NCFE CACHE Level 3 Award in Paediatric First

Aid

Learning Outcomes1.1. Define responsibilities of a paediatric first aider.1.2. Explain how to minimise the risk of infection to self and others.1.3. Describe first aid and personal protection equipment required for emergencies. 1.4. Describe how to use first aid and personal protection equipment safely.

DEFINITION OF FIRST AID

FIRST AID IS THE INITIAL OR IMMEDIATE ASSISTANCE GIVEN TO SOMEONE WHO HAS

BEEN INJURED OR TAKEN ILL BEFORE THE ARRIVAL OF QUALIFIED MEDICAL

ASSISTANCE

THE AIMS OF FIRST AID

1. TO PRESERVE LIFE2. PREVENENT THE CONDITION FROM

WORSENING3. PROMOTE RECOVERY4. Can you think of two more? 5. Activity 1 (1.1)

RESPONSIBILITIES OF A PAEDIATRIC FIRST AIDER

• Preserve life• Prevent further injury• Promote recovery• Scene assessment• Dealing with casualties• Contacting emergency servicesActivity 1 (1.1)

RESPONSIBILITIES OF A PAEDIATRIC FIRST AIDER

Dealing with Casualties• Protect yourself (hygiene, cross infection)• Check level on consciousness (A.V.P.U.)• Airway and breathing• Assess the extent of the injury or illness (secondary

survey and monitor vital signs)• Treat in order of priority• Be calm and confident• Ensure qualified help has been called for

Additional dangers to be aware of as a first aider

• Infection – casualty to first aider– H.I.V.– Hepatitis

• Infection – first aider to casualty– Wound infection– How can we minimise these risks?

How can you minimise the

risk of infection to your self or

others?1.2

HYGIENE • GLOVES• FACE SHIELD• CLEAN HANDS• CROSS INFECTION• APRON• CLEAN AREA (MOUTH)• TAKE TIME

Explain how these items minimise the risk of infection to your self and to others? 1.2

Please describe what these items are 1.3

Reduce the risk to yourself & the casualty by:

Use gloves if available•Dispose of sharp objects carefully – ideally into a special sharps container•Dispose of blood stained or contaminated materials (bandages etc) by using an orange / yellow bag – marked for incineration

Contents of a first aid box

Activity 3 (1.3)

Research first aid equipment and how it should be used appropriately.

Contents of a first aid box

• 1 leaflet giving general guidance on first aid• 1 protective face shield for CPR• 20 plaster (hypoallergenic)• 2 sterile eye pads• 4 triangular bandages• 6 medium wound dressings• 2 large wound dressings• 5 low adherent dressings (melolin)• 1 roll hypo allergenic tape• 3 pairs disposable gloves• 10 packs of 5 sterile gauze swabs• 1 finger bandage and applicator• 1 litre of sterile waterActivity 3 (1.3)

Describe how to use first aid and personal protection equipment required for emergencies'. 1.4

1.4. Describe how to use first aid and personal protection equipment safely.

• Complete your work book to date

NCFE CACHE Level 3 Award in Paediatric First

Aid

Learning Outcomes

1.5. Identify what information needs to be

included in an accident report/ incident record.1.6. Explain reporting procedures following an

accident/incident.1.7. Define an infant and a child for the purposes

of first aid treatment.

Accident / Incident Record Activity 4 (1.4)Cross reference to 11.1, 11.2 Unit 3 main

programme What is an accident?What is an incident?How do you report record an accident / incident

within your setting?What in formation is required to complete your

accident report form?

ACCIDENT AND INCIDENT REPORTING

Following any accident or incident it is important to record all details relating to the situation. The information contained in the accident book can often help employers to indentify accident trends and improve the general Health and Safety of the workplace. These records may also be required for insurance and investigative purposes. In 2003 a new accident book was introduced to comply with data protection legislation. It is designed so that any individual recording an accident is unable to access personal details of previous records.

Planning for an emergency

In your groups make an emergency plan of action

Planning for an emergency• Access to telephone• Do you have someone to who can care for the children if

you have to leave them• Do you have a fully equipped first aid box that is easy for

you and others to find• Are the children’s record forms to hand so you can take

them to the hospital with you• Do you have a fire escape plan? What if the stairs and the

exits are blocked? Do you have an agreed meeting point outside?

Planning for an emergency Do the parents know what to expect if there is an

emergency and what you will ask of them Make a list of important phone numbers that you and

others can find easily1. Parents of the children (home, work, mobile)2. Doctors surgery (yours and the children)3. NHS direct advice line4. Emergency back up person5. Ofsted advisor or Childminding Network Co-ordinator

CONTACTING THE EMERGENCY SERVICES

• If possible take the baby or small child with you• State the service you require• Give your telephone number• State your location• State type of incident• Give number of casualties• State type and extent of the injuries• State any dangerous hazards

11.1,11.2

DEFINITION OF PAEDIATRIC FIRST AID

AGES0-12 months = Baby or an infant

1 year to puberty = a child

NB – common sense must prevail !!Activity 1.7

1.5. Identify what information needs to be included in an accident report/ incident record.

1.6. Explain reporting procedures following an accident/incident.

1.7. Define an infant and a child for the purposes of first aid treatment.

• Complete your work book to date

NCFE CACHE Level 3 Award in Paediatric First

Aid

Learning Outcomes

Be able to:-

2.1. Conduct a scene survey.2.2. Conduct a primary survey on an infant and a

child.2.3. Identify when to call for help.

