How to save your child in an emergency

Children have an incredible number of accidents, and basic first-aid knowledge can make the difference between life and death


A survey in Mother and Baby magazine in Britain recently revealed that of 2,000 parents questioned, only 14 per cent knew enough first aid to save their child's life in an emergency.

"It is staggering that 86 per cent of parents do not know simple first aid,'' says Jon Cunningham, training manager for St John Ambulance. "Children have an incredible number of accidents and basic first-aid knowledge can make the difference between life and death. We recommend that all parents and guardians take a course to learn these vital lifesaving skills.''

"Accidents literally happen in seconds, but the effects can sometimes last a lifetime,'' says Katrina Phillips, chief executive of the Child Accident Prevention Trust.

These tips tell you what to do in the most common emergencies. They are not intended as a substitute for medical care. Once you have carried out first aid, contact your doctor, go to casualty or call an ambulance - depending on the severity of the injury.

Parents should also learn how to open an airway, and perform rescue breathing and cardiopulmonary resuscitation (CPR).

Burns and scalds

The aim of first aid is to stop the burning, relieve pain and swelling and minimise the risk of infection.

Flood the burn for 10 minutes with cold, running water (or any other cold, harmless liquid, if water is not available). Do not immerse small children in cold water as this can cause hypothermia.

Remove clothing from the burnt area only once it has cooled down. Also cut around any material sticking to the skin. Take off any clothing or jewellery that is causing a restriction, before swelling occurs.

Cover the burn loosely with a piece of clean, non-fluffy material, such as a sheet. Do not cover burns on the face. If the injury is on a hand or foot, put a polythene bag or cling film over the fabric. Do not burst blisters or use creams.

Burns to the mouth and throat are potentially life threatening, as they can cause swelling and breathing difficulties.

Loosen clothing around the throat; if possible give sips of cold water and call an ambulance. Calm and reassure the child to minimise shock.

Choking

Remove any visible object from the mouth with a finger, but do not touch the back of the throat - it may cause swelling, which can block the airway - or probe blindly, which could push the object further down.

Babies: lay the baby along your forearm face down and with the head low and supported. Give five firm slaps between the shoulder blades.

If back slapping fails, turn the baby on its back, check the mouth, then place two fingers on the lower half of the breastbone and give five sharp, thrusts towards the head at the rate of one every three seconds. Check the mouth again. Repeat the steps three times, then take the baby with you to call for help and continue with the thrusts until it arrives.

Children over one: Encourage the child to cough, if possible. If this fails, bend the child forward so the head is lower than the chest and give five firm slaps between the shoulder blades. Check the mouth.

If slapping does not work, try chest thrusts. Stand or kneel behind the child, make a fist and place it over the lower breastbone. Hold the fist with your other hand and pull sharply inwards and upwards five times at the rate of once every three seconds. Check the mouth again.

If this has not worked, use an abdominal thrust. Stand or kneel behind the child, make a fist, place it between the child's navel and breastbone, grab your fist with your other hand then give five sharp pulls inward and upwards below the ribs. Repeat the cycle three times. If the obstruction has not cleared, dial for help, but continue the cycle until it arrives.

Bleeding

Unless something is embedded in the wound, apply direct pressure with your fingers or palm to stop the bleeding. Apply a clean pad or sterile dressing and raise the injured area above the level of the heart.

Lay the child down, keeping the injured limb raised, and maintain pressure on the wound for 10 minutes. When the bleeding is controlled, apply a sterile dressing and bandage, being careful not to cut off circulation.

If blood starts to seep through, apply another dressing on top, but if this fails to staunch the flow, remove top dressings and apply fresh ones.

When something is embedded in the wound, place a sterile dressing lightly over the top and put padding around the edges until the padding is higher than the embedded object. Bandage lightly over the padding, taking care not to press down on the object. Keep the limb above the level of the heart.

Poisoning

Each year, about 37,000 children attend casualty with suspected poisoning, most of them under five. Try to find out what has been swallowed and remove anything left in the mouth. If the poison is a corrosive chemical, give frequent sips of water or milk.

Do not make the child vomit as this can cause further harm. Call a doctor and ask for advice. Take the bottle, packet or poisonous plant with you if you go to hospital and, if the child has been sick, take a sample of the vomit, too.

Drowning

An infant who falls forward can drown in just one inch of water. Lift the child out of the water and carry him with his head lower than his chest to reduce the risk of inhaling water. Remove any wet clothing and keep the child warm in a towel or blanket. Resuscitate if necessary and dial for help. Always take the child to casualty, even if he seems to have recovered, in case there has been lung damage from inhaled water.

Head injuries

There are three main types of head injury: concussion, compression and skull fracture. All should be treated seriously. Call for help if there has been even a momentary loss of consciousness or concussion.

If the child is unconscious for more than a few seconds, keep the airway open using the jaw thrust. Kneel behind the child and place your hands over the ears, keeping the head, neck and spine aligned. Then, place your hands on the sides of the child's face with your fingertips at the angles of the jaw. Lift the jaw gently to open the airway without tilting the neck. This is just in case there has been a neck injury). Be prepared to resuscitate.

Compression is caused by internal bleeding or swelling putting pressure on the brain. The effects may appear hours or even days after the injury: the symptoms are confusion, severe headache, slow, noisy breathing, a strong but slow pulse, unequal pupils and weakness or paralysis.

Skull fractures can cause similar but sometimes more severe symptoms to compression of the brain. Seek medical advice immediately.

© The Telegraph Group Limited, London 2003