1 Paediatric First Aid Course

2 Introduction to your course work book
A brief description to the class who FATE are and a little bit about what we do

3 House Rules Mobile phones switched off Toilets Break times
Start and finish timesMobile phones to be silenced during lectures, anyone needing to answer their phone for emergency only please leave the roomToilets point direction to class15minute break half an hour for lunch 15 minute afternoon, please stick to the allocated break times.Course times 9.00/5.00Any candidate who does not attend the full course will not be able to take the examination.

4 Competence assessment
CPR practical sessionIncident trainingCertificates

5 Paediatric First AidWrite down in your own words why you have chosen or asked by your employers to attend this course.From a personal point of view, what would you like to achieve / learn on the course

6 Course objectives Identify a range of illnesses and injuries
Treat a range of illnesses and injuriesManage an unconscious casualtyManage the airwayPerform effective Cardio pulmonary resuscitationManage bleedingCourse objectives

7 What is First Aid?First Aid is the immediate assistance or treatment given to someone injured or suddenly taken ill before the arrival of a ambulance, doctor or other appropriately qualified personAsk the class to take a moment if they have ever been treated by someone for a injury that they may have sustained to the body. Now think how did that person react.Calm, confident, panicky, control,

8 First Aid and the Law

9 Acts and Regulations Health & Safety at Work Act 1974
Health & Safety (First Aid) Regulations 1981Reporting of Injuries, Diseases & Dangerous Occurrences Regulations 1995 (RIDDOR)QUESTION TO THE CLASS WHAT THEIR UNDERSTANDING OF HEALTH AND SAFETY AT WORK AT IS?HOW DO YOUR EMPLOYEES DETERMINE HOW WE DECIDE HOW MANY FIRST AIDERS WE NEED?WHAT WOULD YOU CLASS AS A SERIOUS ACCIDENT ON SITE

10 Risk assessment of First Aid needs
To considerWorkplace hazards and risksSize of the organizationHistory of accidentsNature & distribution of work forceRemoteness for medical servicesNeeds of travelling, lone or remote workersWorking on shared or multi-occupied sitesAnnual leave and other absences of First Aiders

11 The Aims of First Aid Preserve life Prevent the injury from worsening
Promote recovery

12 Role and Responsibilities
First Aider must alwaysAssessDangerPrioritiseAskTreat/TransferASESS WHAT?DIAGNOSE, HOWTREATTRANSFER? HOSPITAL, HOME WORK

13 Managing casualties

14 Aims and Objectives Understand how oxygen gets to the vital organs
State the priorities of lifeTriage a group of casualtiesAims and ObjectivesP3

15 Your trainer will now explain how oxygen is transferred around the body
Transfer of oxygenP3

16 Multiple casualtiesFrom the following list decide who needs your attention first.Remember you can only deal with one casualty at a time.Please give reasons for your answers.P3

17 Who needs you first Screaming child Nose bleed Arterial bleed
Broken legAsthma attackShockQuiet child on the floorChokingAnaphylactic shockWho needs you firstWorkshopP3

18 Answers Quiet child on floor Choking Anaphylactic shock Asthma attack
Arterial bleedNose bleedBroken legShockScreaming childAnswersP3

19 TriageBreathing over Bleeding Burns Bones

20 Aims and objectives Identify life threatening problems
Perform the primary assessmentMaintain an airwayState which three sets of clues help make up a diagnosisPerform a secondary assessmentPlace a casualty in the recovery positionAims and objectivesP3

21 Primary AssessmentD: Danger R: Response A: Airway B: Breathing C: CirculationP3

22 Aims and Objectives Perform effective CPR on the adult, child and baby
Deal with problems that may occur during CPRManage a range of scenariosAims and ObjectivesP4

23 Cardio-Pulmonary Resuscitation
Adult Child BabyP4

24 Cardio Pulmonary Resuscitation
DangerResponseAirwayBreathingCompressionsP4

25 In cases involving children and infants we should attempt one minutes CPR (3 cycles) before leaving the casualty to go and get helpChild and babyP5

