Child First Aid by Het Oranje Kruis

Course material for the certificate Child First Aid

Child First Aid

Child First Aid Course material for the certificate Child First Aid, compiled under commission and supervision of Stichting Koninklijke Nationale Organisatie voor Reddingwezen en Eerste Hulp bij Ongelukken “Het Oranje Kruis” (the Royal Dutch Foundation for Rescue and First Aid “The Orange Cross”). Author Het Oranje Kruis, Den Haag Design and layout VastinVorm, Delft Correction G. Luijk, O. Meulstee and R. Habermehl Photography Rob Lamping, Balyon, Zoeterwoude Print Deltahage Acknowledgement Zo Kinderopvang & BSO, Den Haag Basisschool Het Mozaïek, Alphen aan den Rijn ISBN/EAN: 978-90-77259-08-5 Fourth edition, second issue

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Foreword In recent years, the interest in first aid for children has increased strongly. With this new edition of Child First Aid, The Orange Cross gladly meets the need for an actual curriculum containing the latest First Aid guidelines, including resuscitation. In combination with sufficient practical training, this book offers a firm foundation for The Orange Cross certificate Child First Aid. The Board of The Orange Cross wish to thank those who contributed towards the realization of this book. The Hague, December 2013

B.A.J. Jongejan, MD Director

CHILD FIRST AID

TABLE OF CONTENTS

PREFACE

PART 1

GENERAL 1

The child and his environment 1.1 1.2

Prevention: measures to increase the safety of children 2.1 2.2 2.3 2.4

The infant (0-1 years) The child

General measures Home Outdoors Child care, school

Five important rules 3.1 Beware of danger 3.2 Assess the situation and then the child 3.3 Reassure the child and provide protection 3.4 Get professional help 3.5 Help the child at the place where he lies or sits Rautek rescue manoeuvre, from the ground

Childhood illnesses and disease symptoms 4.1 4.2

Childhood illnesses Disease symptoms

Child abuse 5.1 5.2

Forms of child abuse Signs of child abuse

12 12 13 17 18 18 20 20 21 21 21 22 23 24 25 26 26 30 34 34 35

PART 2

ALTERED VITAL SIGNS

Impaired consciousness 1.1 1.2 1.3

Fainting Epilepsy Febrile seizures

38 40 40 42

Breathing difficulties 2.1 2.2 2.3

Airway obstruction Injury Disease

Resuscitation

43 43 50 50

3.1 Rescue breaths 3.2 Chest compressions 3.3 Drowning Basic resuscitation scheme for children

51 52 54 59 60

Severe blood loss

Shock

PART 3

INJURIES 1

External wounds 1.1 1.2 1.3 1.4 1.5 1.6

Small wounds Large wounds Abrasions Cuts Bite, tear and scratch wounds Burns

68 68 69 70 71 72 73

Electrical injuries

Bruises and sprains

Bone fractures and dislocations

80 80 82 83

4.1 4.2 4.3

Fracture Spinal injury Dislocation

Eye, nose and ear injuries 5.1 5.2 5.3

Eye injuries Nosebleed Object in nose or ear

86 86 88 89

CHILD FIRST AID

Tooth injuries

Overheating

Hypothermia

Frostbite

10 Poisoning

11 Stings and bites

97 97 98 99

PART 4

11.1 Insect bites 11.2 Tick bites 11.3 Jellyfish stings

DRESSINGS, BANDAGES AND OTHER MATERIALS 1

Dressings and bandages

102

Other materials

107

112

Board of experts

117

CHILD FIRST AID

1. External wounds Based on your own assessment, decide whether you can treat a wound yourself, or whether you should take preliminary measures to prevent worsening and leave the rest of the treatment to medical professionals. Wounds you can treat yourself are: cuts, abrasions and splinter wounds. The larger wounds, deep wounds, dirty wounds such as bite-, tear-, scratch wounds and seriously bleeding wounds should be treated by a general practitioner or in the hospital after having provided first aid.

1.1 Small wounds All wounds are contaminated with germs. A small wound can best be cleaned by rinsing it with tap water. The body is perfectly capable of destroying the germs within 24 hours. In the absence of clean water, you may use a skin disinfectant. Cover the wound using: sticking plaster l sterile compress with plaster tape

PA R T 3

Sticking plaster l When applying the sticking plaster, make sure you do not touch the strip of gauze attached to the plaster tape. l Do not leave the plaster on the skin longer than one day; replace it with a clean plaster if necessary. Sterile compress with plaster tape (at least 2Â˝ cm wide) 1. Open the packaging of the sterile compress. 2. Remove one half of the packaging and apply the released half of the compress onto the wound.

