First Aid, Illness, and Injury
The most important thing to know about first aid is how to avoid the need for first aid. Thinking proactively and avoiding dangerous situations, will reduce your need for first aid by limiting accidents and injuries. When caring for children, you should frequently ask yourself “What are the potential dangers in this situation? What do I need to look out for? How can I reduce the risk of injury to children in my care?”
Your reaction during emergencies is extremely important - not only will you need to get help quickly, but you also need to show the child that everything is going to be all right. It is very important that you stay calm. The child is watching you to see how you react. If you panic and lose your cool, the child is going to follow your example and panic too. During emergencies, children need to see that their adult caretaker is in control. This makes them feel secure during a scary time. Panicking tells the child that you have lost control of the situation, and will frighten the child.
Seek medical attention immediately if you see any of the following:
- A bone appears to be broken
- High fever combined with vomiting
- Serious burn: the skin blisters
- Ingestion (swallowing) of household chemicals, medicine, or other dangerous substances
- Convulsions or seizures
- An animal bite has broken the skin
- Breathing difficulties
- Sudden, severe headache
- Signs of shock: weak, rapid pulse, and skin that is pale, cold, and moist, or “clammy” to the touch
Allergies are very common among children. Allergies happen when the body reacts to a substance, like pollen (called hay fever), a certain food, or an animal. Allergies can cause sneezing, runny nose, itchy eyes, and rashes on the skin. Some allergies, like those to bee stings and to peanuts, can be very dangerous because they are so severe. Your host parents should tell you if a child has a severe allergy. Children with bee sting allergies usually take special medication with them wherever they go, just in case. Children allergic to peanuts have to avoid peanuts completely: no peanut butter, no candy with peanuts. They can’t even touch a food with peanuts in it, or they could have trouble breathing. Know about the children’s allergies so that you can help them to avoid things that cause a reaction, and to respond appropriately if they do have a reaction. When any child has what appears to be a severe allergic reaction - swelling, itching, difficulty breathing - you should treat it as an emergency.
Asthma is an increasingly common childhood illness, and it can be very dangerous if not treated promptly and appropriately. Talk to your host family about managing the child’s asthma, and make sure the child has his inhaler with him at all times if that is necessary. During an asthma attack, a child may complain of tightness in his chest. He may start coughing uncontrollably, wheezing, or breathing very rapidly. These attacks can understandably be very frightening for children - help the child to stay calm while he uses his inhaler. Sometimes, asthma attacks are triggered by allergies, air temperature, or by exercise. Help your child to avoid situations that might cause an attack.
If the bite has broken the skin, clean the wound and call the pediatrician - this includes animal bites and people bites.
Run the burned area under cool running water - don’t use ice. Cover the area with clean gauze. If the burn causes blisters or breaks the skin, call the doctor. You should also call the doctor about any burns to the hands, mouth, or genitals.
Chickenpox is a common and very contagious childhood illness. Children with chickenpox will initially feel unwell: tired, cranky, or “yucky.” Then, they will break out with itchy red spots, which frequently first appear on the abdomen. If you suspect a child has chickenpox, call the pediatrician. Keep the child away from other children, and you or a parent should notify the child’s school that the child has chickenpox. Soothing bath treatments are available at the pharmacy to alleviate the itching. Discourage the child from scratching, as this can cause scars and infection - they might even wear gloves while sleeping. Chicken pox can be very dangerous for adults who have not already had it. If you have not had chickenpox, or aren’t sure, talk to the family doctor about getting a vaccination.
As a child care provider, you should be familiar with the Heimlich maneuver and CPR, or cardiopulmonary resuscitation. The Heimlich maneuver is used to assist choking victims, to dislodge items that are stuck in the windpipe and obstructing breathing. CPR and Rescue Breathing are used to restore a heartbeat and respiration in someone whose heart has stopped beating, or who has stopped breathing. It is a very good idea to review these techniques frequently. Your local library and the Red Cross are excellent sources of review materials.
If a child is constipated, it means they can’t have a bowel movement or that their bowel movements are difficult and painful. Don’t give children laxatives unless the pediatrician directs you to do so. Instead, increase fiber in an older child’s diet. Raw fruit and vegetables are rich in fiber. Dried fruit is a delicious snack and is also full of fiber. Encourage the child to drink more water. If the child is constipated often, tell your host parents. If the host parents or pediatrician think it is a good idea, you can give the child a stool softener, which makes it easier to have a bowel movement.
Diarrhea is very loose, watery stool. It can be caused by something the child ate, a stomach virus or illness, or by stress. If diarrhea is accompanied by fever and/or vomiting, call the pediatrician. Diarrhea can make children dehydrated, so give them plenty of clear liquids. Milk, cola, or other sweet drinks may make diarrhea worse. Children with diarrhea need to replace their electrolytes. These are chemicals that help the body work properly.
Your host parents may use a special drink like Pedialyte™ (or the equivalent in your program country) to replace electrolytes. If diarrhea is severe, or persists for more than 24 hours, call the pediatrician. If the child has diarrhea often, let your host parents know.
Clean the area and put pressure on the wound to stop the bleeding. Cover the wound with a bandage. Find out how the child cut himself - if the child hurt himself on a piece of rusty metal, check with the pediatrician to see what you should do. If the cut or scratch becomes infected, call the pediatrician. Very deep cuts also require medical attention. Call the pediatrician if you think a cut needs stitches or sutures, and call an emergency phone number if bleeding is very severe, or if the blood pulses or spurts from the wound.