2.4. Explain what information needs to be given when obtaining assistance.

The Primary Survey

D – Danger to yourself and the casualtyR – Response from the casualtyA – Airway – is it clear and openB – Breathing – is the casualty breathing normallyC – Circulation – look for signs of major bleeding

(Think Dr ABC)

Assess for Danger

Fire & Smoke Vehicles

Electricity

Water Chemicals

People Falling objects & machinery

Road traffic accident

Additional dangers to be aware of as a first aider

• Infection – casualty to first aider– H.I.V.– Hepatitis

• Infection – first aider to casualty– Wound infection

R – Response from casualty

• Check for a response from the casualty– As you approach the casualty shout ‘ hello, my name is As you approach the casualty shout ‘ hello, my name is

… I’m a first aider and I am here to help you.… I’m a first aider and I am here to help you.– Kneel down beside the casualty, place one hand on his / Kneel down beside the casualty, place one hand on his /

her forehead and use the other hand to TAP the collar her forehead and use the other hand to TAP the collar bones. bones.

– Shout ‘ hello, ‘open your eyes’Shout ‘ hello, ‘open your eyes’– If no response SHOUT FOR HELPIf no response SHOUT FOR HELP

R – Response from casualty

• Tap and Talk

A - Airway

• Check if the airway is clear– Gently open the casualty’s mouth– Look inside for any foreign object that may be blocking

the airway i.e. chewing gum, food – False teeth may be left in place if well fitting –

otherwise remove– If vomit or blood are present turn the head to one side

and allow it to drain

SHOUT FOR HELP

ONCE YOU HAVE DETERMINED THE CASUALTY’S

LEVEL OF RESPONSE SHOUT OUT FOR HELP BUT DO NOT LEAVE YOUR CASUALTY UNTIL YOU HAVE CHECKED THE AIRWAY AND BREATHING

B – Breathing 1

• Check if the casualty is breathing– Tilt the head backward to lift the tongue away from the Tilt the head backward to lift the tongue away from the

wind pipe at the same time place two fingers on the wind pipe at the same time place two fingers on the bony part of the chin and slide the jaw forwardbony part of the chin and slide the jaw forward

– Place your ear against the casualty’s mouth and look, Place your ear against the casualty’s mouth and look, listen and feel for breathing for 10 secondslisten and feel for breathing for 10 seconds• Look – for signs of the chest rising and fallingLook – for signs of the chest rising and falling• Listen – for breathing soundsListen – for breathing sounds• Feel – for movement of the chestFeel – for movement of the chest

B – Breathing 2

• Check if the casualty is breathing– Tilt the head Tilt the head

backward with one backward with one hand and place two hand and place two fingers under the fingers under the chin to slide the chin to slide the jaw forwardjaw forward

B – Breathing

• If the casualty is breathing normally but unconscious, and you have no bystander to send for help immediately place them in the recovery position

• Look for and treat any major bleeding (C)• Carry out a brief secondary survey• Call for help (999 or 112) on your return re-check

airway and breathing, stay with the casualty until help arrives.

B – Breathing

2.4 If the casualty is breathing, go for help immediately – or send a bystander (call 999)

– L - Location of the casualtyL - Location of the casualty– I - IncidentI - Incident– O - Other services required (fire or police)O - Other services required (fire or police)– N - Number of casualtiesN - Number of casualties– E - Extent of their injuriesE - Extent of their injuries– L - Repeat the locationL - Repeat the location

THE A.B.C. OF LIFEWhat is the priority in this case?What is the priority in this case?

Answer…………..AirwayAnswer…………..Airway

TASK http://www.nhs.uk/Conditions/Accidents-and-first-aid/Pages/CPR.aspx

In pairs demonstrate how to perform CPR Adult, child and babyRemember to conduct your scene survey

Recovery Position

http://www.sja.org.uk/sja/first-aid-advice/first-aid-techniques/the-

recovery-position.aspx

RECOVERY POSITION

• WHY – allows for drainage of fluids prevents tongue falling to back of throat

safe position…

• WHEN – if you have to leave casualty to get assistance, or if there is no suspicion of spinal trauma, after A.B.C has been established.

GO FOR HELP

• IF THE SITUATION IS TOO DANGEROUS FOR YOU TO DEAL WITH THE CASUALTY

• ONCE YOU HAVE CHECKED THE LEVEL OF RESPONSE

• THE AIRWAY AND BREATHING HAVE BEEN CHECKED

• THE CASUALTY IS IN A SAFE POSITION - RECOVERY

PREGNANT CASUALTY

• Best treatment for the unborn child is treat the mother

• Primary survey first

• If casualty is heavily pregnant , then the weight of the baby / uterus will compress her large blood vessels

• Right hip slightly raised (displaces uterus )

NCFE CACHE Level 3 Award in Paediatric First

Aid

Learning Outcomes

Be able to:-

3.1. Assess the level of consciousness of an infant and a child.3.2. Explain why an infant and a child should be placed in the

recovery position.3.3. Place an infant and a child in the recovery position.

3.4. Continually monitor an infant and a child

whilst they are in the recovery position.3.5. Assist an infant and a child who is experiencing a seizure.

Be able to provide first aid for an infant or child who is unresponsive and breathing normally

In pairs discuss and note how we would :- Assess the level of consciousness of an infant and

a child. Why should an infant or child be put in the

recovery position? In pairs demonstrate how to put each other / baby

dummies into the recovery position this will be demonstrated in your final assessment.

EPILEPSY – What is it?

Primarily two types – Major and Minor

However, some young children experiencewhat is termed as a Febrile Seizure whichis brought on when the child has a hightemperature or infection.

FEBRILE SEIZURE

Recognition• Flushed and sweating• Body may stiffen and the back arch• Fists may be clenched• Casualty may hold their breath and appear blue in colour.

FEBRILE SEIZURE

Treatment• Protect them with cushioning or padding• Cool them down by removing clothes and ensuring a

fresh supply of cool air• When seizures stop place them into the recovery position

and monitor signs of life• If they become unconscious call 999

EPILEPSY – What is it?

