Pediatric Emergency Procedures

Whether you're a parent or a child-care provider, knowing what to do in the event of an emergency is paramount. In fact, knowing the proper procedures for different emergencies can literally mean life or death to the child you're caring for. Being prepared with pediatric emergency procedures can make you more confident, and can increase the odds of being able to help a child in danger.

Preparing for an Emergency

• Prepare for common emergencies by ensuring that you have first-aid supplies, learning CPR and the Heimlich Maneuver, and taking steps to prevent children in your care from being hurt. Placing medicine bottles and cleaning supplies out of reach, inserting outlet guards into all outlets, placing barriers near stairways, and locking gates surrounding pools are just a few preventative methods. In the event of any emergency, call for an ambulance as you're attempting to treat the child. Quick contact with emergency services is imperative.

Cuts/Wounds/Stings

• Assess the situation. Superficial cuts and scrapes can be cleaned with mild soap and water, treated with an antibacterial cream, and then bandaged. Minor stings or bug bites can be treated with a paste created from baking soda and water. Allow the paste to remain for 10 to 15 minutes, rinse the sting, and then place an anti-itch cream on the sting.

  Cuts that are open or gaping (typically longer than 1/2 inch) may need cuts or sutures. Place clean, sterile gauze over the wound and apply pressure to staunch bleeding on the way to the hospital or while you're waiting for paramedics to arrive. Don't remove soiled gauze. Place new, clean gauze on top of the soiled gauze and continue applying pressure. If there is an object inside the wound, do not attempt to remove it, as it could cause more bleeding. Allow emergency professionals to deal with this.

  If the child has severed a finger, toe, or other limb, rinse it briefly to remove dirt. Place the severed limb into a zipper bag or other clean bag. Place the bag into a container filled with ice to preserve the limb. Professionals may be able to reattach the limb. Tourniquets should only be used if a child is in danger of bleeding to death. The use of a tourniquet can cause the child to end up losing a limb.

  To make a tourniquet, use a long, clean strip of cloth. Tie it around the limb that is bleeding and make a knot. Place a strong, straight item such as a wooden spoon or a ruler on top the knot and tie another knot over the item. Twist the item to cut off the blood supply to the limb. It is important to understand that a tourniquet should only be used to save a child's life. Otherwise, wait for professionals to arrive.

Burns

• Mild burns that are small and slightly red can be treated with topical burn ointment or aloe vera. Any burn on the face, hands, feet, or genitals should be seen by a doctor. In addition, if there is blistering, blackened or charred skin, or the burn area is greater than one limb, the child should be taken to the emergency room immediately.

  First-degree burns may produce redness, pain, and swelling. Second-degree burns are typically splotchy, swollen, and may produce blisters. Third-degree burns are dangerous and can damage all layers of skin, as well as muscle and nerves. The skin may look white or charred, and the patient may not feel pain, as nerves may have been damaged.

  For first and second-degree burns, run the affected area under cool water to direct heat away from the skin. This can be done until help arrives, or in the case of first-degree burns, for 10 to 15 minutes before treating with burn cream. If the child has what you suspect is a third-degree burn, do not run water over the burn. Do not attempt to remove any clothing that may be stuck to the burned skin. Try to elevate the burned area so that it's above the heart, and wait for emergency professionals to arrive.

Choking

• If the child in your care suddenly stops laughing or talking, begins turning blue, panics, or is unable to talk, she or he may be choking. Call emergency services immediately. For babies or toddlers, sweep your index finger over their tongue and into the back of their throat to check for an object. If you find an object, pull it out. If no object can be found, attempt to clear the passageways by hand thrusts.

  Turn the baby over so that he or she is facing the floor. Support him or her across the chest with one arm, and deliver firm blows with the palm of your hand between the child's shoulder blades. Do this five times before checking the child's mouth with your finger again. If you still can't find the object the baby is choking on, turn him or her over and utilize the hand thrusts again.

  For children between the ages of 3 and 6, you can use hand thrusts or the Heimlich Maneuver. To perform the Heimlich Maneuver, place your arms around the child's waist and lock your hands together in front of the child's body. Place your hands in the center of the child's sternum (breastbone) and quickly press down about 1/2 of the depth of the child's chest. Do this five times before assessing the child again, or checking for an object in the child's mouth. Turn the child over and deliver hand thrusts before checking again.

  For children over age 6, the Heimlich Maneuver is the best method to dislodge items that the child may be choking on. Continue to attempt to clear the child's throat while waiting for emergency professionals to arrive.

Performing CPR

• If your child is not breathing, call emergency services immediately and then begin CPR. Begin by placing the child on his or her back and clearing the airway by tilting the head back and lifting the chin slightly. Pinch the child's nose shut and cover his or her mouth with yours. Give two small breaths (lasting about one second each), and then place your ear near the child's nose or mouth to detect breathing.

  If the child isn't breathing and you can't detect a heartbeat, give the child 30 chest compressions. Place the palm of your hand directly over the child's sternum and then place your other hand above the first. Give quick chest compressions, forcing the sternum down about 1/4 to 1/2 the depth of the child's chest. The 30 chest compressions should be given at a rate of 100 compressions per minute.

  You can then give the child two more quick breaths. Listen again for signs of breathing or heartbeat before repeating the procedure. Continue the CPR procedure until emergency professionals arrive.