Playing and having fun at the playground is a fundamental part of being a child. Unfortunately, while children are playing, there is also the very real risk of injuries. From minor falls and scrapes to more serious injuries such as broken bones, accidents can and often do happen. Even outside of the playground, children's play time can result in injuries. For this reason, it is important that teachers, playground monitors, and parents know how to administer first aid. When adults have knowledge of how to treat injuries, they can better prevent infection, or worse, from occurring.
Children are highly active, and it isn't uncommon for them to get a few cuts and scrapes during the course of daily play. Although they are not unusual, it is important that these injuries are checked by an adult to ensure that they are actually minor and that first aid is administered to prevent infection. One of the first steps is to stop any bleeding. This can be done by placing a clean cloth on the injury and applying gentle pressure. Once the bleeding has stopped, the scrape or cut should then be cleaned with plain, clean water, while the skin around the cut should be cleaned with soap and water, taking care to keep the soap away from the cut. According to the Mayo Clinic, cleaning the cut with hydrogen peroxide or iodine is unnecessary. Before covering it with a bandage, a layer of antibiotic ointment should be spread across the scrape or cut to help prevent infection. Parents will want to change the bandage daily, although you should do so more often if it becomes dirty or wet. Typically, a doctor isn't needed for minor scrapes and cuts; however, if the cut is a gaping wound or larger than a quarter of an inch, stitches may be necessary and a doctor should be seen. Additionally, a doctor should be consulted if swelling, redness, or other signs of infection should develop.
When a child falls and hits their head, it is naturally a cause of great concern. A head injury can be a scalp injury or an internal injury. Of the two, an internal injury is the most severe, as it can harm the brain. A scalp injury often looks more frightening than it is, as it can result in excessive bleeding due to the large amounts of blood vessels in the scalp. This type of injury will often produce swelling or a lump that can take weeks to resolve. When administering first aid for a head injury, it is important to determine if it is a scalp or internal injury. A lack of consciousness after a fall could indicate an internal injury. If the child is unconscious, they should not be moved, as this can worsen any injuries, particularly if there is also a neck or spine injury involved. However, if vomiting occurs or if there is a seizure, the child should be gently turned to the side to prevent choking. If the child is unconscious or suffers a seizure or vomiting, call 911 immediately or seek other forms of emergency medical assistance. Other signs of an internal injury include blood or clear fluids coming from the mouth, ear, or nose, abnormal breathing, slurring of speech, and changes in vision or abnormal pupils. Additionally, parents will want to look out for weakness or any sign of paralysis, stiffness in the neck, or bleeding that does not stop. These symptoms are cause for concern and require emergency care from a doctor.
If a child has injured their head but is alert and behaving normally, place a covered cold pack over the injured area. The area should be iced every four hours for 20 minutes at a time. Watch the child carefully for two hours, even if there were no initial signs of serious injury. If at any point the child begins to display abnormal behavior or symptoms, they should be taken to the emergency room. If no problems arise after two hours, it is safe to give ibuprofen for minor pain relief. At this time the child may be allowed to sleep, but they should be supervised for any changes. Observation should continue for 24 hours.
When a child has a suspected sprain, their parent, teacher or guardian should make certain that the child stops any further activity. A sprain is typically characterized by swelling and bruising as well as pain, and it most often occurs in the ankle or wrist. Sprained thumbs are also not uncommon, particularly in kids who participate in sports. For soft tissue injuries such as this, the RICE method should be used: RICE stands for rest, ice, compress, and elevate. The injured are should be rested, and a cold pack should be placed on the area as soon as possible after the sprain for up to 20 minutes. The cold pack should then be reapplied between four to eight times daily for 48 hours. To compress the injury, place a wrap or bandage around the area for two days, and elevate it above the level of the heart as often as possible to bring down the swelling. Over-the-counter medication for pain, such as acetaminophen or ibuprofen, may be used.
A broken bone in a child is a frightening and excruciating injury that must receive immediate and appropriate attention. While he or she must receive medical care, it is important that basic first aid is given. If the child has suffered a broken leg, pelvis, or hip, or if the bone is protruding from the skin, call 911 immediately. If a broken neck or back is suspected, emergency help should also be summoned as quickly as possible. If any of the mentioned breaks have occurred or are suspected, the child should not be moved until help arrives. If a broken bone in another area is suspected and there are no problems with breathing, lack of consciousness, excessive or heavy bleeding, or discoloration in extremities, administer first aid and take the child to the emergency room or their doctor for medical treatment. First aid in these cases includes stopping the bleeding, if there is any, with the application of pressure on the wound. Splinting the area with a magazine or newspaper that has been rolled up tightly will help limit movement. Children should not be given any food, drink, or medication until they are seen by a doctor. Ice packs can help lessen the pain for older children but should not be applied if a toddler or an infant has a break.
If a child has an accident that causes them to stop breathing, it is important that caregivers and parents know what action to take and do so swiftly. A lack of oxygen to the brain can cause brain damage and eventually death if no action is taken. The plan of action depends on whether or not the child has a pulse. If a quick check reveals that there is no pulse, then CPR must be performed. If there is a pulse, perform rescue breathing until the child is able to breathe without assistance. Rescue breathing for a child will be slightly different from rescue breathing for adult: The child's head receives only a slight tilt, enough to allow the air to flow in. With an infant, the adult's mouth will need to cover both the mouth and the nose. For older children, cover the child's mouth and begin to push air into the lungs at a rate of one breath every three seconds. Every 20 breaths, the pulse should be checked to ensure that it has not stopped.
If a child does not have a pulse, chest compressions are needed. When chest compressions are added to rescue breathing, a person is performing CPR. On a child older than 1, the heel of your hand should rest on the breastbone but not the end of the breastbone. The heel of the hand should press down quickly and hard for 30 counts. The chest compressions should then be followed by two breaths. For an infant, chest compressions are done using three fingers placed below the baby's nipples. When pressing down, it should only be to one-third of the depth of the infant's chest. Give 30 chest compressions followed by two breaths.
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