A disorder of brain function that can be brought on by head injuries, emotional upset, anxiety, a reaction to certain foods, changes in body temperature, vibration, flashing lights and even tiredness.

Minor seizures are a brief loss of consciousness sometimes only lasting for a few seconds. Convulsive movements usually accompany major seizures.

EPILEPSY – MINOR

Recognition• Sudden absence• Staring blankly ahead• Slight twitching of the face, lips, eyes and limbs• Chewing and lip smacking• Plucking at clothing• Noises

EPILEPSY – MINOR

Treatment• Make the casualty safe, sit them down and reassure them• Monitor and discuss the condition with the casualty• Establish a history of the condition and ask if medication

is being taken• Refer to a doctor if necessary

Some of the steps may need to be done with a parent

EPILEPSY - Major

Recognition• A warning period (casualty may have strange sensations)• Casualty becomes rigid and often cries out• Sudden collapse and becomes unconscious (tonic phase)• Cyanosis (grey / blue skin, particularly the extremities

such as the lips and the ear lobes) may be present and breathing may cease…..

EPILEPSY - Major

Recognition cont…• Convulsive movement, which can be violent (clonic

phase)• Loss of bladder or bowel control• Clenched jaw and congestion of the face.

• https://www.youtube.com/watch?v=7MPJauo4DdY

• Take notes how would we treat someone after they have suffered a seizure.

EPILEPSY - Major

Treatment• Make area around the casualty clear and safe• Do not restrain the casualty (make comfortable)• Place padding under their head• DO NOT put anything in their mouth• Loosen tight clothing (if safe to do so)• Record duration of the seizure• Dial 999 if the seizure lasts more than 3 minutes….

EPILEPSY - Major

Treatment cont….• Dial 999 if multiple seizures occur or if it is their first

seizure, any injuries occur, if the seizure occurred in water (possible secondary drowning)

• Place into the recovery position and monitor until they have recovered.

NCFE CACHE Level 3 Award in Paediatric First

Aid

Learning Outcomes

Be able to:-

4.1. Identify when to administer Cardio Pulmonary Resuscitation (CPR) to an unresponsive infant and an unresponsive child who is

not breathing normally.

4.2. Administer CPR using an infant and a child manikin.

CPR

Start CPR!

https://www.youtube.com/watch?v=ILxjxfB4zNk

https://www.youtube.com/watch?v=avYRvVHAvfM

NCFE CACHE Level 3 Award in Paediatric First

Aid

Learning Outcomes

Be able to:-5.1. Identify when a foreign body airway

obstruction is:

· mild· severe.

5.2. Administer first aid to an infant and a child who is choking.

CHOKING - ADULT• Check for danger• Ask ‘are you choking’• Tell them you are going to help them• Check Airway• Lean them forward, place your arm across the chest, stand to

one side of the casualty• Deliver 5 back blows – if obstruction is not removed• Stand behind the casualty wrap your arms around the waist,

place one fist (thumb side in between the belly button and the lower part of the sternum

• Place the other hand over the first fist and pull sharply inward and upwards – repeat this 5 times

• Repeat back blows and abdominal thrusts until the obstruction is removed or the casualty starts to lose consciousness

choking adult or child

5Back Slaps

5 Abdominal ThrustsCough!

http://www.redcross.org.uk/What-we-do/First-aid/Baby-and-Child-First-Aid/Choking-child?gclid=CJnvjfj948ACFZMRtAod-xoAbQ

choking baby

5Back Slaps

5Chest Thrustshttps://www.youtube.com/watch?v=h4uS5EmpeEs

choking - unconscious

Start CPR!

UK choking statistics

About 16,000 cases of choking are treated in UK hospitals each year

In 1999, a total of 218 people choked to death on food. A further 55 died after choking on non-edible objects

About half the choking fatalities in 1999 were men and women aged 75 and over

About 2,600 choking accidents in the UK each year involve children under four years of age

Task In pairs demonstrate how you would treat a person who is chocking Adult – Please use Vest Baby Dummies Child Dummies This will form your practical assessment for 5.1 and 5.2

NCFE CACHE Level 3 Award in Paediatric First

Aid

Learning Outcomes

Be able to:-

6.1. Describe the types and severity of bleeding in infants and children.

6.2. Explain the effect of severe blood loss on an infant and a child.

6.3. Control external bleeding.

TYPES OF WOUNDS• What types of wounds can you think of?Answers on the white board please

• BRUISES OR CONTUSIONS• LACERATIONS• INCISIONS• GRAZES• PUNCTURE • GUN SHOT

TYPES OF BLEEDINGArterialArterial

VenousVenous

CapillaryCapillary

from an artery under direct pressure from from an artery under direct pressure from thethe heart. Rich in oxygen said to be bright red, heart. Rich in oxygen said to be bright red, spurts from a wound… spurts from a wound… not under direct pressure form the heart but may not under direct pressure form the heart but may

carry same volume of blood as arteries. Depleted carry same volume of blood as arteries. Depleted of of oxygen so is said to be dark red, may ‘ooze’ oxygen so is said to be dark red, may ‘ooze’ profusely. profusely. occurs in all wounds, although blood loss may occurs in all wounds, although blood loss may start off quite fast at first, blood loss is usually start off quite fast at first, blood loss is usually slight. slight.

BLEEDING CONT..

HOW MUCH BLOOD DO WE HAVE?• Varies in relation to our size…• Rule of thumb 1 pint per stone in body weight…

average weight 70kgs• Average adult 8-12 pints (4.5 to 6.5 litres)…• Children have less so they cannot afford to loose

the same amount…• An infant only has around 1 pint of blood, so they

can only loose 1/3 of a pint before the blood pressure falls.

How much blood loss is critical

The body can compensate if it is losing blood.It does this by : • Closing down the blood supply to non-

emergency areas of the body (including the skin and digestive system)

• Speeding up the heart to maintain blood pressure.