Young children can get inner ear infections fairly frequently. They are very painful and require medical attention. Tell your host parents and call the pediatrician if you suspect that a child has an ear infection. Symptoms of an ear infection include tugging or pulling on the ear, fever, and hearing and balance problems. Babies or very young children with ear infections cry and may have difficulty sucking and swallowing. Children with ear infections may also be reluctant to lie down, because moving their head worsens the pain.
If a child gets something in her eye, help her to flush it with water. Call the doctor if the eye appears very red, is very watery or teary, is extremely sensitive to light, or is injured in any way. If something has been stuck into the eye, don’t remove the object and seek emergency medical attention immediately.
Conjunctivitis, or “pink eye,” is a very common childhood eye infection. An eye with conjunctivitis will turn pink, produce pus, itch, and be very watery. Call the pediatrician if you think a child has conjunctivitis. Conjunctivitis is very contagious, so make sure you and the children in the house wash your hands often when someone has pink eye, and don’t share towels or washcloths.
If a child has a low-grade fever, keep them calm and encourage them to drink lots of liquids. Check with your host parents to see what kind of medication they give the child when he has a fever. If the fever is high (more than 101.6° F) or is persistent, call the pediatrician. If any fever is accompanied by a stiff neck, vomiting, and headache, notify your host parents and call the pediatrician immediately, because these can be symptoms of a very serious illness.
Even if you’re very careful and make sure children wear their helmets when biking and skating, they still are very talented at bumping their heads. Know how to recognize a serious head injury. A concussion is a bruise on the brain, and it can be serious if ignored. If the child feels dizzy, sleepy, or nauseated after the head injury, or if the pupils of his eyes are different sizes, he may have a concussion. Do not let the child sleep until you seek medical attention.
If the child in your care attends school, camp, daycare, or otherwise interacts with other children, she may bring home head lice: small insects that live in the hair. Regular shampoo doesn’t kill them, so even the cleanest child can catch them. Notice if the child scratches her head a lot - lice itch, and a constantly scratching child is an indication that she may have lice. Examine the child’s hair by looking through the hair, close to the scalp. Check behind the ears and at the neck. You probably won’t see the actual insects, which are very small, but you will see their eggs. Lice eggs look like dandruff - tiny white-gray capsules glued to the hair shaft. If you think you see an egg, flick it with your finger: Dandruff will move, but lice eggs are glued to the hair and will not. You are likely to see them in clusters.
If you determine that a child has head lice, you will need to work with your host family to get rid of them. Examine all the children in the house and even the adults should examine each other. If a child in your house has lice, it’s a good idea to keep long hair up or under a scarf until you’re sure the problem is resolved. Lice are rather difficult to get rid of, because if you don’t get them all, they just infest the hair again. Notify the child’s school that you have found head lice. Treat the child with an anti-lice shampoo and comb through the child’s hair very thoroughly with a fine comb (one is usually provided with the shampoo) to remove the eggs. It is very important to remove all of the eggs, or else they will hatch and you will have to start all over again. In addition, everything that has touched the child’s head - including sheets, pillows, toys, hairbrushes, and hats - needs to be washed in hot water or put in a plastic bag for several weeks to kill any lice.
Pinch the nose tightly and lean the child over the sink to catch the blood. The bleeding should stop in no more than ten minutes. If the child has nosebleeds often, tell your host parents.
Know the number for the poison control hotline and keep it near the phone. If you think that a child has swallowed something that could be dangerous, call the poison control number. Tell them what the child has swallowed. Don’t make the child vomit unless you know that what they swallowed will not hurt them when it comes back up; some chemicals, like bleach or drain cleaner, can burn the child’s throat if they vomit them back up. The poison control center will tell you what to do. If you don’t have a telephone number for poison control, call an emergency services phone number.
Prevent poisoning accidents by keeping dangerous substances out of the reach of children. Children should not play in the garage, bathroom, or kitchen cupboards. Even children’s vitamins can be very dangerous if many are swallowed.
A seizure is the uncontrollable shaking of the body, as seen in epilepsy. Seizures may be violent, or they may appear as a loss of control over the body. If a child in your care has a seizure, call the emergency services number or tell someone else to call it immediately. Move the child to the floor and clear the area around the child so that she does not hurt herself. Tilt the child’s head to the side so that she does not choke, but do not put anything in the child’s mouth. Do not try to restrain the child’s movement. Most seizures are very brief, and do not hurt the child.
Children get a lot of sore throats. Warm drinks can ease the pain of a sore throat, and older children may gargle warm salt water, which you can make by mixing a small spoonful of salt in a large glass of water. If a child continues to complain of a sore throat, use a flashlight to look at the back of the throat. If there are white patches or red spots or stripes in the back of the throat, or if the child continues to have a sore throat, call the pediatrician, as the child’s throat may be infected.
Children vomit when they are sick, when they have eaten something they shouldn’t have, when they are carsick, and even when they are upset. Most of the time, vomiting is not a serious problem. Have the child lie down quietly on her side so that she doesn’t accidentally get fluid in her lungs. Don’t give her anything to drink for at least 15 minutes. Then, have the child slowly sip some water. If they can keep the water down, they may have clear fluids and later perhaps some mild foods, such as plain white rice, if they feel well enough. Call the doctor if the child vomits several times in a few hours, or if the vomiting is accompanied by other symptoms, such as fever or diarrhea.
Contact your local coordinator if you think you notice signs of child abuse. Child abuse may be physical, sexual, or emotional. Physically abused children frequently have severe bruises and other repeated injuries. Sexually abused children may have unexplained bleeding or bruising in the genital or anal area. Many parents use the swimsuit rule: No adult should touch children in any place that is covered by their underwear or swimsuit.