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A Study Guide on Children's Health

Unit 5: First Aid Basics

How will this unit help me?

This unit will:

• answer some of your questions about various emergency situations, to introduce you to some basic First Aid skills; help develop your confidence in dealing with a range of injuries and illnesses.

On completion of this unit, you should be able to:

• assess an emergency situation quickly and safely;
• maintain functions of Airway, Breathing and Circulation;
• administer cardiopulmonary resuscitation (CPR) when required to adults and children;
• place an unconscious casualty into the recovery position.

Setting the scene

In an emergency situation, certain basic First Aid procedures must be followed in order to assist a casualty before the arrival of professional help. These procedures involve giving care with confidence, based on knowledge of the principles and skills of First Aid.

In some situations, this might simply involve reassuring a casualty, or dealing with a minor cut or graze, or applying ice and compression to a sprain. However, in other more serious situations, the First Aider may be called upon to prioritise multiple casualties, make safe an unconscious person, or perform CPR on a casualty who is not breathing or who has no pulse.

Before you find out about some important First Aid skills and procedures, you should read the following information about the aims and priorities of First Aid.

The aims of First Aid are:

• to preserve life

• to prevent worsening of the casualty's condition

• to promote recovery

In order to achieve these aims, the First Aid procedures which must be followed in an emergency situation are:

• assess the situation;
• make the area safe;
• give emergency First Aid;
• get help.

Assess the Situation

1. Observe what has happened, looking for clues

2. Look for dangers to yourself and to the casualty

Make the Area Safe

1. Protect the casualty from danger

2. Prevent further casualties

Give Emergency First Aid

1. Assess each casualty. You must first check for consciousness or unconsciousness by trying to get a response from the casualty. This should be done by carefully shaking the casualty's shoulders, shouting their name, and asking questions such as 'What happened? Are you okay?'

2. Determine treatment priorities - Airway, Breathing, Circulation, Bleeding, Fractures, Other Injuries

3. Treat those with life threatening conditions first

Note: The above steps give us a Danger - Response - Airway - Breathing - Circulation procedure or D - R - A - B - C.

Get Help

Ensure that any specialist help has been summoned and is on its way

Developing your understanding

Activity 1 : Learn about First Aid

The Mayo Clinic information site can be found at: www.mayoclinic.com Click on the link to "First-Aid & Self-Care Guide". Choose some of the first aid topics (e.g. choking, fainting and fever) and read the advice provided.

Go back and click on Resuscitation, then Mouth-to-Mouth Rescue Breathing. Read this information.

Click on Cardiopulmonary Resuscitation. Read this information. You should now know how to check whether an unconscious casualty's airway is clear, and how to check that breathing and circulation are present.

Activity 2 Which order?

Re-organise the following statements to show the correct order of first aid. (An ambulance has already been summoned).

1. If there is no sign of circulation, begin chest compressions.

2. Try to get a response by shaking the casualty's shoulders and shouting, 'Are you okay?'

3. Look, listen and feel for breathing.

4. Check for signs of circulation by noting the skin colour and looking for movement in the limbs and eyes. If you know how, check for the carotid pulse by feeling for 10 seconds at the side of the casualty's neck.

5. Continue with CPR until professional help arrives.

6. If no response, open casualty's airway by tilting their head back and lifting up their chin.

7. If not breathing, pinch casualty's nose closed and give 2 full breaths into their mouth.

8. Perform 15 compressions to every 2 breaths at the rate of 100 per minute.

The correct order of statements is given at the end of this unit

Activity 3: CPR for infants and children

Go to web site

www.learncpr.org/index.html

Click on CPR for Children. Read the information describing the CPR procedure when the casualty is a young child. Make your own notes.

Click on CPR for babies/infants and read the information about the correct CPR procedure. For more information, click on Ask The Doctor and CPR Facts. Now try the Quiz.

The information in this web site should have helped you to understand the differences in the CPR procedure for adults, young children and babies/ infants.

Using the table below try to identify what you have learned without reference to the website.

The answers are given at the end of the unit.

Activity 4: The recovery position

Finally, go to web site

www.surgerydoor.co.uk

Click on Emergencies, then Emergencies. You can choose to read about a range of injuries and illnesses, but first read the information about the Recovery Position.

The step by step procedure to put an unconscious casualty into the recovery position is:

1. Kneel down beside the casualty and open their airway.

2. Take the casualty's arm that is nearest you. Bring it towards you and place it flat on the ground, palm uppermost.

3. Bring the casualty's other arm across and hold the hand, palm outwards, against their near cheek. With your other hand, bend the casualty's far away leg at the knee, with the foot flat on the floor.

4. Keep the casualty's hand pressed against the cheek to support the head while you pull the far away knee and thigh towards you, rolling the casualty on to their side.

5. Remove your hand from under the casualty's head, and make sure the airway is still open. Place the casualty's top leg at right angles to their body.

6. Free straight arm if necessary, ensure airway remains open and monitor the casualty at regular intervals.

If you have the opportunity in the near future, practise this procedure with a colleague, following the above steps. This will help you to carry it out in an emergency with care and confidence.