26 AdultA Flow chart for adult CPR, you can see it is amazingly simple, CPR should continue until normal breathing resumes or the casualty get up and says get offIt is no longer necessary to teach a different protocol for Trauma/drowning and cardiac arrest, this has been taken out of FAW as it is very difficult for the lay person to identify the cause of cardiac arrest. Lifeguards will still be required to manage them differently#If they ask:Include 5 initial rescue breaths, CPR for one minute then get helpP6

27 CPR Adult 30 compressions : 2 inflations 5 – 6cm depth of compression
2 Handsrate per minuteCPRP6

28 Problems during resuscitation
Broken ribsCasualty vomitsStomach distensionNot making a good sealIntroduce two person operator to the classP9

29 Hygiene Considerations During Resuscitation
workshopP9

30 What is tetanus?Tetanus and Lock Jaw

31 Paediatric CPRIt has been identified that many children and babies do not receive CPR purely because people are frightened of hurting them, there are no medical findings to support the idea that that is the case. The protocol is nearly the same encourage students learn it or include it in your course.Paediatric CPRHead tilt, chin lift as normalBreathing check is still look listen and feel for 10 seconds5 initial rescue breaths, over one secondThen 30 compressions, two hands, one third the depth of the chest, two fingers if under one year3 cycles of 30 : 2 should equal approximately one minute, go for helpContinue with 2 : 30 until something happensFor paediatric courses where there are two or more rescuers with a duty to respond, these should learn 15:2 protocolChest compressions can be one or two handed as long as the correct depth is achieved, so again in training it should be emphasised that two hands should be used especially as the rescuer tires.P10

32 CPR Child 30 compressions : 2 inflations 3 cycles of 30:2 = 1 minute
At least a 1/3rd depth of chest1 hand100 – 120 rate per minuteP10

33 CPR Infant 30 compressions : 2 inflations 3 cycles of 30:2 = 1 minute
At least a 1/3rd depth of chest2 fingers100 – 120 rate per minuteP12

35 Assessing casualties Primary assessment Secondary assessment
Recovery positionA practical session

36 Secondary AssessmentP14

37 Secondary Assessment History Signs Symptoms Remember children &
babies may not be able toclearly explain how they feel& what has happenedSecondary AssessmentP14

38 Unconsciousness Causes Fainting Stroke Heart attack Shock
Head injuriesHypoxiaPoisoningEpilepsyDiabetesP15

39 The AVPU Code A Alert V Responds to Voice P Responds to Pain
To check response:A AlertV Responds to VoiceP Responds to PainU Unresponsive4 METHODS OF RESPONSEALERT CAN HEAR AND RESPOND TO YOURESPONDS ONLY TO YOUR VOICERESPONDS TO GENTLE PAINNOT RESPONDING AT ALLP15

40 The Recovery PositionP15

41 ChokingP16

42 Children & babies Causes of airway obstruction
Inhalation of vomitForeign object e.g. toy, peanutSubmersion in waterInfection of the lungs or throatInjuries to the head, neck or chestCot deathP16

43 Recognition of choking
Often stand up very quicklyclutching throatCongested face, veinsprominent in face and neckCoughingDifficulty breathingMay have been eatingRecognition of chokingP16

44 Choking Adult Treatment
Choking sequenceAgain very easy

45 Adult choking Encourage the casualty to cough Up to 5 sharp back slaps
Up to 5 abdominal thrustsRepeat cycleUnconscious CPRAdult choking

46 Choking Paediatric Treatment
Choking sequenceAgain very easy* Chest for infants/abdominal for child > 1P16

47 Child Choking Encourage to cough Up to 5 sharp back slaps
Up to 5 abdominal thrustsUnconscious CPRChild ChokingP16

48 Baby Choking Up to 5 sharp back slaps Up to 5 chest thrusts
Unconscious CPRBaby ChokingP17

49 Obtaining medical assistance
In pairs write a list of information the 999 operator may ask you for

50 Conditions that affect the breathing

51 Causes of breathing problems
WorkshopMake a list of all of the conditions that could affect your casualties breathing

52 HypoxiaBlockage Suffocation Febrile convulsions Gas/smoke Sickle cell anemia Paralysis Lack of O² Electrical injury Poisoning Carbon monoxide Compression of chest Fits

