First Aid in Children

1) CPR2) Unconsciousness3) Foreign body aspiration4) Intoxication

CPR (cardiopulmonary resuscitation) is a procedure to support and maintain breathing and circulation for a person with a respiratory arrest and/or with cardiac arrest.

CPR providing is required by law for everybody.Punishment for breaking this law is twice higher for health professionals than for „normal“ citizens.

Pediatric Gold Rule: Child ≠ Miniaturized Adult

In CPR minimal differencies:„newborn“ immediately after birth„infant“ - under one year old „child“ - from one year

The differences from the adults:Paediatric cardiopulmonary arrests are usually initially

respiratory arrests.Cardial arrests only in specific groups (congenital heart disease,

hypertrophic cardiomyopathy, abertant coronary artery, prolonged QT sy, critical aortal stenosis).

Causes of CP Arrest in Newborns and Infants

Congenital developmental defects

Respiratory failure

SIDS

Sepsis – infection

Metabolic diseases

Causes of CP Arrest in Children

Injury (traffic, game, drowing, intoxication, burns)

Tumors

Respiratory failure

Sepsis – infection

Dehydratation – hypovolemic shock

Neurological diseases

Metabolic diseases

Congenital developmental defects

NewbornIf the newborn does not regulary breath (cry) during the first minute after

interruption of umbilical cord. In 99% of cases need only respiratory basic support – ventilation by mask (mouth) frequency 40-60/min as in the simplest conditions of developmental countries.

irresponsive unbreathing patient

head tilt-chin lift maneuver

2 breaths

30 compressions at rate 100/min in depth 1/3 of chest

continue in CPR 30:2, call 155 - AED

CABD: circulation(compressions)-airways-breathing-defibrilation

CABD

Infants, Toddlers, Younger Children

Is the child reacting? gently tap the child, ask loudly “Are you OK?”, (don´t shake the baby) .... unresponsive....

OBSERVE the chest movements

HEAR nearby the nose and mouth, tracing the signs of breathing

FEEL the air flow on the face

...no longer than 10 seconds

Circulation

Airways

open the airway using a head tilt–chin lift maneuver

Breathing

Causes of Unconsciousness in Children

FEVER

injury

intoxication

hypoxy/ischemia

infection

metabolic disease

ORTHOSTATIC COLLAPSE

tumor of the CNS

epilepsy

heart arytmia

Convulsions, fever

Breathing normally?

turn the child onto the side - „recovery position“ and control regular breathing

Signs of The Aspiration of The Foreign Body

Direct adult witness of the aspiration(associated with eating, game, ...)

Sudden start-up of dyspnea

Cough: ineffective with inability to speak and breath, cyanosis,

unconsciousness

effective with crying or verbal communication, loud cough, ability to breath

Deliver 5 back blows (slaps), alternatively followed by 5 chest thrusts.

Heimlich Maneuver

KI: infants, obese

Possible to alternate with back blows (slaps)

Intoxication

Call the poison control center at 800-222-1222 if you think your child has taken poison and he is alert or if your child has done any of these things and is alert:- Swallowed too much medicine or the wrong kind- Swallowed plants- Swallowed any abnormal substance – household chemistry -Has pieces of pills on clothes or lips-Poison has splashed on his face or eyes

Phycians have to take poisoning in differential diagnosis if:- Is not breathing properly or having trouble breathing- Is unconscious or not alert - Has collapsed- If having seizures- Is acting differently- You have any suspicion from history- Has a strange smell .. And follow the centre instructions