DROWNINGS

About one in five people who die from drowning are children aged 14 or younger. Kids are specially at risk because they are curious, fast and attracted to water but are not yet able to understand how dangerous it is. For every child who dies from drowning, another five receive emergency department care for nonfatal submersion injuries.

Children ages 1 to 4 have the highest drowning rates. In 2009, among children 1 to 4 years old who died from an untentional injury, more than 30% were from drowning, occuring most of them in home swimming pools. Drowning is responsable for more deaths among children 1-4 than any other cause except congenital anomalies. Among children between 1 and 14, fatal drowning remains the second-leading cause of uninentional injury-related death behind motor vehicle crashes.


WHAT FACTORS INFLUENCE CHILDREN DROWNING RISK?

• Lack of swimming ability
• Lack of barriers
• Lack of close supervision
• Location
• Failure to wear life jackets
• Seizure disorders

WHAT TO DO

• Get the child out of the water as quickly as possible.
• Begin rescue breathing and call for help
• Open the child's airway
• If he/she does not seem to breathe, place your mouth over child's nose and lips and give two breaths, each lasting about one second (if they are under age 1) or pinch the kid's nose and seal your lips over his/her mouth, giving two slow, full breaths from one to two seconds each (in case they are 1 or older)
• If doing that the chest rises, check for a pulse. If not, try again. If there is a pulse, give one breath every three seconds. Check for a pulse every minute and continue rescue breathing until the child is breathing on her own or help arrives.
• If you cannot find a pulse, with children under age 1, imagine a line between the child's nipples, and place two fingers just below its centerpoint. Apply five half-inch chest compressions in about three seconds. After five compressions, seal your lips over your child's mouth and nose and give one breath. With children 1 or older, use the heel of your hand to apply five quick one-inch chest compressions to the middle of the breastbone (just above where the ribs come together) in about three seconds. After five compressions, pinch your child's nose, seal your lips over his mouth, and give one full breath. All ages: Continue the cycle of five chest compressions followed by a breath for one minute, then check for a pulse. Repeat cycle until you find a pulse or help arrives and takes over.

HOW TO PREVENT CHILDREN FROM DROWNING

• Supervise children in or around the water
• Use the buddy system
• Seizure disorder safety
• Learn to swim
• Learn Cardiopulmonary Resuscitation (CPR)
• Be careful with air-filled or foam toys
• Bear in mind the local weather conditions and forecast before swimming or boating.
• If you have a swimming pool at home, install four-sided fencing and clear the pool and deck of toys.

ASTHMA FLARE-UPS

Asthma is an illness that affects a person's airways or bronchial tubes. These tubes lead from the trachea into the lungs.

 

For most kids, breathing is an unconscious action: they breathe in through their noses or mouths and the air goes into the trachea, travelling next through the airways into the lungs. Nevertheless, such an easy action can be really difficult because of the sensitivity of their airways.

WHO GETS ASTHMA?

Asthma is more common than we might think. In fact, it affects about 1 or 2 kids out of 10. It can start at any age, being specially common in school-age kids.

The reason why people are affected by asthma is still unknown, but it has been proved that it runs in families.

WHAT IS AN ASTHMA FLARE-UP?

An asthma flare-up or asthma attack happens when a person's airways get swollen and narrower and it becomes extremely difficult for air to get easily in and out of the lungs. What is more, the swollen airways may sometimes produce extra mucus, becoming breathing even more difficult. Kids with asthma may wheeze, cough or feel tightness in the chest.

After an asthma flare-up, the airways almost always return to the way they were before, although it can take several days. Nevertheless, if asthma is not treated can get worse and worse.

 

WHAT CAUSES AN ASTHMA FLARE-UP?

An asthma flare-up may occur when a children comes in contact with:

• Dust mites
• Mold
• Pollen
• Colds
• Furry animals
• Perfume
• Chalk dust
• Cigarrette smoke

TREATMENT

Kids affected by asthma should try to avoid those elements that can cause their airways to tighten. Nevertheless, some of them, such as animals, colds or chalk dust, cannot be avoided. Thus, these children need to manage their illness with medication.

Since there are different types of asthma, there are also different kinds of medicines for treating it. In order to provide the best treatment, the doctor will take into account the causes of the asthma flare-ups, how often they happen and how serious they are.

There are two main sorts of medication:

• The rescue medicine: when it is taken only once in a while, when a flare-up happens. It works fast opening the airways, so the person can breathe easily again.
• The controller medicine: it needs to be taken every day. It is mainly used to prevent flare-ups.

EARLY WARNING SIGNS OF AN ASTHMA FLARE-UP

• Coughing, even if your child has no cold
• Throat clearing
• Rapid or irregular breathing
• Unusual fatigue
• Trouble sitting or standing still
• Restless sleep

WHAT TO DO

Asthma flare-ups demand IMMEDIATE attention. Take the rescue medication and go to the doctor (if it is really serious, even go to the hospital).