53 Anaphylactic ShockP19

54 Anaphylactic shock Major allergic reaction Bee stings Peanuts, foods
DrugsP19

55 Anaphylactic shock Anxiety Red blotchy skin
Swelling of the face and neckPuffiness around the eyesImpaired breathingA rapid pulseP19

56 Anaphylactic shock Treatment Calm and reassure Get help
Help the casualty to sit up if consciousRecovery position if unconsciousHelp them to take their EpipenP19

57 The casualty then finds it difficult to breathe
AsthmaWhere the air passages to the lungs go into spasm causing the lining of the airways to swell.The casualty then finds it difficult to breatheCauses of attackPollen / Dust / Cigarette smokeAllergens such as pet hairExerciseP20

58 Asthma recognitionDifficulty breathing Wheezing Distress and anxiety Difficulty in speaking Grey blue skin Dry, tickly cough May become exhaustedP20

59 Asthma treatment Calm and reassure casualty
Sit them down, leaning forward supportedPlenty of fresh airAllow him to use medicationIf attack is prolonged or medication does not relieve attack, seek medical helpP20

60 Conditions that affect the circulation
P22

61 Aims and objectives List the different types of blood vessel
Treat bleedingApply a dressingIdentify different types of injuryRecognise and treat various conditions affecting circulationAims and objectivesP22

62 What sudden illnesses or conditions can affect the circulatory system?
Section 7What sudden illnesses or conditions can affect the circulatory system?P22

63 ShockWhat is it?CausesP22

64 Causes of shock Severe bleeding Loss of body fluids Loss of serum
Severe painAcute heart attackAbdominal emergenciesP22

65 Shock Recognition Pale or grey skin Cold, clammy skin
Feel faint or giddyFeels sick or may vomitFeels thirstyAnxious or restlessYawn or gasp for airRapid, weak pulseShallow, rapid breathingMay lose consciousnessP22

66 Shock Treatment Deal with the injury or cause
Lay casualty down, raise legs if possibleHead low and turned to one sideLoosen tight clothingMoisten lips if thirstyKeep casualty warmTransfer to hospitalP22

67 Incised Laceration Puncture Contusion Abrasion
Wounds and bleeding

68 ArteriesVeinsCapillariesBlood VesselsP22

69 Types of bleedingArterial Severe. Bright red oxygenated blood spurts from wound with each heartbeat Venous Dark red. Blood may escape from the body as quickly as an arterial bleed, may gush profusely Capillary Oozing occurs at the site of all wounds, blood loss is usually slightP22

70 External bleeding Pale skin with cold clammy skin Rapid weak pulse
Shallow fast breathingFeels sick or may vomitFeels cold and thirstyConfused/distressedObvious injuryExternal bleedingP23

71 Internal bleeding Recognition Cold, clammy skin Rapid, weak pulse Pain
ThirstConfusion, restlessnessPossible collapsePattern bruisingBleeding from orificesP23

72 Treatment of severe bleeding
Direct pressureElevate the injuryApply a sterile dressingTransfer to hospitalP23

73 Treatment for Bleeding
Practical Dressings and BandagesTreatment for BleedingP24

74 Hygiene considerations during first aid
Wash your handsWear protective glovesWash the affected areaDon’t talk or coughClean up afterHygiene considerations during first aid

75 EyesIrrigate the eye with eye wash, dress if the object won’t come outEars & NoseDo not insert anything into the ear to remove the object, seek medical attentionForeign ObjectsP25

76 Animal bites and stings can be extremely painful and distressing, bites are susceptible to infection, stings can lead to anaphylactic shockBites and StingsP27

77 Seek medical assistance where the child or infant suffers an allergic reaction
Scrape the sting out of the skin using a credit card or similarApply a cold compress to relieve painWash bites with soap and water and dress any open injuriesTreatmentP27

