Management of Injuries & Acute Illness

1. Management of Injuries & Acute Illness Prevention of unintentional childhood injuries is a major responsibility of families and teachers. Due to the magnitude of injuries to children, and because many injuries occur in school it is important that schools as part of health services address safety and emergency care. Written emergency policies and preparations for handling emergencies are two ways to addressed safety and emergency care.

2. Appropriate training and preparation, staff will be able to respond to emergencies in a prompt and knowledgeable manner (Figure 10-1). A program’s comprehensive emergency response plan should address • Training of personnel in infant/child CPR and basic first aid techniques • Assign responsible staff for managing emergency care • Obtaining notarized parental/guardian permission forms for each child that authorize emergency medical treatment.

3. Continued… • Having an accessible telephone • Posting emergency telephone numbers next to the telephone. • Making arrangements for emergency transportation • Providing a fully equipped first aid kit in each classroom or central location (Table 10-1)

4. Whenever emergency policies and procedures are being formulated, special attention should be given to protecting children and adults from transmissible illnesses, such as hepatitis B and C, and Aids/HIV. Following universal precautions will limit the likelihood of transmission of disease through exposure to body fluids. Universal precautions are those activities designed to deal with body fluids and include use of gloves, masks, and proper receptacles for placing materials used to clean up body fluids. School are required to have an exposure control plan and have materials available for use when dealing with body fluids.

5. Serious Injury & Illness Plan • Remain with the child at all times • DO NOT MOVE a child with serious injury unless there is immediate danger from additional harm. • Begin appropriate Emergency health care procedures immediately and send for help. • DO NOT give fluids, food or medication unless ordered by professional help. • Call 911 • If the child is being transported, remain with child until parents arrive. • Contact the child’s family • Record all information

6. Emergency Care vs. First Aid Emergency Care: Refers to immediate treatment administered for life threatening conditions, which includes a quick assessment of the emergency ABC’s. The victim is also checked and treated for severe bleeding, shock, and signs of poisoning.

7. Life Threatening Conditions Airway Obstruction- Partial or complete blockage of the breathing tubes to the lungs. Infant • Have someone call for emergency medical help • Position infant face down over then length of your arm with the child’s head lower than their chest as you support head and neck with hand • Use the back of your hand to give the infant five back blows between the shoulder blades • Support and turn infant over, face up, head lower than chest. • Give five chest thrust. Place two fingers between nipple line, compress the infants chest (1/2-1in). Release pressure • Look inside the child’s mouth for foreign objects. Remove if so. • Repeat Steps

8. Airway obstruction Continued Child • Summon emergency medical assistance • Stand or kneel behind the child with your arms around the child’s waist • Make a fist with one hand against the abdomen, midway between the base of the rub cage and the navel • Press your fisted hand into the child’s abdomen with a quick, inward and upward thrust. • Continue to repeat abdominal thrusts until the object is dislodged or the child becomes unconscious

9. Shock-is a life-threatening condition that occurs when the body is not getting enough blood flow. • -have someone call for emergency medical assistance-quickly asses the ABC's- keep lying down-elevate child feet (8-10in), if there are no indication of fractures-maintain body heat-moisten a clean cloth to wet child's lips-stay clam-observe child's breathing closely

10. ASTHMA-is a chronic disorder of the respiratory system characterized by periods of wheezing, gasping, and labored breathing; the attacks can be really difficult and must be treated as life threatening. -summon emergency medical help if child shows anxiety, wheezing, restlessness, loss of consciousness, blue discoloration on nail beds or lips-reassure the child-administer any medication prescribed for child's asthma-encourage child to relax an breathe slowly-have child get into a comfortable position-notify child's family

11. BLEEDING- the flow of blood from a ruptured blood vessel, usually caused by a laceration or deep gash.-summon emergency medical help -follow universal precautions-place a pad of sterile gauze or clean material over wound-apply firm pressure-place additional pads over bandage next to skin if blood soaks through-elevate the bleeding part if there is no evidence of fracture-apply ice pack in wrapped cloth/towel-Secure bandages-locate the nearest pressure point above the bleeding has not been stopped

12. DIABETES-a polygenic disease characterized by abnormally high/low glucose levels in the blood. You must determine between two conditions: Hypoglycemia-high blood sugar cause by too little insulin. Symptoms are slow deep breathing, gradual onset, increased thirst, drowsiness, excessive urination. -Summon medical assistance Hypoglycemia-low blood sugar cause by too much insulin. Symptoms: sudden onset, skin cool/clammy/pale, dizziness, shakiness, headache, hunger, rapid shallow breathing and seizures.-summon emergency medical help.-if conscious and alert, administer orange juice/glucose tablets-if unconscious maintain airway and rush child to nearest hospital

13. Non-Life Threatening Conditions • First AID: Refers to treatment of administered for injuries and illnesses that are not considered life threatening • (Non- life threatening conditions) Emergency care& First AID  treatment are based on principles that should be familiar to anyone who works with young children.

14. Drowning-suffocation and death resulting from filling of the lungs with water or other substance • Begin CPR • Gently shake the child or infant to determine if they are conscious • Position child with extreme care on back on a hard surface • Remove any vomitous/excess mucus by sweeping finger inside mouth • To open airway gently tilt the childs head up and back by placing one hand on the forehead and the fingers of the other hand under the chin, push downward on the forehead and lift the chin upward • Listen carefully for no more than 10 secs to determine if the child is breathing http://www.redcross.org - and search for CPR courses

15. CPR Infant • Place your mouth over the infants nose and mouth to create a tight seal • Gently give two small puffs of air (one sec/breath with a short pause in between). Observe chest for movement • Administer 30 quick chest compressions by placing two fingers just below the nipple line • Continue cycles of two breaths followed by thirty chest compressions (2:30) until infant resumes breathing or help arrives

16. CPR for Child • Gently pinch the nostrils closed. Place your mouth over victims forming a tight seal • Give two small breaths (one second/breath) • Administer 30 quick chest compressions by placing the heel of your hand over the nipple line • Continue cycles of two breaths followed by 30 compressions • DO NOT STOP or GIVE UP until child is breathing or help arrives

17. Baby/Infant • http://www.youtube.com/watch?v=hOtvVIB8ULo Child • http://www.youtube.com/watch?v=aamJ2UApBF8&feature=channel

18. The ABC’s for assessing injuries • A-      Airway: Make sure the air passageway is open and clear. Roll the infant or child onto his/her back. Tilt the head back by placing your hand on the child’s forehead and gently push downward. At the same time, place the finger of your other hand under the child’s chin and lift it upward.B-      Breathing: Watch for the child’s chest to move up and down. Feel and Listen for air to escape from the lungs with your ear.C-      Circulation: Note the child’s skin color (esp. around the lips and nail beds), and if the child is coughing or moving.

19. Non Life Threatening Conditions •       Abrasions, cuts, and or other minor skin wounds•       Bites•       Blisters•       Bruises•       Burns•       Eye Injuries•       Fractures•       Frostbite & Hypothermia•       Heat Exhaustion & Heat stroke•       Nosebleeds•       Seizures•       Splinters•       Sprains•       Tick bites•       Tooth Emergencies