HOW TO PREVENT ASTHMA FLARE-UPS

• Take the prescribed medication
• Keep rescue medicine on hand at all times
• Avoid triggers, such as allergens

 

HIVES (Cases of urticaria)

Red raised spots on children's skin are often a case of the hives (a common biological reaction to something like an allergen). They seldom cause serious health problems and most of them eventually clear up and go away.

Hives or urticaria are red raised bumps or welts on the skin. They can appear in any part of the body as small individual spots or large interconnected bumps. They can last from a few hours to a week (sometimes this period of time can be longer).


MOST COMMON CAUSES

• Allergic reactions to food (specially shellfish, tree nuts, milk and fruit), medications and allergy shots, pets or other animals, pollen, insect bites and stings.
• Infections, including colds
• Exercise
• Anxiety or stress
• Exposure to the sun
• Exposure to the cold
• Contact with chemicals
• Scratching
• Putting pressure on the skin

TREATMENT

• In many cases hives won't require any treatment and they will go away on their own.
• In case a trigger is identified, treatment will include making sure the child avoids it. If there is important itchiness, the doctor may prescribe an antihistamine medication.
• For chronic hives, the doctor may recommend a non-sedating prescription or over-the-counter antihistamine to be taken every day. If this does not work, a stronger antihistamine, another medication or a combination of medicines may be suggested by the specialist. In rare cases, oral steroids could be provided.

SEEK EMERGENCY CARE or CALL THE DOCTOR URGENTLY if you observe one of the followings:

• anaphylactic shock
• severe attacks
• angioedema

You may find interesting these videos about hives:

Abdominal Pain and Poisoning

ABDOMINAL PAIN

Children often complain of stomach pain. It is one of the most common reasons that parents take children to the doctor or the hospital emergency department. Stomach pain can be hard to diagnose. 

Most of children with stomach pain get better in hours or days without special treatment. 

A range of causes:

There are many health problems that can cause stomach pain for children. Here you have the most common ones:

· Bowel problems (constipation, colic or irritable bowel)

· Infections (gastroentiritis, kidney or bladder infections, or infections in other parts of the body)

· Food-related problems (too much food, food poisonng or food allergies)

· Problems outside the abdomen (muscle strain or migraine)

· Surgical problems (appendicitis, bowel obstruction or intussusception)

· Period pain (some girls can have it before their periods start)

· Poisoning (spider bites, eating soap...)

Some children suffer repeat attacks of stomach pain which can be worrying for parents. Children might feel stomach pain when they are worried about themselves or people around them. 

What to do:

· Have the child rest (avoid activity especially after eating).

· Ask your child’s doctor before giving any medicine for abdominal pain. Drugs can mask or worsen the pain. Give to the child paracetamol as a painkiller, remember that doses for children are often different to those for adults, so please, check the packet carefully, for the right dose. Avoid giving aspirin.

What to do so as to treat symptoms:

· Provide clear fluids to sip, such as water, broth, or fruit juice diluted with water.

· Serve bland foods, such as saltine crackers, plain bread, dry toast, rice, gelatin, or applesauce.

· Avoid spicy or greasy foods and caffeinated or carbonated drinks until 48 hours after all symptoms have gone away.

· Encourage the child to have a bowel movement.

When to call a doctor:

Call the child's doctor immediately if your child has any of the followng:

· Persistent pain on the right side of the abdomen, which could be an appendicitis.

· Pain confined to one part of the abdomen.

· Severe or rapidly worsening abdominal pain or pain that doesn't go away within 24 hours.

· Pain or tenderness when you press on the belly.

· A swollen abdomen or an abdomen that is rigid to the touch.

· Pain in the groin, or pain or swelling in a testicle.

· Unexplained fever.

· Lots of vomiting or diarrhea for more than 24 hours.

· Refused to eat or drink.

· Bleeding from the rectum.

· Blood in the stool or vomit.

· A recent abdominal injury.

· The child becomes pale, sweaty and unwell.

Abdominal Pain in 4-12 Year Old Children (VIDEO)

Children's First Aid: Vomiting and Diarrhoea (VIDEO)

Child poisoning: 

Accidental poisoning is common, especially among young children aged between one and three years. 

Poisoning may be a a medical emergency: if you suspect a child has been exposed to a poison or if a child has been given the wrong medicine or wrong dose of medicine, phone the Poisons Information Centre inmmediately.

If the child has collapsed, stopped breathing, is having a fit or is suffering an anaphylactic reaction, immediately ring for an ambulance. 

Symptoms of poisoning:

If the child has had a significant poisoning, any symptoms that develop will depend on a number of factors.

Symptoms of poisoning can include:

· Nausea.

· Vomiting. 

