Basic First Aid Supplemental Pediatric First Aid Topics

1. Basic First AidSupplemental Pediatric First Aid Topics

2. Introduction Designed to be used with ASHI Basic First Aid and ASHI CPR and AED Materials cover child care topics required by most states Licensing requirements vary by state and may require additional topics Is consistent with Caring for OurChildren: National Healthand Safety PerformanceStandards; Guidelines forEarly Care and EducationPrograms, 3rd Edition at http://nrckids.org/CFOC3.

3. Emergency Action Plans • A must have for child care facilities • Written plan dealing with: • Children • Staff • Volunteers • Child care providers review plan: • When hired • Once per year from then on

4. Emergency Action Plan Contents National Standards for Emergency Action Plans include: Managing emergencies for children with special health needs When and how to notify of parent or guardian Going with a child to an urgent care facility and staying with the child until the parent or guardian gets there to take over

5. Emergency Action Plan Contents • Getting emergency medical care and consent forms signed by the parent or guardian to medical personnel • Managing other children during an emergency • Providing a backup caregiver, teacher, or substitute • Pre-planning what urgent care facility to use • Completion of a written incident or injury report • Inspection and restocking of first aid kits • Reviews of staff members’ ability to perform first aid • Staff supervision following an incident when a child is lost, missing, or seriously injured

6. Talking to Children about the Emergency Action Plan Preparing children for the possibility of a medical emergency: • Do practice drills • Stress the importance of following directions • Invite EMS and Fire personnel to work with children • See "Listen, Protect, Connect" — Psychological First Aid for Teachers and Schools; http://www.ready.gov/kids/downloads/PFA_SchoolCrisis.pdf

7. Incidents and Injury Reporting for Child Care Facilities State child care licensing offices require reporting of injuries Many states have forms that must be used All child care providers should be familiar with their state’s incident or injury report form

8. Incidents and Injury Reporting for Child Care Facilities National standards recommend that report forms provide the following information: Name, sex, and age of the injured person Date and time of injury Location where injury took place

9. Incidents and Injury Reporting for Child Care Facilities • Description of how the injury occurred including: • Who saw the incident • What they reported • What was reported by the child • Body parts involved • Description of any consumer product involved • Name and location of the staff member responsible for supervising the child at the time of the injury • Actions taken by staff members

10. Incidents and Injury Reporting for Child Care Facilities Recommendations for actions to avoid future incidents Name of person who completed the report Name, address, and phone number of the facility Signature of the child’s parent or guardian or of the adult injured Documentation that the report was sent home the day of the injury

11. Addressing Other Children’s Needs • During a medical emergency, the needs of the other children still need to be met. Develop a plan that specifies: • Which staff member(s) will handle the medical emergencies • How the supervision of the other children will be handled

12. Addressing Other Children’s Needs • In general: • Keep the other children away from the emergency • Keep the other children safe • Answer their questions simply and honestly • Maintain normal routines

13. Illness-related Emergencies • Conditions and illnesses can trigger medical emergencies • Suspect serious illness when child has: • Sudden onset of fever • Headache • Stiff neck • Blood-red or purple rash

14. Other Warning Signs • Change in mental state • Breathing difficulty or shortness of breath • Pain, severe pressure, or discomfort in the chest • Severe abdominal pain

15. Early Warning Signs • Catch • Take action • Improve overall outcome

16. Meningitis • Caused by an infection of the fluid surrounding the: • Brain • Spinal cord • Signs and symptoms: • Sudden fever • Vomiting • Headache • Stiff neck

17. Other Illness Considerations Temperature • Rising temperature is body’s defense against infection • Can be taken in the: • Mouth • Rectum • Armpit • Ear

18. Other Illness Considerations Fever Guidelines — • Immediate medical attention when a child under 4 months old has a temperature of • 101°F rectally • 100°F in the armpit • Medical attention within an hour for an infant under 2 months old with any fever • Report fever in children older than 4 months to parent or guardian: • 101°F orally, • 102°F rectally • 100°F in armpit • and 101°F in ear

19. Other Illness Considerations Vomiting — Be sure the airway is clear Vomiting more than once within 24 hours Vomiting with a fever, stiff neck, or head injury Vomit with a green or bloody appearance Vomiting occurring with a lower urine output

20. Other Illness Considerations Diarrhea — • Blood or mucus in stool • Abnormal color (very black or very pale) • Diarrhea with less urineoutput • Diarrhea with fever • Diarrhea with jaundice or a yellow coloring to skin or eyes

21. Other Illness Considerations Rash – Can be an indicator of illness Refer to pages 5 - 6 in the supplement for more information

22. Shaken Baby Syndrome Shaken Baby Syndrome • Dangerous due to larger head vs. body • Injury may cause: • Blindness • Seizures • Retardation • Paralysis • Death

23. Shaken Baby Syndrome • Shaken Baby Syndrome • Crying is often the trigger • Understand normal crying • Know when to call health care provider • Caregivers • Know the dangers of shaking • Not overly stressed • No alcohol or drug abuse

24. Shaken Baby Syndrome • Signs and Symptoms vary depending on force • Cranky • Listless • Tremors • Vomiting • Seizures • Coma • Death

25. Caring for Children with Special Health Needs • Special needs: • Chronic condition • Requires health services • Often requires medical equipment

26. Special Health Care Needs • Children who have: • Seizures • Life-threatening or severe allergic reactions • Diabetes • Asthma or other breathing difficulties

27. Care Plan for Children with Special Needs More information, including a Care Plan form, can be found in Caring for OurChildren: National Healthand Safety PerformanceStandards; Guidelines forEarly Care and EducationPrograms, 3rd Edition at http://nrckids.org/CFOC3, Appendix BB.

28. Care Plan for Children with Special Needs • Parent or guardian works with Health Care provider to create a care plan • Care plan includes: • Child information • Routine care information • Needed accommodations • Special equipment/medical supplies • Emergency care • Suggested special training for staff • Parental notes • Signature

29. Care Plan for Children with Special Needs Example from New Jersey Dept. of Health and Senior Services

30. Care Plan for Children with Special Needs Example from New Jersey Dept. of Health and Senior Services

31. Care Plan for Children with Special Needs Example from New Jersey Dept. of Health and Senior Services

32. Care Plan for Children with Special Needs Example from New Jersey Dept. of Health and Senior Services

33. Care Plan for Children with Special Needs Example from New Jersey Dept. of Health and Senior Services

34. First Aid for Children with Special Needs • Secure the child’s safety: • Wheels locked when moving child from a wheel chair to flat surface • Do not interfere with the child’s specialized medical equipment • Follow initial steps described in the child’s Care Plan while waiting for parent or EMS arrival • Additional condition-specific procedures may be required