78 A poison is a substance which, if taken into the body in sufficient quantity, may cause temporary or permanent damagePoisonsP28

79 WorkshopIn small groups compile a list of things which could poison children and infants. Think carefully about your work place.P28

80 How can a poison enter the body?
PoisonsHow can a poison enter the body?IngestedInhaledInstilledInjectedAbsorbedP28

81 Poisons The affects of poisons
Cause confusion, fits and unconsciousnessBurn lips, mouth and food passagesAffect the normal action of the heartCause vomiting & diarrheaDamage blood preventing oxygen reaching the tissuesInhaled poisons can cause severe respiratory distressP28

82 Burns and ScaldsP30

83 Burns and Scalds What sort of things cause burns and scalds?
What could cause a burn to a child or infant in the care environment?Burns and ScaldsP30

84 Burns and Scalds Causes Friction Dry heat Electric current
Acids and alkalisIntense coldRadiationScalds are caused by moist heat, water, steamP30

85 Classification of Burns
Superficial: Redness, swelling, tenderness Partial thickness: rawness of skin and blisters Full thickness: scorching, damage to nerves, fat tissue and musclesP30

86 Treatment of Burns and Scalds
Chemical burnsChemicals to the eyeAnd: Foreign objects in the eyeTreatment of Burns and ScaldsP30

87 Medical Attention Must be sought for: Full thickness burns
Burns to face, hands, feet or genital areaBurns that extend all around a limbPartial thickness burns greater than1% of body surface = palm of casualties handP30

88 ElectricityP31

89 Electricity in the Workplace
Where in the work place could the children and infants in your care receive an electric shock?Electricity in the WorkplaceP31

90 Domestic Voltage Shocks
Isolate the applianceOnce safe D.R.A.B.If not breathing start CPRTreat any burnsMonitor and record conditionRecovery position if unconsciousDomestic Voltage ShocksP31

91 High Voltage InjuriesP31

92 FracturesP32

93 Aims and Objectives Recognise fractures
Manage the treatment of fracturesRecognise and treat injuries to muscles and jointsAims and ObjectivesP32

94 Causes of Fractures Direct force Indirect force
Can you think of some examples of incidents or accidents that may cause a fracture to a bone?Causes of FracturesP32

95 Fractured ends of the bone protrude through the skin
Open FractureP32

96 When the skin is not broken
Closed FractureWhen the skin is not brokenP32

97 Complicated FractureLeads to further damage and injury to major organs or blood vessels.P32

98 A partial fracture or hairline fracture where the bone does not break in two are quite common in children and infants where bones are still quite flexibleGreen Stick FractureP32

99 Fractures Recognition features Casualty may hear the bone snap Pain
TendernessSwelling, bruisingLoss of powerGrating sound on movementDeformityP32

100 Practical Treatment of Fractures
A practical sessionCollarboneUpper armLower arm / wristHand / fingersThighLower leg / anklePractical Treatment of FracturesP32

101 Bones, Muscles and Joints
Provides support, protects vital organs and allows movement

102 Sprains, Strains & Dislocations
Sprain is an injury to a ligament at a jointStrain is an injury to a muscle or tendonDislocation is the dislodging of a bone head at a ball and socket jointP33

103 TreatmentRestIceComfortable PositionElevationP33

104 Disorders of the BrainP34

105 Aims and Objectives Identify the various levels of consciousness
Recognise a range of head injuries and describe the treatment for themRecognise and manage epilepsyAims and ObjectivesP34

106 The AVPU Code A Alert V Responds to Voice P Responds to Pain
To check response:A AlertV Responds to VoiceP Responds to PainU Unresponsive4 METHODS OF RESPONSEALERT CAN HEAR AND RESPOND TO YOURESPONDS ONLY TO YOUR VOICERESPONDS TO GENTLE PAINNOT RESPONDING AT ALL

107 Concussion History of blow to the head
Brief or partial loss of consciousnessDizziness or nauseaLoss of memoryMild headacheMonitor and sent to hospitalP34