Other Situations

Other typical First Aid incidents which may arise in school include:

• Choking
• Cuts, grazing and bleeding
• Broken bones and dislocations
• Burns and scalds
• Sprains, strains and bruises
• Bites and stings

You can find information to help you deal with these incidents in the First Aid Manual (Revised 7th Edition) (Voluntary Aid Societies, 1999). The web site www.surgerydoor.co.uk has a useful section on 'Emergencies'.

Allergic Reactions

Some people experience severe allergic (anaphylactic) reactions to food, insect stings, drugs or latex (rubber). Common food allergens include: milk, eggs, fish/shellfish, wheat, soy and nuts. An allergic reaction occurs because the body's immune system over-reacts to the presence of a foreign body. Some people experience mild symptoms which can be treated with oral antihistamine. In others the reaction is severe and may be life-threatening. In severe cases, a crisis plan will have been developed with the GP or specialist clinic. This may include the administration of adrenaline by injection. In such situations, teachers should be involved in discussions about the correct emergency first aid procedures. More information is available from: The Anaphylaxis Campaign ( www.anaphylaxis.org.uk ).

What would you do?

Situation 1

You are called to the playground where the school janitor has collapsed. Nobody has seen what happened. What is the first thing you should do? As a result of your assessment, you have discovered that the janitor is unconscious, is not breathing, and has no pulse. What action should you take to give him the biggest chance of survival?

The ambulance arrives, and the janitor is taken to hospital. Meanwhile, one of your colleagues appears to have been affected by the situation and faints in the staff room. She has no obvious injuries, but is unconscious, although she is breathing and has a pulse. What should you do? A commentary is provided at the end of the unit.

Situation 2

You are helping two friends to decorate their kitchen. One has removed a power socket… Your immediate reaction is to switch off the electricity at the consumer unit. The other friend phones for an ambulance. What is your next step?

Your friend is unconscious, is not breathing, and has no pulse. What next?

What is the correct CPR procedure? You continue with the CPR procedure, but you suspect that air is not getting into the casualty's chest. Which four things should you check?

If the casualty was a child, how would the CPR procedure be different?

A commentary is provided at the end of the unit

Want to know more?

The following are considered useful background reading and references for students involved in initial teacher education. They are not intended as recommendations for classroom use.

Resources/Texts

British Red Cross (1998)
Practical First Aid
London: Dorling Kindersley Ltd.

The Health and Safety Executive (1997) First aid at work: the health and safety (first aid) regulations 1981 approved code of practice and guidance. Sudbury, Suffolk: The Health and Safety Executive.

St. Andrew's Ambulance Association (1996) First Aid Book for Young People. Glasgow: St. Andrew's Ambulance Association.

Webb, M. (1999) First Aid Manual (Revised 7th Edition) Voluntary Aid Societies, London: Dorling Kindersley Ltd.

Agencies/Support Group

www.medicinenet.com

A site that helps answer questions

www.surgerydoor.co.uk

Provides wide-ranging information

British Red Cross
Red Cross House
1 Glebe Avenue
Stirling FK8 2HZ

Health Education Board for Scotland
Woodburn House
Canaan Lane
Edinburgh EH10 4SG

Heartstart UK
British Heart Foundation
45a Moray Place
Edinburgh EH3 6BQ

St. Andrew's Ambulance Association
St Andrew's House
Milton Street
Glasgow G4 0HR

Answers

Activity 2: Which order?

The correct order of statements is:

(2 - 6 - 3 - 7 - 4 - 1- 8 - 5)

Activity 3: CPR for infants and children

Commentary

Situation 1

You must make a quick assessment of the casualty, based on the Danger- Response-Airway-Breathing-Circulation procedure, to indicate what needs to be dealt with first, and how to deal with it.

You must send someone to dial 999 for an ambulance, explaining the casualty is unconscious, is not breathing, and has no pulse. You must start CPR immediately in the sequence of 2 ventilations to 15 compressions.

Place the casualty into the recovery position, maintaining an open airway. Monitor regularly her breathing and pulse. Get professional help, if the unconsciousness continues.

Note: A first aid kit at work, provided for staff purposes, should include in it a leaflet giving guidance on basic first aid.

Situation 2

Please note the different technique for children and babies/infants.

You should check for a response from the casualty using the 'shake and shout technique' before working your way through the Response-Airway- Breathing-Circulation procedure.

Dial 999 for an ambulance, or send someone to do so, stating that the casualty is an unconscious male who is not breathing and has no pulse. Continue with CPR.

The four things you should check are:

1. The head is tilted sufficiently far enough back

2. There is a firm seal around the mouth

3. The nostrils are closed

4. The airway is not obstructed

The correct CPR sequence for an adult is 2 ventilations to 15 compressions. For a child only one hand is used to compress the chest to a lesser depth (normally one third of the depth of the chest) than for an adult. After initially giving 5 breaths, the sequence is then 1 breath to 5 compressions.

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