next step first.

Now, the next steps depends on the age of your child:

If your child is 1 year old or younger:

STEP 4: Place your baby face down on your forearm, in line with your thigh, with the baby head lower than their bottom. Your arm should be resting on your thigh. You should be adopting a half-kneeling position (picture a man in a kneeling position proposing to his lover). With the heel of your other hand, give the child five quick, forceful blows between the shoulder blades.

STEP 5: If this fails, turn the infant on her back so that the head is lower than the chest. (Quick tip: you can do this swiftly by changing to use the other thigh and switching the kneeling position from left to right or vice versa.) Then, place two fingers in the center middle of the breast bone, just below the nipples. Press inward rapidly five times.

STEP 6: If you have not called 995 or the emergency line, do so now.

If your child is above 1 year old:

STEP 4: **Deliver 5 Back Blows: Position yourself perpendicular to the choking child/teenager/adult. If the child is much smaller or shorter, you can kneel down in a stable position. Place an arm across the child’s chest for support. Bend the child over at the waist so that the upper body is parallel with the ground. Deliver five separate back blows between the child’s shoulder blades with the heel of your hand.

STEP 5: Deliver 5 Abdominal Thrusts (i.e. Heimlich Maneuver): Change your position to be standing or kneeling directly behind the choking child. If you can, place one foot in front for balance and stability. Tip the child forward slightly. Make a fist with one hand. Position it slightly above the child’s navel. Grasp the fist with the other hand. By now, you should be wrapping your arms around the child’s waist. Press hard into the abdomen with a quick, upward thrust — as if trying to lift the person up. Perform between six and 10 abdominal thrusts until the blockage is dislodged.

STEP 6: If you have not called 995 or the emergency line, do so now.

** (Note: The back blows technique is taught by the American Red Cross, and should be practiced with a professional trainer/training agency. The American Heart Association does not teach this. It is okay not to use back blows if you haven’t learned the technique. Both approaches are acceptable.)

Final 2 Steps Regardless of Age

STEP 7: Then, continue your sequence of five back blows and five chest thrusts until the foreign object comes out or until the infant loses consciousness (passes out). If the infant passes out, tell 995 immediately, and commence CPR* (*i.e. rescue breathing and chest compressions – which would be conveyed to you over the phone by 995, and is beyond the scope of this article, but details are available in the link below). Never put your fingers into the infant’s mouth unless you can see the object. Doing so may push the blockage farther into the airway.

STEP 8: Once the object comes out, take your child to the emergency department/room. This is because there could be residual or partial object(s) left in the airway and cause infections or other complications. Make sure you have sought proper medical attention before resuming your normal daily activities.

Credits:

There are plenty of useful information, demonstrations and videos in the links below. We’d like to thank these open sources for allowing us to write our help piece too. Check them out to gain deeper understanding. It never hurts to be prepared!

• https://www.redcross.org.uk/first-aid/learn-first-aid-for-babies-and-children/choking-baby
• https://www.redcross.org.uk/first-aid/learn-first-aid-for-babies-and-children/choking-child
• https://www.stanfordchildrens.org/en/topic/default?id=how-to-help-a-choking-child-1-197

What not to do:

• Panic, and forget everything you have learnt here.
• Shove other objects, rice, fluids or food into your child’s mouth.
• Attempt to dig or retrieve objects or food when none of it is visible yet.
• Hit or slap your child inappropriately (in a method not as per described above).