How much blood loss is critical

Blood vessels can only close down so much andThe heart can only go so fast so there is a Limit to how much blood the body can lose.

The body can no longer compensate after 1/3of its blood has been lost.

After this the blood pressure falls quickly The blood supply to the brain falls and deathwill result

BLEEDING CONT..EFFECTS OF BLOOD LOSS – HYPOVOLEAMIC SHOCK

BLOOD LOSS 10% 20% 30% 40%+CONSCIOUSNESS NORMAL MAY FEEL

DIZZY STOOD UP

LOWERED LOC RESTLESS, ANXIOUS

UNRESPONSIVE

SKIN NORMAL PALE CYANOSIS, COLD & CLAMMY

SEVERE CYANOSIS, COLD & CLAMMY

PULSE NORMAL (THIS IS AMOUNT DONATED)

SLIGHTLY RAISED

RAPID (OVER 100/MIN) HARD TO DETECT

UNDECTABLE

BREATHING NORMAL SLIGHTLY RAISED

RAPID DEEP SIGHING BREATHS (AIR HUNGER)

METHODS OF CONTROLLING EXTERNAL BLEEDING

• Primary survey• Correct casualty positioning• Examine / Expose wound…• Do not remove foreign objects…• Elevation…• Direct Pressure, apply dressings (2 max)…• Think SHOCK

PRESSURE POINTS

INTERNAL BLEEDING

• Blood is not actually lost ‘externally’ from the body, it is lost out of the arteries and veins so shock can quickly develop

• Can be difficult to recognise in it’s early stages• Can be of a result of direct trauma to chest or

abdomen• Can happen spontaneously i.e. bleeding into the

stomach from an ulcer or weak artery

INTERNAL BLEEDINGSIGNS & SYMPTOMS

• History…• Signs and Symptoms of Shock…• Pain…• Bruising and / or swelling…• Other symptoms related to the site of bleeding (i.e.

difficulty in breathing if the bleeding is in the lung).

INTERNAL BLEEDING CONT…

Bleeding from the lower bowel/rectum. Possibly haemorrhoids or injury.Bleeding from the large intestines/bowel

Bright red fresh blood

Black ‘offensive smelling’ stools

Anus

Menstruation, miscarriage, injury or disease to the vagina or womb.

Fresh blood or clotsVagina

Bleeding in the kidneys or bladder.

Smoky red colourUrethra

Bleeding in the lungs.Bleeding in the stomach.

Bright red, frothyVomited, or brown ‘coffee grounds’ appearance

Mouth

Nose bleed.Fractured skull, leaking cerebrospinal fluid from around the brain.

Bright red / clotsBlood with a ‘watered down’ appearance

Nose

Perforated ear drum, fractured skull.Fractured skull, leaking cerebrospinal fluid from around the brain.

Bright red / clots

Blood with a ‘watered down’ appearance

EarPossible causesAppearanceBleeding from

Demonstrate control of Bleeding

• Remember your hygiene measures

Compression • Elevation • Elevated sling

• http://www.youtube.com/watch?v=JQdvMC87l94

• http://www.youtube.com/watch?v=C63rt-fleGY

NCFE CACHE Level 3 Award in Paediatric First

Aid

Learning Outcomes

7.1. Define the term ‘shock’relevant to first aid.

7.2. Describe how to recognise an infant and a child who is suffering from shock.

7.3. Explain how to manage the effects of shock.

DEFINITION OF SHOCK

A LACK OF OXYGEN TO THE TISSUES OF THE BODY WHICH IS CAUSED BY A FALL IN BLOOD

VOLUME OR BLOOD PRESSURE

HOW TO RECOGNISE SHOCK

• ANY OBVIOUS CAUSE• SKIN – PALE AND CLAMMY (WITH BLUE OR

GREY TINGES IF SEVERE)• DIZINESS OR PASSING OUT• PULSE – FAST AND WEAK• BREATHING – RAPID AND SHALLOW• NAUSEA

TREATMENT OF SHOCK

• PRIMARY SURVEY• TREAT ANY OBVIOUS CAUSE• POSITION OF CASUALTY – LAY OR SIT

THEM DOWN • RAISE THEIR LEGS IF THERE IS NO OTHER

INJURY• KEEP THEM WARM• NIL BY MOUTH

In pairs demonstrate how you would treat shock

https://www.youtube.com/watch?v=V4R9GSah93g

Task

Produce a Fact sheet to:- •Define the term ‘shock’ relevant to first aid.•Describe how to recognise an infant and a child who is suffering from shock.•Explain how to manage the effects of shock.

NCFE CACHE Level 3 Award in Paediatric First

Aid

Learning Outcomes

8.1. List common triggers for anaphylaxis.8.2. Describe how to recognise anaphylaxis in an

infant and a child.8.3. Explain how to administer first aid for an

infant and a child with anaphylaxis.

Why does anaphylaxis happen….

Your body’s immune system is reacting badly to the presence of a foreign object

(e.g. food or a substance) it wrongly perceives as a threat.

What part of the body does it affect?

How quickly does it happen ?

What are the routes of entry?

How does the body reactBody releases a massive amount of histamine and other Chemicals into the blood stream

Blood vessels widen leading to a sudden and severe Lowering of the blood pressure.

Constriction on the Airway

Local anaphylaxis/allergic reaction

This cause urticaria and or oedema at the site Of exposure to the allergen, this may lead ontoA full anaphylactic or Anaphylactiod reaction

Urticaria -

Effects of the body..

