Eulalee Thompson

AS A caregiver in the home, school or nursery, would you know what to do if the child in your care had an accident? Today, Winston Henry, first aid and CPR educator and supervisor, based at the Heart Foundation of Jamaica in Kingston, takes us through four possible scenarios. Bear in mind that you may actually have to attend one of Mr. Henry's teaching sessions to feel confident enough to administer these first aid techniques.

eulalee.thompson@gleanerjm.com

1) Objectsblocking the throat

Small objects such as the five-dollar coins, beads and marbles are attractive to a toddler exploring his or her new world. Suppose your child swallows one of these small objects, would you know what to do? Mr. Henry said that if the child can speak or cry, then take him or her to the hospital; if the object is down but not affecting breathing, then take him or her to the hospital.

If the child (younger than one year old) is coughing but not breathing properly, then hold the child face down, administer five back slaps, followed by five chest thrusts (if the object is not expelled upon slapping). The thrusts are administered using two fingers just below the nipple line of the sternum.

If the child is between one and eight years old, Mr. Henry said that abdominal thrusts can be administered. First, make a fist and place just above the belly button, then do fast in-and-up movements until the object is expelled. You may also have to administer to the mouth, one breath every three to five seconds for one minute to restart breathing.

"In infants and children, respiratory arrest is the most common cause of sudden death, so caregivers need to ensure that children are sitting, not jumping, while eating to prevent food from slipping down the throat," Mr. Henry said. He explained that even an egg yolk could prove fatal to a small child.

2) Cutsand bruises

3) A fever

Active children may get minor cuts, scrapes and bruises; Mr. Henry said that you should not put anything that burns on fresh wounds. Of course, this advice runs against the cultural practices but not all of these practices are based on sound evidence so it's a good idea to follow his advice. He said further that whatever you put on fresh wounds should be something that you can put in your eyes. So use a little antibiotic cream; it will prevent infection. You could also clean the area around the wound with diluted solutions and place a plaster over the wound.

Your child may develop a fever (constant elevated temperature above 37.2 degrees Celsius or 99 degrees Fahrenheit). The caregiver's action is not panic but to start sponging down the child. "It is important that if the fever keeps recurring after sponging that the caregiver doesn't sit and wait but go seek medical help," Mr. Henry said.

When you sponge, he said that you should not use ice-cold water but tepid water from the tap because you could be cooling the outer temperature but locking in the core temperature, putting your child in harm's way. "You can, however, give your child as much cold drinks as you wish to cool down the core temperature," Mr. Henry said.

For the sponging technique, use four wet wash-cloths. Place one on the forehead, one under each arm and the fourth one is used to keep bathing the child. The fourth one is also the 'roving washcloth', so, for example, as the one on the forehead becomes warm (from the fever), replace it with the wet fourth wash-cloth as many times as necessary.

4) Broken bones

Your active child may fall and break a bone. "Never straighten a broken limb (and) deformity is the commonest sign of a fractured limb. If you touch the area, it will also feel warm or hot if broken because of the proliferation of white blood cells rushing to the area," Mr. Henry said.

The area may also appear red and he said that there may be crepitation, a grating sound in the area. "You may not see swelling or feel heat, but if you hear that grating sound then that is a clue to broken bones," Mr. Henry said.

He advises you to go to the doctor for all broken bones. If it is a simple fracture - the bones are broken but not protruding - then the caregiver can use two splints to immobilise the affected body part and prevent compounding the fracture. "If you lift the child, the bone may start protruding, osteomyelitis could occur along with compound fractures," Mr. Henry said.

To create splints to immobilise the area you could even use your old newspapers.