PART 3 INJURIES

3. Use one finger to press the compress next to the wound against the skin and remove the remainder of the packaging, allowing the compress to cover the wound completely. Do not unfold the compress and make sure not to touch it. 4. Use strips of plaster tape to attach the compress to the skin in such a way that it is sealed on four sides, in case of deep chest wounds on three sides. Do not attach the plaster over a joint.

Object in the skin

Act • Only pull a splinter or needle from the skin if a tangible point sticks out. • Always grab the splinter as close to the skin as possible using tweezers and remove it lengthwise. • Disinfect the skin after removing the splinter. • If the splinter or needle cannot be removed easily, go to the general practitioner or Out-of-Hours GP Service. This also applies if a child has a fish hook stuck in his skin or a piece of skin between a zipper. • With tweezers, you also can remove superficial seated dirt, such as gravel.

PA R T 3

1.2 Large wounds Large wounds may involve serious blood loss. Do not touch the wound and do not clean it. Wounds have to be stitched, glued or stapled within 6 hours. After this time, due to bacteria growth and the dying of cells from the wound edges, it cannot be done neatly. Cover a wound with a rapid application dressing, first aid bandage or by using a sterile compress. Attach the compress with an elastic bandage or plaster tape. If you do not have any bandages, use a clean cloth, such as a handkerchief or tea towel.

CHILD FIRST AID

9. Frostbite If the body has frostbite, it is unable to keep the local body temperature at the necessary level. The fingers, toes, nose and ears are vulnerable, because they are exposed to the cold more than other body parts. There are three degrees of frostbite. The differences become visible mainly after thawing. First degree: the skin colour is pale grey; after thawing, it is red to violet and then it becomes painful. Second degree: the skin has blisters filled with clear or bloody fluid and is very painful. Third degree: the skin is white and numb.

First, second or third-degree frostbite

Act • Warm the frozen body parts for 20-30 minutes with water. This water should not be warmer than 40° Celsius. Check the heat with the tip of your elbow or the inside of your wrist. In addition, you can warm up the child using your own body heat. • Do not pierce blisters; cover them, preferably, in a sterile manner. • In second and third-degree frostbite, always contact medical professionals.

PA R T 3

Be careful with warm water. The child may have a disrupted sense of pain, causing you to burn the skin without him noticing. In no case, should you rub the skin, since this will damage it. Rubbing will not accelerate the thawing process. Do not warm the frozen body parts, if there is any risk that after warming they may freeze again.

PART 3 INJURIES

10. Poisoning Despite the proper storage of harmful substances and the safety locks on bottles and jars, a child may still get in contact with harmful substances, such as medicine, tobacco, batteries, toxic berries and plants, toxic mushrooms or toxic plants. Toxic substances exist in: solid form, such as sleeping pills l liquid form, such as cleaning agents l gas and vapour form, such as smoke l

Toxic substances may enter the body via: the digestive system, through the mouth, throat, oesophagus and into the stomach l the airway, through the nose or pharynx, via the trachea into the lungs l the skin and/or the eyes l

Symptoms of poisoning are varied and not always easily identifiable. The consequences of poisoning can be severe. One can lose consciousness or go into respiratory arrest.

The digestive system

PA R T 3

Example of toxic substances: l a corrosive toxin: dishwasher detergent, ammonia, chloride and many other cleaning agents l a petroleum product: lamp oil, turpentine l a non-corrosive toxin: (overdose of) medicine, some plants and mushrooms, drugs Poisoning through the digestive system

Act • Try to find out which substance is involved. • Call 1-1-2. The ambulance dispatcher will tell you what to do. • Take the rest of the toxin or the packaging with the casualty, if he has to go to the hospital. It is not always easy to discover that a child has ingested something.

CHILD FIRST AID

1. Dressings and bandages Sticking plaster A sticking plaster is a strip of sterile gauze, attached to a plaster tape. It is used for small wounds and available in different types and sizes: in strips and as pre-cut strips.

PA R T 4

The butterfly strip is a special sticking plaster. It is used to pull the edges of the wound together for smaller, deeper wounds. Suture strips may also be used to pull the wound edges together.

102

PART 4 DRESSINGS, BANDAGES AND OTHER MATERIALS

Sterile compress A sterile compress or gauze is sterile and wrapped in such a way that it can remain sterile for four to five years in a dark and dry environment. Preferably use non-stick compresses on wounds, such as a metalline compress. Common compresses can be used to properly clean the area around the wound or to dab it dry.

Also, the compress can be secured with a Finger Bob.

PA R T 4 103

Child First Aid Do you know what to do if a child falls from his bike? Or if he chokes on a delicious sweet or has a nosebleed? This book provides you with the course material for the Child First Aid certificate. Combined with the First Aid certificate, this certificate will give you the skills to provide efficient help to everyone, whatever the age group.

ISBN 978-90-77259-08-5

9 789077 259085