Signs and Symptoms of Anaphylaxis

• Anxiety• Swelling of the face and neck• Swelling of the mouth and tongue• Red blotchy skin• Difficulty in breathing• Rapid pulse• Signs and symptoms of shock

Treatment• Primary survey – DRAB• Ensure 999 has been called• If casualty is conscious sit them up to assist

breathing• Encourage casualty to use medication if available• Monitor the vital signs• Be prepared to carry out CPR• The casualty needs further medical attention even

if they appear to recover

Epi-pen

A patient who has suffered a previous anaphylactic Reaction may carry a syringe of adrenalin (Epi-Pen)

This can save the patient’s life if it is given promptly

The patient should be able to inject this on their own but, if necessary, assist them to use it.

Epi-pen

Task

• To produce a poster highlighting List common triggers for anaphylaxis.

• Describe how to recognise anaphylaxis in an infant and a child.

• Explain how to administer first aid for an infant and a child with anaphylaxis 8.1, 8.2 and 8.3

NCFE CACHE Level 3 Award in Paediatric First

Aid

Learning Outcomes

1.1. Describe types of fractures.

1.2. Recognise suspected: · fractures

· dislocations· sprains and strains.

1.3. Administer first aidfor suspected:

· fractures· dislocations

· sprains and strains.

4 MAIN TYPES• CLOSED – where the broken bone does not puncture the

skin• OPEN – where the broken bone has punctured the skin

creating a wound and possible infection• COMPLICATED – can be either closed or open and will

involve injury to another part of the body• GREEN STICK – Bones are more flexible and split but are

not totally severed. Often mistaken for sprains and strains.

CAUSES OF FRACTURES • Direct Force – slipping on a wet surface and landing on

you back or being struck with a blunt object• Indirect Force – landing heavily or awkwardly from a fall

or jump – bones in the foot may break but also possibly leg, pelvis, spine and skill

• Muscular contraction – electricity, epilepsy• Twisting Force – torsion forces on the bones and muscles• Pathological – bones have become brittle or weak due to

disease

Recognition of a Fracture• Pain• Loss of Power• Unnatural movement• Swelling or bruising• Deformity• Irregularity• Crepitus• Tenderness

Treatment of Fracture/break Keep injury still and the child warm Dial 999 for an ambulance if1. There is a suspected injury to the spine, head or neck2. The child has difficulty breathing3. There is deformity, irregularity or unnatural movement4. It is an open fracture5. Child is in a lot of pain treat for SHOCK6. You cannot easily get the child to hospital whilst keeping the injury

still Cover open wounds with a dressing

Treatment of a Dislocation • If in doubt treat as a fracture / break• DO NOT try to relocate the dislocation• Support the dislocation• Keep the child warm• Do not give anything to eat or drink• THINK SHOCK

NCFE CACHE Level 3 Award in Paediatric First

Aid

Learning Outcomes

2.1. Describe how to recognise suspected: · concussion

· skull fracture· cerebral compression

· spinal injury.

2.2. Administer first aid for suspected: · concussion

· skull fracture· cerebral compression

· spinal injury.

HEAD INJURIES

The skull is usually able to provide adequate protection for the brain if it receives a blow to it. When the injury is more serious the skull could fracture and lead to damage to the brain.

All injuries to the head should be treated as serious as they are potentially dangerous.

Medical assistance should be considered in all cases.

THE BRAIN

Cerebrum

Cerebellum

Medulla Oblongata

Cerebrospinal Fluid

THE BRAINCONSISTS OF THREE COMPONENT PARTS

Cerebrum – consists of two hemispheres (left and right) – houses sensory functions, motor functions and higher intellectual functions such as intelligence and memory.

Cerebellum – co-ordinates movement

Brainstem – controls all the vital automatic function, contains the medulla which controls temp, heart rate, breathing, swallowing.

TYPES OF HEAD INJURIES

• Concussion – can be thought of as a ‘shaking up’ of the brain.

• Compression – bleeding or swelling in the cranial cavity

• Skull fracture – blunt or penetrating trauma

SIGNS and SYMPTOMS

pupils

Normal

Unequal

Dilated

ASSESSMENT CONT..

P - PupilsE - EqualA - AndR - ReactL - Light

Concussion CompressionUnconsciousness for a short period, followed by an increase in levels of response and recovery.

Could have a history of recent head injury with apparent recovery, but then deteriorates

Short term memory loss (particularly of the incident). Confusion, irritability.

Levels of response become worse as condition develops

Mild, general headache. Intense headache.

Pale, clammy skin. Flushed, dry skin.

Shallow / normal breathing. Deep, noisy, slow breathing.(Pressure on the respiratory control area of the brain)

Rapid, weak pulse. (Blood diverts away from the extremities)

Slow, strong pulse. (Caused by raised blood pressure)

Normal pupils, reacting to light. One or both pupils dilate as pressure increases on the brain.

Possible nausea or vomiting on recovery. Condition becomes worse. Fits may occur. No recovery.

head injuries

compression

Concussion• Sit a conscious casualty down or place in recovery position if

weak and unsteady• If unconscious and breathing place into recovery position• Seek medical assistance as situation calls for• Monitor airway, breathing and response levels (AVPU)• Keep casualty calm and warm • Do not let them resume play

Compression

Treatment• If conscious lay casualty down and raise the head and

shoulders• Monitor airway, breathing and response levels• Loosen tight clothing• Keep warm and reassure• Dial 999 if not already done so• If unconscious try to keep in position found unless you have to

leave them• Be prepared to carry out CPR• Do not give them anything to eat or drink

SKULL FRACTURES• Occur mainly in two places• The dome or vault (back of the skull) this is

usually due to direct force• Base of the skull from indirect force from a fall• Consider always injury to the spine• Look for obvious wounds• Be aware of signs and symptoms of concussion

and compression

SKULL FRACTURE

Recognition• Evidence of a head injury and unconsciousness• Wound, bruise or depression in the skull• Deterioration in response levels• Fluids from the ears and nose• Blood in the whites of the eyes• Distortion of the head and face• Associated spinal injuries