· Drowsiness.

· Falling over.

· Tummy pain.

· Fitting.

DO NOT WAIT FOR POISONING SYMPTOMS TO APPEAR. DO NOT TRY TO MAKE THE CHILD VOMIT, THIS CAN DO MORE HARM THAN GOOD.

Children First Aid: Poisoning and harmful substances (VIDEO)

Heat illness and heatstroke

HEAT ILLNESS AND HEATSTROKE

Our bodies are normally cooled through sweating and radiating heat through our skin. Under certain circumstances (unusually high temperatures, high humidity, or vigorous exercise in hot weather) this natural cooling system may begin to fail, allowing internal heat to build up to dangerous levels. The result may be heat illness, which can result in heat cramps, heat exhaustion, sunstrokes or heatstroke.

Heat cramps:

Heat cramps are brief, severe cramps in the muscles of the legs, arms, or abdomen that can occur during or after vigorous exercise in extreme heat. The sweating that occurs with vigorous exercise causes the body to lose salts and fluids. And the low level of salts causes the muscles to cramp.

Kids are particularly susceptible to heat cramps when they haven't been drinking enough fluids. Heat cramps aren't serious.

What to do:

Most heat cramps don't require special treatment.

· Go to cool places. 

· Rest.

· Drink fluids. 

· Massage cramped muscles.

Heat Exhaustion:

Heat exhaustion is a more severe heat illness that can occur when someone in a hot climate or environment hasn't been drinking enough fluids. Symptoms may include:

· Dehydration

· Fatigue

· Weakness

· Clammy skin

· Headache

· Nausea and/or vomiting

· Hyperventilation (rapid breathing)

· Irritability

What to do:

· Bring the child indoors or into the shade.

· Loosen or remove the child's clothing.

· Encourage the child to eat and drink.

· Give the child a bath in cool (not cold) water.

· Call your doctor for further advice. If the child is too exhausted or ill to eat or drink, intravenous (IV) fluids may be necessary.

If you don’t treat it, heat exhaustion may escalate into heatstroke, which can be fatal.

Heatstroke

The most severe form of heat illness, heatstroke is a life-threatening medical emergency. The body loses its ability to regulate its own temperature. A quick medical treatment is required to bring the body temperature under control.

Factors that increase the risk for heatstroke include overdressing and extreme physical effort in hot weather without drinking inadequate fluid. 

Heatstroke also can happen when a child is left in, or becomes accidentally trapped in, a car on a hot day.

What to do:

Call for emergency medical help if your child has been outside in the sun exercising for a long time and shows one or more of these symptoms of heatstroke:

· flushed, hot, dry skin with no sweating

· temperature of 105° F (40.6° C) or higher

· severe, throbbing headache

· weakness, dizziness, or confusion

· sluggishness or fatigue

· seizure

· decreased responsiveness

· loss of consciousness

While waiting for help…

· Get the child indoors or into the shade.

· Undress the child and sponge him or her with cool water.

· DO NOT give fluids.

How to protect kids from heat illness:

· Teach kids to always drink plenty of fluids before and during an activity in hot, sunny weather.

· Make sure kids wear light-colored, loose clothing.

· Make sure your kids only participate in heavy activity outdoors before midday and after 6 PM.

· Teach kids to come indoors immediately whenever they feel overheated.

New - First Aid for Heat Stroke with Nick Rondinelli (Video) 

Wounds

WOUNDS 

Most children get cuts and scrapes once in a while. These wounds are usually minor and easily looked after. Larger or deeper wounds may need medical care.

How to treat cuts and scrapes:

· Wash your hands.

· Tell your child to sit or lie down.

· If the wound is bleeding: take sterile gauze (or a clean cloth) and press it on the wound, until the bleeding stops.

· Clean the cut or scrape with water (or a clean cloth). DO NOT use hot water. If there is any dirty or sand, you can clean a pair of tweezers with rubbing alcohol (or boiling water) and use them to pick out debris.

· Cover the cut or scrape until a scab forms: use a sticky (adhesive bandage) to cover the cut or scrape until it has dried or formed a scab. You can use an antibiotic ointment such as Polysporin to protect against infection and help keep the bandage from sticking to the wound.

· Once a cut or scrape has formed a scab, you can leave it open to the air. But if the wound is at risk of becoming dirty or irritated, keep it covered for protection.

· DO NOT USE: alcohol, iodine, mercurochrome, hydrogen peroxide, or similar agents to clean the wound. They will cause pain and irritation, and will not clean the wound better than water. 

How to care for more serious wounds: puncture wounds

Puncture wounds are deep, narrow wounds made by an object. It can be hard to tell how deep they are, and they are more likely to become infected. Your child may need a tetanus booster shot. If your child has a puncture wound, you should usually see a doctor.