108 Compression May be disorientated, confused, unconscious or weeping
Progressive loss of consciousnessStrong pulseWeakness or paralysis of mouth, face and one side of the bodyFlushed face with hot, dry skinPupils unevenly dilatedP34

109 Treatment Monitor and record levels of response Calm and reassure
Ensure privacyCarry out the general management and treatment for unconsciousnessArrange for urgent transfer to hospitalP34

110 Skull fractureP34

111 Could lead to compression
Skull fractureCould lead to compressionA wound or bruise to the headA soft area or depression of the scalpDeterioration in level of responseClear fluid or watery blood coming form the nose or earsBlood in white of the eyeDistortion of the face or headMonitor & seek medical attentionP34

112 Treatment Monitor and record levels of response Calm and reassure
Ensure privacyCarry out the general management and treatment for unconsciousnessArrange for urgent transfer to hospitalP34

113 Observation of head injuries
EyesSkinBreathingConsciousnessPulseP35

114 The Spinal ColumnSpinal injuries are rare in children and infants but we should still have an awareness of the recognition featuresP36

115 Spinal Injuries Damage to spinal bones: Damage to the cord:
Recognition featuresDamage to spinal bones:Pain at injury siteStep or twist in spineTendernessDamage to the cord:Loss of control or one or more limbsAbnormal sensations, tinglingDisorientation or bewildermentDifficulty in breathingP36

116 How should we manage a suspected spinal injury?
10MIN TO DISCUSSP36

117 Spine Cord Injury Management skills
Management using two peopleHead tilt and chin liftP36

118 Other Medical Conditions
DiabetesAffects of heat and coldPoisoningForeign bodiesElectrical injuriesBites and stingsFebrile convulsionsSickle cellMeningitisOther Medical ConditionsP37

119 Aims and Objectives Recognise a range of injuries
Manage a range of illnessesTreat a range of injuriesAims and ObjectivesP37

120 A serious condition where the red blood cells become sickle shaped instead of the normal doughnut shape. This prevents oxygen moving around the body causes severe pain and organ damage.Is common in families from Africa, Caribbean, eastern Mediterranean, the Middle East and Asia.Sickle Cell AnaemiaP37

121 Sickle Cell Anaemia Recognition features: Treatment:
Severe abdominal painTreatment:Keep the child comfortable and transport to hospitalSickle Cell AnaemiaP37

122 Meningitis Viral and aseptic meningitis are both relatively mild.
Bacterial meningitis is far more serious.Infection attacks the fluid that surrounds the brain and spinal cord.MeningitisP38

123 Caused by a viral or bacterial infection, this can be spread by discharge from the nose and throat of the infected personMeningitisP38

124 Recognition Features Newborns and infants Inactivity Irritability
VomitingPoor feeding and high pitched cryFever, headache and neck stiffnessRecognition FeaturesP38

125 Recognition Features Over two years old
High fever (101 – 106f or – 41.1c)Headache, stiff neck developing between 1 – 2 daysNausea, vomitingBack pain, fuzzinessRed or purple skin rashLoss of appetiteRecognition FeaturesP38

126 Seek urgent medical assistance Be aware not all sufferers develop all the recognition features
TreatmentP38

127 The pancreas fails to produce the hormone insulin
This condition is caused when the body can no longer regulate the levels of sugar in the bloodThe pancreas fails to produce the hormone insulinHypoglycaemiaHyperglycaemiaDiabetesP39

128 Recognition of Hypoglycemia
DiabetesRecognition of HypoglycemiaPallor of skinProfuse sweatingCasualties pulse is rapidBreathing is shallowLimbs may trembleConfused or abnormally aggressive, can be mistaken for someone who is drunkFaintness or unconsciousnessP39

129 Treatment of Hypoglycemia
Conscious casualty:Give a sweetened drink with 2 or tablespoonsof sugar, or other sweet substanceIf the casualty improves dramatically ensurehe gets more sugar, as the problem was anexcess of insulinUnconscious casualty:Place into recovery positionEnsure open airwaySent to hospitalP39

