Sunday, October 7, 2012

CPR and Choking Emergencies


CPR and Choking Emergencies of Children

                Working in an early childhood environment one must remain calm and composed to keep the environment a positive experience for the children. Remaining calm and level headed is a must when an emergency arises in an early childhood environment. When working with children 5 years old and under an individual must have training in CPR, and know what to do in case a child is choking. I will give a scenario of each case and the steps to follow during the emergency.  Being prepared is the key to dealing with emergencies. I will be explaining how to be prepared for these situations and why.

                Infants/toddlers put things in their mouths constantly, so when working with them an educator has to be on alert all the time. The first scenario is with a 4month old girl and a 1 ½ year old girl. The 4 month old girl is playing on the floor rolling over and chewing on appropriate toys. The 1 ½ year old girl is sitting at a table eating cheerios with her baby doll; she is sharing her cheerios with her doll.  The 1 ½ year old looks over at the infant, gets up and goes over to the infant placing a cheerio in the infants mouth. The educator looks over to see the 1 ½ year old standing over the infant saying hungry. The educator looks at the infant and hears a weak cough indicating the infant could be choking. In this second scenario the children are outside playing on a hot day. There are three boys playing tag. The one boy who is 3 years old looks a little tired. The educator goes over to see if he is ok, as she approaches he falls to the ground. Upon reaching him the educator realizes he is unconscious and having a seizure. Once the seizure quite the boy was unresponsive and not breathing. This boy does not have a history of seizures or any other illness. [YOU NEED TO PUT IN ABOUT CPR].

                For scenario 1 the 4 month old is choking and needs immediate help. If the infant “is not coughing forcefully or does not have a strong cry” then follow these steps while remaining calm: (Medlineplus a, 2011, p. 1)

1.       Place infant face down on your forearm. The infant’s chest in your hand and jaw between fingers. The head needs to be lower than the body, so point head down.

2.       Using the palm of your hand “give 5 quick forceful blows” to the infants back between the shoulder blades.(Medlineplus a, 2011, p. 2)

3.       Turn infant over placing her on you thigh with head supported.

4.       Using 2 fingers find the middle of the infant’s “breastbone just below the nipples” and give 5 quick thrust down (Medlineplus a, 2011, p. 2). You only want to compress 1/3 to ½ deep on chest.

5.       Repeat with 5 back blows and then 5 chest compressions. Continue this until the object becomes dislodged or infant losses consciousness. 

6.       If infant is unconscious call 911; then call parents of child.

7.       Start CPR

8.       After 1 minute look in mouth see if you can view object if not continue CPR until help arrives. DO NOT do blind sweeps of the mouth as it can cause more damage.

If an infant is choking one should have someone call 911 while you begin first aid.

                For scenario 2 the three year old boy is having exertion heat stroke, the symptoms for this are increase in body temperature, change in consciousness, “seizures, confusion, emotional instability, irrational behavior or decreased mental acuity”(National Safe Kids Campaign, 2003, p.3). Other symptoms to look for are nausea, vomiting, diarrhea, headache, dizziness, weakness, fast breathing, dehydration or combativeness. Steps that need to be taken are:

1.       First call 911 and then call the parents of child.

2.       Follow seizure first aid by making sure that there is nothing around that the child could harm themselves.

3.       DO NOT put anything in the child’s mouth; they will not swallow their tongue.

4.       After seizure is over check it see it child is breathing. If child is not breathing start CPR.

a.       CPR for a child; if no response from the child when you gentle shake them then place child on their back.

b.      With the heel of your hand find the breastbone, which is below the nipples then start chest compressions. Keep head tilted back. “Give 30 chest compressions” only compressing 1/3 to ½ deep on chest (Medlineplus, 2011, p.2).

c.       Once the chest compressions are complete check for breathing. Look, Listen and Feel. Place ear close to the mouth of child to do this, and watch for chest to move up and down.

d.      If child is not breathing then cover mouth with yours and give 2 breaths. Make sure head is tilted and mouth is tightly over the child’s mouth. Pinch nose closed and give 2 breaths. (There are masks that should be in first aid kits).

e.      Repeat chest compressions and breathing until help arrives or child starts to breath.

These two scenarios can be scary, but if educators are prepared then they can handle it very well. To be prepared for both scenarios an educator must be trained in first aid procedures and CPR. Infants/toddlers can or will put anything in their mouths so understanding the proper procedures is very helpful. First aid training needs to be taken every year to keep personal up on changes and keep it fresh in their minds. Making sure the first aid kits do not have out dated equipment, and keep it stocked. It is best to have a child’s personal information organized and quickly accessible, as it can help in the event of an emergency.  Exertion heat stroke is rare but does happen when children are in sports and playing hard in hot weather. An educator needs to be aware of what and how much a child is drinking, as well as limiting exposure. “Children replace less of their fluid losses when drinking water,” thus when in high activity sports drinks help replenish a child’s fluid loss (National Athletic Trainers’ Association, 2003, p.4).

In conclusion, first aid training and CPR training is a must educators of children 5 and under. Preparing personal in procedures of a choking infant and CPR of children needs to be done every year. Helping staff stay calm in emergencies will help resolve the emergency in a swift manner. Having emergency action plans helps staff and parents understand what happens in the event of an emergency.

Reference

Medline Plus (2011), Choking-infant under 1 year, Retrieved on September 19, 2012 from http://www.nlm.nih.gov/medlineplus/ency/article/000048.htm

Medline Plus (2011) CPR-children (1 to 8 years old), Retrieved on September 19, 2012 from http://www.nlm.nih.gov/medlineplus/ency/article/000012.htm

National Athletic Trainer’s Association (2003), Parents’ and Coaches’ guide to dehydration and other heat illness in children, Retrieved on September 19, 2012 from http://www.nata.org/sites/default/files/Heat-Illness-Parent-Coach-Guide.pdf

 

 

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