SKULL FRACTURE

Treatments• Dial 999 or 112 for an ambulance• Control any bleeding and fluid loss• If you suspect spinal injury do not move casualty• If unconscious but breathing keep them in position you found

them (neck and back damage may be present)• If you are UNABLE to manage the airway turn them into the

recovery position (use log roll if you can)……• If you are able to move them as NO neck and spinal injuries are

suspected raise the head and shoulders

SKULL FRACTURE

Treatments• If you are able to move them as NO neck and spinal injuries are

suspected raise the head and shoulders• Monitor the vital signs – level of consciousness (AVPU)

breathing rate, pulse rate, PEARL etc• Treat for shock• Be prepared to carry out CPR if required

NCFE CACHE Level 3 Award in Paediatric First

Aid

Learning Outcomes

3.1. Identify conditions affecting the:

· eyes· ears

· nose.3.2. Explain the action to take when conditions

are identified.

Blow to the eye – check for injuries to the eyeball, injuries to the eye socket andAssociated injuries to the head and neckDo not remove any embedded foreign objectsClean any cuts to prevent infectionUse glovesWash handsCheck vision – PEARLSeek medical help if required

EYE INJURIES

EYE INJURIES (SERIOUS)

• Keep the child still and gently hold a soft sterile dressing over the injured eye (this can be carefully bandaged in place if required)

• Ask the child to close their good eye to avoid movement of the injured eye (if necessary bandage the good eye)

• Reassurance of the child is essential and if both eyes have been covered DO NOT leave them unattended

• Take the child to hospital or dial 999 if necessary

Eye Injuries Chemicals

• Wash with copious (lots) of clean water ensuring the water runs away from the good eye

• Dial 999• Check COSHH if available

What conditions could effect the ears?

Discuss and take note

What action would you take?

Conditions effecting the ear • Cuts, scrapes, burns, or frostbite. When there's an injury (even

minor) to the outer ear or ear canal, bleeding and infection can affect other parts of the ear.

• Inserting something into the ear. Things like a cotton swab, fingernail, or pencil can scratch the ear canal or cause a tear or hole in the eardrum (called a ruptured eardrum).

• Direct blows to the ear or head. Falls, car accidents, sports injuries, or fights may tear the eardrum, dislocate the ossicles, or damage the inner ear. Wrestlers, boxers, and other athletes who endure repeated forceful hits to the outer ear can develop severe bruising or blood clots that block blood flow to the cartilage of the outer ear and damage its shape and structure (known as cauliflower ear).

Treatment for ear injury Make sure to call your doctor if :•The child has had any type of ear or head injury, even if it seems minor•any signs of problems with balance or hearing•severe ear pain•blood or fluid draining from the ear (that doesn't look like earwax)•If a child has an object in their ear try to see if the object will fall out simply by tilting your child’s head.•If you can see the object in the ear and think you can remove it easily, carefully pull it out with a pair of tweezers. Be careful not to push it in deeper, and don’t poke at the ear or try to remove the object by force. The ear canal is very sensitive, and this could be painful.•If this can not be done safely place a large sterile dressing over the ear and take the child to A&E.

Nose Injury

Discuss and take note

What action would you take?

Nose BleedsAction to take

Treatment for nose injury

Sit the child down, with their head tipped forward.Nip the soft part of the nose. Maintain constant pressure for 10

minutes.Tell the child to breath through the mouth

Give the child a disposable cloth to catch the blood.If bleeding persists, take the child to hospital in an upright position.

Task

Make a leaflet to provide information to a paediatric first aider to recognise

conditions affecting the eyes, ears and nose and inform them of what action they

should take. 3.1, 3.2

NCFE CACHE Level 3 Award in Paediatric First

Aid

Learning Outcomes

4.1. Describe how to recognise:

· sickle cell crisis· diabetic emergencies

· asthma attack· allergic reaction

· meningitis· febrile convulsions.

4.2. Explain how to manage:

· sickle cell crisis· diabetic emergency

· asthma attack· allergic reaction

· meningitis· febrile convulsions.

Task

• In your pairs research the signs and symptoms and treatments for:-

• sickle cell crisis· diabetic emergencies· asthma attack· allergic reaction· meningitis· febrile convulsions.

NCFE CACHE Level 3 Award in Paediatric First

Aid

Learning Outcomes

5.1. Describe how to recognise the effects of:

· extreme heat· extreme cold.

5.2. Explain how to manage the effects of:

· extreme heat· extreme cold.

Heat and Cold

The body’s thermostat is located in the brain and enables the body temperature to be monitored and to some extent, controlled at a level approximately 36.9 degrees Celsius.

The temperature control can be affected by extremes of external heat or cold, dehydration of the body’s fluid content by injury to the head or spine that in turn affects the central nervous system.

How does the body maintain its normal temperature ?

• Conversion of food into energy (metabolism), from external heat sources and by muscle activity

• In hot conditions blood vessels dilate allowing excess heat to be lost through the skin (sweating) and by increasing our breathing rate.

• In cold conditions the blood vessels contract which reduces sweating.

The effects of cold

• Shuts down the blood vessels in the skin – this stops the internal or core heat from escaping

• During prolonged exposure to cold, wet and windy conditions the core body temperature may fall below 35 degrees Celsius causing normal bodily function to slow down and eventually stop. This is known as hypothermia.

• Apart from the environmental conditions the casualty’s age and general condition play a large part in the development of hypothermia

Hypothermia

Recognition• Shivering (this will stop as the condition progresses)• Cold, pale and dry skin• Slow shallow breathing• Slow weak pulse• Strange irrational behaviour• Lethargy (very tired)• Unconsciousness leading to coma and cardiac arrest

HypothermiaTreatment• Find out how they have been exposed to the cold for

the length of exposure and the lower the body temperature determines the rate at which you should re-warm the casualty

• If a young person fall into cold water but is recovered quickly they will be a cold casualty but not hypothermic. These casualties can be warmed rapidly.