130 Recognition of Hyperglycemia
DiabetesRecognition of HyperglycemiaHot red faceDry skinAcetone smell on the breathMay be wearing a medic alert braceletMay be carrying a testing kitConfused or abnormally aggressive, can be mistaken for someone who is drunkFaintness or unconsciousnessP39

131 Treatment of Hyperglycemia
DiabetesTreatment of HyperglycemiaCalm and reassureLoosen tight clothingAdvise to seek medical assistancePlace into recovery position if unconsciousP39

132 Disturbance in the normal electrical activity
Major epilepsyDisturbance in the normal electrical activityof the brainMay have an “Aura” or warning periodSudden loss of consciousness, falls to the floor and becomes rigidFlushed or livid face and neckCommences convulsions, may lose control of bladder or bowelRelaxes and becomes unconsciousRecovers after a few minutesP40

133 TreatmentTry to support or ease the fall of the casualty, lay him downClear the space around the casualtyLoosen tight clothing, put something soft under the headDO NOT move, restrain, try to wake or put anything in the casualties mouthWhen convulsion has finished place into the recovery position, check for other injuriesAdvise casualty to see a doctorP40

134 Effects of heat and cold
Heat exhaustion Caused by a loss of salt and water from excessive sweating Hypothermia Body temperature falls below 35C Heat stroke A failure of the “thermostat” in the brain causes this conditionP41

135 Associated with high temperature caused by ear, nose and throat infections. Occasionally seen after MMR vaccinationFebrile ConvulsionsP42

136 Febrile Convulsions Unconsciousness Violent muscle spasms
Fever, hot flushed skinBreath holding, red “puffy” face and neckConvulsions lasting no more than four minutesFebrile ConvulsionsP42

137 Prevent injury by padding around the body during seizure
Supply cool fresh airSponge the skin with tepid water to assist coolingMaintain airway, place into the recovery positionFebrile ConvulsionsP42

138 How to recognise Heat Exhaustion
May have a head acheBe profusely sweating or has stopped sweatingBe hot to the touchBecome pale with cold clammy skinSuffer from crampBecome confusedP43

139 Treatment for Heat Exhaustion
Move the casualty to a cool placeAllow to sip cool waterArrange for medical assistance if they don’t recover quicklyTreatment for Heat ExhaustionP43

140 Keep the casualty comfortable and send to hospital urgently
Heat strokeP43

141 Hypothermia is where the body’s core temperature drops below 35c

142 How to recognise Hypothermia
May have very cold skin which feels like marbleHave white skin and blue extremitiesBe shivering uncontrollablyHave slow breathingHave a slow pulseBecome confused and very slow to reactP44

143 Infants with Hypothermia
Infants may not shiver and as such cannot warm themselves in this wayInfants with HypothermiaP44

144 The Aftermath Record in the accident book Replenish first aid supplies
Report to the HSERecord in the accident bookReplenish first aid suppliesP47

145 Accident details Name of casualty Home address
Name of person writing the reportWhen the accident happenedWhere the accident happenedWhat happenedTreatment givenMethod of disposalHANDOUTS TO THE CLASS THE INCIDENT REPORT FORMS AND GET THEM TO COMPLTETE THEM MAKING UP THEIR OWN INCIDENT.( 18YEARS BEFORE YOU CAN MAKE A CLAIM)P47

146 First Aid containersWorkshopP48

147 Think about the type of injuries and illnesses you see in your workplace. What do you need in your first aid kit?First Aid ContainersP48

148 First Aid Containers Contents Disposable gloves Guidance card
20 individually wrapped sterile dressings2 sterile eye pads4 individually wrapped triangular bandages6 safety pins6 medium sized individually wrapped sterile dressings2 large sized individually wrapped sterile dressingsPLACE THE FIRST AID CONTAINERS IN FRONT OF THE CLASS AND ASK THE CLASS TO look at what is contained I a kit and how it could be used then run through list of contentsFEED BACK TO THE CLASS YOUR FINDINGS(ANYTHING CAN GO IN A FIRST AID BOX) IF YOU CAN JUSTIFY IT by risk assessment.P48

149 Question and Answer Session