   

When to see a doctor for cuts and scrapes

Cuts that are complicated may require a doctor's care, possibly including a repair with skin glue, stitches or staples.

Take your child to a doctor if ….

· You cannot stop the bleeding. 
· The cut seems very deep or keeps opening. 
· The edges of the cut are jagged or are far apart from each other. 
· Your child has been bitten by an animal or another child. 
· Your child has a puncture wound. 
· You cannot clean the injury properly. 
· You are concerned there may be a deeper injury such as a broken bone or possible tendon injury. 
· Your child is not using the affected hand, arm, or leg. 
· The injury involves sensitive areas like the eyes, face, or genital/anal area. 
· Your child's pain is not easily managed. 
· Your child is not immunized or has not had a tetanus immunization within the last 5 years. 
· You see signs of infection while the wound is healing, such as redness, pain, pus, fever, or red streaks.

  

Children First Aid Video: Bleeding (British Red Cross)

Insect Bites and allergies to insect stings

INSECT BITES

Insect stings and bites in young children may be painful, frightening, or irritating, but they're rarely a cause for concern unless your child has an allergic reaction. For most bites the local area to the bite is the primary issue for first aid.

Signs and Symptoms of Insect Bites

· Redness

· Pain

· Mild swelling

· Bruising

· Shock

Call to the doctor if ….

· Your child has been bitten or stung near the mouth

· The area seems to be getting larger or redder or is oozing, which are signs of infection.

What to do …

· Remove the stinger (for Honeybee stings)

• Honeybees are the only insects that leave a stinger in the skin. Scrape the area with a fingernail or credit card to remove it.
• Don't pinch the stinger with your fingers or tweezers -- that can inject more venom.

· Clean the area

• Wash the bite or sting with mild soap and water.

· Treat symptoms

• Remove any tight jewellery from the area of the bite or sting. It could be hard to get off once the area swells.
• Ice the area for 10 minutes and then remove the ice for 10 minutes. Then, repeat the process.
• If the sting was on an arm or leg, elevate the area.
• Pain relievers that are formulated for babies or children, such as acetaminophen (Tylenol) or ibuprofen (Advil, Motrin) can help. Be sure to follow the dosing instructions on the bottle. If your child is under the recommended age, call a paediatrician.
• An antihistamine formulated for children may help with swelling and itch. Call a paediatrician before using an antihistamine in infants or children.
• Apply a mixture of baking soda and water or calamine lotion for itch.

ALLERGIES TO INSECT STINGS

For a child who is allergic, insect stings can cause serious and sometimes even deadly reactions. Insects that can trigger allergic reactions include honeybees, yellow jackets, hornets, wasps, and fire ants. When they sting, they inject venom into the skin.

The severity of an insect sting reaction varies from person to person. There are three types of reactions: normal, localized, and allergic:

· A normal reaction:  pain, swelling, and redness around the sting site.

· A large local reaction: swelling that extends beyond the sting site. For example, someone who has been stung on the ankle may have a swelling in the entire leg. Although it may looks alarming, it is not usually more serious than a normal reaction.

· The most serious reaction to an insect sting is an allergic one. This condition requires immediate medical attention.

What are the symptoms of an insect sting allergy?

Symptoms of a severe insect sting allergy (called an anaphylactic reaction) can include one or more of the following:

·Difficulty breathing

· Hives that appear as a red, itchy rash and spread to areas beyond the sting

· Swelling of the face, throat or mouth

· Swallowing difficulty

· Restlessness and anxiety

· Rapid pulse                   

· Dizziness or a sharp drop in blood pressure

Severe allergic reactions are not very common; they can lead to: shock, cardiac arrest, and unconsciousness in 10 minutes or less. This type of reaction can occur within minutes after a sting. Get emergency treatment as soon as possible.

A mild allergic reaction to an insect sting can cause one or more of the following symptoms at the site of the sting:

· Pain

· Redness

· Mild to moderate swelling

· Warmth at the sting site

· Itching

Insect sting allergy safety tips

The best way to prevent allergic reactions to insect stings is to avoid getting stung in the first place. Teach your child to:

· Avoid walking barefoot while on the grass.

· Avoid playing in areas where insects like to be, such as flower beds.

· Avoid drinking from open soda or juice cans and keep food covered when eating outside. Check for insects in drink cups and straws when outside.

· Remain calm and quiet around stinging insects. Move slowly to back away without any arm-waving or swatting.

· Never disturb an insect nest. Have an exterminator get rid of nests near your home.

· When in wooded areas, keep as covered up as possible. Long-sleeved shirts, long pants, socks, and closed-toe shoes can help keep the bugs away. (Loose clothing can allow insects to get between the clothes and skin.)

· Avoid perfumes, scented body products, and brightly coloured and flowered clothing because they all attract insects.

Interesting web page about: "Identifying insects and their bites"