• Remember a drop in the body temperature causes hypothermia

Hypothermia

Treatment• Move the casualty to a sheltered and warm place• Keep the casualty in a horizontal position• Insulate them from the ground and surroundings• Treat for shock• Cover with blankets but do not overheat• Prevent heat escaping from the extremities• Call 999 or 112 and monitor their airway and

breathing….

Hypothermia

Treatment..• Do not give any food or drink• Do not rub the skin or put the casualty next to a heat

source• Do not stand them up or walk them around to get

warm• Do not overheat them warm them slowly

The effects of HeatHeat Exhaustion

• When the body temperature exceed the atmospheric temperature particularly in humid conditions heat will not evaporate from the body. This often takes place with strenuous exercise causing a loss of salt and water from the body (dehydration). This is known as heat exhaustion and because the fluid component of the blood is reduced and the casualty will suffer from shock.

HEAT EXHAUSTION

Recognition• Headache• Confusion• Sweating with pale, clammy skin• Muscle cramps in the abdomen and limbs• Rapid weakening pulse and breathing• Temperatures around 39 degrees Celcius

The effect of HeatHeatstroke

• When there is a failure of the thermostat in the brain the body’s temperature will rise above 40 degrees Celsius. This may have been brought on by uncontrollable heat exhaustion, prolonged exposure to high temperatures or as a result of an illness or fever. If this is not treated immediately brain damage can occur.

Heatstroke

Recognition• Headache• Confusion and general discomfort• Hot, flushed and dry skin• Body temperature above 40 degrees celcius• Rapid deterioration• Full bounding pulse• Slow and noisy breathing• Levels of response deteriorate rapidly

Heatstroke

Treatment• Place in a cool or shaded environment• Remove outer clothing and cool down (a cold wet

flannel or sheet) be careful not to overcool • Dial 999 or 112 if not already done so• Ensure a good source of fresh air• Be prepared to carry out CPR as required.

TASK

To make an information leaflet to give to parents to inform them extreme cold extreme heat. 5.1Explain how to manage the effects of:extreme cold extreme heat. 5.2

NCFE CACHE Level 3 Award in Paediatric First

Aid

Learning Outcomes

6.1. Explain how to safely manage an incident involving electricity.

6.2. Describe first aid treatments for electric shock incidents.

ELECTROCUTION

• The electrical current passes through the body to travel to earth. This can interfere with the body’s own

electrical impulses which may cause the breathing or the heart to stop.

• Check for burns remember the burns may be internal • Electric shock causes muscle contraction which may

prevent the casualty breaking the connection this means your casualty may be ‘live’ so approach

with care

Electricity – safe management

• Isolate the electricity (if high voltage prevent anyone approaching the area 18 metres around the casualty)

• Use a non conductive item to disconnect the casualty from the electricity if you cannot isolate it

• Be aware of any water or metal around the casualty• Contact the emergency services

Electrical Shock - treatment

• Primary Survey – Danger, response, airway, breathing• Treat any burns• Treat any other injuries• Check for signs and symptoms of shock – skin colour

and temperature, levels of consciousness (alert, voice, pain, unresponsive) pulse rate, dilated pupils, breathing rate.

• Treat signs and symptoms as required

Task

Learners to produce a leaflet present information on how to safely manage an incident involving electricity, describe treatment for shock incidents.

Task 4 6.1, 6.2

NCFE CACHE Level 3 Award in Paediatric First

Aid

Learning Outcomes

7.1. Describe how to recognise the severity of:

· burns· scalds.

7.2. Explain how to manage:

· burns· scalds.

BURNS

• The skin is the largest organ in the body

• Composed of 3 tissue layers

• Epidermis – outermost layer made up entirely of epithelial cells no blood vessels

• Dermis – framework of connective tissues that contain blood vessels, nerve endings, sebaceous glands and sweat glands

• Subcutaneous- combination of elastic and fibrous tissue as well as fatty deposits

BURNS CONT..WHAT DOES THE SKIN DO?

• Protective barrier against outside environment

• Helps prevent infection

• Prevents fluid loss

• Helps regulate body temperature

• Dermal layer contains nerve endings that convey impulses between the brain and the body

SKIN LAYERS

CLASSIFICATION OF BURNS

• Superficial

• Partial Thickness

• Full Thickness

TYPES OF BURNS• Dry • Wet • Chemical• Electrical • Cold • Radiation

TREATMENT FOR BURNS or SCALDS

• Primary assessment

• Position of casualty

• Cool the burn immediately with cold running water for minimum of 10 minutes (do not overcool the casualty and do not touch the injured area)

TREATMENT FOR BURNS or SCALDS

• Remove constricting items (shoes, jewellery etc) but be careful not to remove anything stuck to the burn

• If chemical burns be careful not to contaminate yourself or other areas of the casualty’s body)

• Elevate the affected area if possible (reduces swelling)

• Dress the burn – non fluffy and non sticky – cling film is good but do not wrap the burn tightly

• Alternatives – unused plastic bags or specific burns dressings

• Now recommended all children with burn are assessed by medical staff

TREATMENT FOR BURNS or SCALDS

DO NOT….

• Burst blisters

• Touch the burn

• Apply lotions, ointments, fats

• Apply adhesive tape or dressings

• Remove clothing that has stuck to the burn

TREATMENT FOR BURNS or SCALDS

SEEK MEDICAL ADVICE IF…

• The burn is larger than 1 inch square

• The patient is a child

• The burn goes all the way around the limb

• Any part of the burn appears to be full thickness

• The burn involves hands, feet, genitals or the face

• If you are not sure seek advice

Radiation (Sun burn)

INHALATION INJURIESSIGNS AND SYMPTOMSSIGNS AND SYMPTOMS

Burns to the face or neck Singed nasal hairs Stridor (noisy breathing similar to snoring) A hard cough, spitting up soot

Inhalation injury is the major cause of death in burns victimsInhalation injury is the major cause of death in burns victims . .

CHEMICAL BURNS

CAUSTIC SODA BURNS WITH HEAD INJURY

Chemical burn

CHEMICAL BURNS

TREATMENTTREATMENT Protect yourself first Wash the casualty down immediately Do not waste time removing clothing, until washing down

is under way Flush until all chemicals are removed Airway management is a priority Keep casualty well oxygenated and warm Dry sterile dressings for all burns

Electrical Burn

ELECTRICAL BURNS

NOTE COMPOUND FRACTURE / DISLOCATION OF WRISTNOTE COMPOUND FRACTURE / DISLOCATION OF WRISTCAUSED BY SEVERE MUSCULAR CONTRACTIONCAUSED BY SEVERE MUSCULAR CONTRACTION

ELECTRICAL BURNSTHINGS TO LOOK OUT FORTHINGS TO LOOK OUT FOR

Don’t become part of the circuit

Anticipate greater damage than is visible

Examine the patient for associated injuries to bones and internal organs

Monitor patient closely, arrange transportation to hospital

Task

To produce a poster detailing how they would need to recognise and treat the severity of burns and scalds Task 5 7.1, 7.2

NCFE CACHE Level 3 Award in Paediatric First

Aid

Learning Outcomes

8.1. Identify routes that poisonous substances can take to enter the body.

8.2. Identify sources of information for treating those affected by sudden poisoning.

8.3. Explain how to manage sudden poisoning.

POISONS DESCRIPTION

ANY SUBSTANCE THAT CAUSE A HARMFUL EFFECT ON THE

BODY .

HOW POISONS ENTER THE BODY

INGESTED SwallowedINHALED Breathed inABSORBED Through the skinINJECTED Through the skin directly

into the tissues or blood

INSTILLATION Eyes

Common Household Poisons

1. Medicines2. Cosmetics3. Cleaning Products4. Pesticides5. Paints and Paint thinners6. Plants (including household) (see handout)7. Batteries8. Anti freeze9. Hydrocarbons (petrol, kerosene, motor oil, lighter fluid)

NHS Helpline – 0845 4647

Treatment for Poisoning

For all types and routes of poisoning the following rulesapply.• Limit further intake of the poison• Maintain the airway• Identify the poison taken• Call the emergency services (999 or 112)• If COSHH available refer to specific treatment• Do not make the casualty vomit• Keep calm and reassure the casualty• Keep them warm

POISONING BY HOUSEHOLD CHEMICALS

Bleach, oven cleaners, paint strippers, toiletcleaners will cause• Redness, blistering and burns to the skin with swelling

to the face, mouth and lips if swallowed• Distressed breathing• Dizziness and unconsciousness

• First aid manual

• COSHH sheets

• Label on bottles

• NHS Direct

• National Poisons information service

• Hospitals

• Doctors

Sources of information on Poisons

Task To produce a fact sheet to identify the routes that poisons or substances can enter the bodyIdentify how they can be treated and explain how to manage casualties who have been poisoned.

NCFE CACHE Level 3 Award in Paediatric First

Aid

Learning Outcomes

9.1. Identify severity ofbites and stings

9.2. Explain how to manage bites and stings.

BITESBITES AND STINGS CAN BE CATEGORISEDAS POISONS BECAUSE THE SKIN PUNCTUREDAND EITHER GERMS, VENOM, BACTERIA ETCARE INTRODUCED INTO THE BLOOD STREAM

Severity – if the skin is broken, puncture wounds, on the face,neck, genital, bleeding is severe, poisonous animal, allergic reactions, pain, breathing problems, if unsure seek further medical advice

DOG AND HUMAN BITES OR RODENT ETC..

• MAKE THE AREA SAFE• WASH THE WOUND WITH SOAPY WATER AND

DRY - INFECTION• COVER WITH A STERILE DRESSING• ARRANGE FOR TRANSPORT TO THE HOSPITAL IF

REQUIRED – IF THE SKIN IS PUNCTURED THEY MUST GO TO THE HOSPITAL

STINGS

• USUALLY MORE PAINFUL AND DISTRESSING THAN THEY ARE SERIOUS BUT OCCOSIONALLY MULTIPLE STINGS OR AN ALLERGIC REACTION MAY OCCUR

• Severity – allergic reaction, eyes, mouth etc, breathing problems, severe swelling, pain, multiple stings

STINGS

• USUALLY MORE PAINFUL AND DISTRESSING THAN THEY ARE SERIOUS BUT OCCOSIONALLY MULTIPLE STINGS OR AN ALLERGIC REACTION MAY OCCUR

• Severity – allergic reaction, eyes, mouth etc, breathing problems, severe swelling, pain, multiple stings

STINGS

IF THE STING IS IN OR AROUND THE MOUTH OR NECK YOU MAY NEED TO SEEK MEDICAL ADVICE

IF THERE ARE ANY BREATHING DIFFICULTIES DIAL 999

NCFE CACHE Level 3 Award in Paediatric First

Aid

Learning Outcomes

10.1. Explain how to administer first aid for:

· small cuts· grazes

· bumps and bruises· small splinters· nose bleeds.

Learning Outcomes

11.1. Identify what information needs to be recorded for illnesses, injuries and emergencies. Cross reference 1.5 but need to add illness and

emergencies. 11.2. Describe how to record the information for

illnesses, injuries and emergencies.11.3. Explain confidentiality procedures for

recording, storingand sharing information.