Firstaid 2017

NCFE CACHE Level 3
Award in Paediatric First
Aid

Learning Outcomes
1.1. 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 LIFE
2. PREVENENT THE CONDITION FROM
WORSENING
3. PROMOTE RECOVERY
4. 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 services
Activity 1 (1.1)

AIDER
Arrival on the scene
• Assess the situation
• Make the area safe if possible
• Ask questions about the situation
• Obtain help from others
• Send for help….
Activity 2 (1.2)

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
Activity 2 (1.2)

Contents of a first aid box
Activity 3 (1.3)
Research first aid equipment and how it should be used appropriately.

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?

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
• 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 water
Activity 3 (1.3)
Describe how to use
first aid and personal
protection equipment
required for
emergencies'. 1.4

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

1.4. Describe how to use first aid and
personal protection equipment safely.
• Complete your work book to date

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
What is an accident?
What is an incident?
How do you report record an accident /
incident within your setting?

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

• 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?

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 easily
1. Parents of the children (home, work, mobile)
2. Doctors surgery (yours and the children)
3. NHS direct advice line
4. Emergency back up person
5. 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
AGES
0-12 months = Baby or an infant
1 year to puberty = a child
NB – common sense must prevail !!
Activity 1.5

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

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 casualty
R – Response from the casualty
A – Airway – is it clear and open
B – Breathing – is the casualty breathing normally
C – Circulation – look for signs of major bleeding
(Think Dr ABC)

Assess for Danger
Fire & Smoke Vehicles
Electricity
Water Chemicals
People Falling objects & machinery

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

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

R – Response from casualty
• Check for a response from the casualty
– As you approach the casualty shout ‘ hello, my name isAs 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 collarher 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 theTilt the head backward to lift the tongue away from the
wind pipe at the same time place two fingers on thewind 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 headTilt the head
backward with onebackward with one
hand and placehand and place
two fingers undertwo fingers under
the chin to slidethe chin to slide
the jaw forwardthe jaw 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 LIFE
What is the priority in this case?What is the priority in this case?
Answer…………..AirwayAnswer…………..Airway

TASKhttp://www.nhs.uk/Conditions/Accidents-and-first-aid/Pages/CPR.asp
In pairs demonstrate how to perform CPR
Adult, child and baby
Remember 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 )

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 experience
what is termed as a Febrile Seizure which
is brought on when the child has a high
temperature 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=7MPJauo4D
• 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.

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.yo
utube.com/watc
h?
v=avYRvVHA
vfM

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
5
Back
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
5
Back
Slaps
5
Chest
Thrusts
https://www.youtu
be.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

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 BLEEDING
ArterialArterial
VenousVenous
CapillaryCapillary
 from an artery under direct pressure from thefrom an artery under direct pressure from the
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 maynot under direct pressure form the heart but may
carry same volume of blood as arteries. Depleted ofcarry same volume of blood as arteries. Depleted 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 mayoccurs in all wounds, although blood loss may
start off quite fast at first, blood loss is usuallystart 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 and
The 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 1/3
of its blood has been lost.
After this the blood pressure falls quickly
The blood supply to the brain falls and death
will result

BLEEDING CONT..
EFFECTS OF BLOOD LOSS – HYPOVOLEAMIC SHOCK
BLOOD LOSS 10% 20% 30% 40%+
CONSCIOUSNES
S
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

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 BLEEDING
SIGNS & 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, frothy
Vomited, or brown ‘coffee grounds’ appearance
Mouth
Nose bleed.
Fractured skull, leaking
cerebrospinal fluid from around
the brain.
Bright red / clots
Blood 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
Ear
Possible causesAppearanceBleeding from

Demonstrate control of Bleeding
• Remember your
hygiene measures
Compression
• Elevation
• Elevated sling
• http://www.youtube.com/watc
• http://www.youtube.co
m/watch?v=C63rt-fleGY

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.

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 react
Body 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 onto
A full anaphylactic or Anaphylactiod reaction
Urticaria -

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.

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

Learning Outcomes
1.1. Describe types of fractures.
1.2. Recognise suspected:
· fractures
· dislocations
· sprains and strains.
1.3. Administer first aid
for 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 if
1. There is a suspected injury to the spine, head or neck
2. The child has difficulty breathing
3. There is deformity, irregularity or unnatural movement
4. It is an open fracture
5. Child is in a lot of pain treat for SHOCK
6. 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

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 BRAIN
CONSISTS 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

ASSESSMENT CONT..
P - Pupils
E - Equal
A - And
R - React
L - Light

Concussion Compression
Unconsciousness 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

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

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 and
Associated injuries to the head and neck
Do not remove any embedded foreign objects
Clean any cuts to prevent infection
Use gloves
Wash hands
Check vision – PEARL
Seek 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?

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

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
· meningitis

Task
• In your pairs research the signs and symptoms and
treatments for:-
• sickle cell crisis
· diabetic emergencies
· asthma attack
· meningitis

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

The effects of cold
• Re-warming a casualty too quickly can be fatal
especially if they are in poor health, have been injured
or have suffered prolonged exposure. This will result
in cold blood being circulated through cold body tissue
and will cause the blood to become even colder and
lower blood pressure. Shock will occur and possible
cardiac arrest.
• Conscious cold casualty’s can – change wet clothing
for dry, give warm drinks, extra blankets
• Do not let them move around as this will circualte cold
blood.

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

Hypothermia
Treatment
• 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 Heat
Heat 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 Heat
Heatstroke
• 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. 5.1
Explain how to manage the effects of:
extreme cold
extreme heat. 5.2

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

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

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)

• 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

DO NOT….
• Burst blisters
• Touch the burn
• Apply lotions, ointments, fats
• Apply adhesive tape or dressings
• Remove clothing that has stuck to the burn

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

INHALATION INJURIES
SIGNS 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 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 BURNS
NOTE COMPOUND FRACTURE / DISLOCATION OF WRISTNOTE COMPOUND FRACTURE / DISLOCATION OF WRIST
CAUSED BY SEVERE MUSCULAR CONTRACTIONCAUSED BY SEVERE MUSCULAR CONTRACTION

ELECTRICAL BURNS
THINGS 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

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 Swallowed
INHALED Breathed in
ABSORBED Through the skin
INJECTED Through the skin directly
into the tissues or blood
INSTILLATION Eyes

Common Household Poisons
1. Medicines
2. Cosmetics
3. Cleaning Products
4. Pesticides
5. Paints and Paint thinners
6. Plants (including household) (see handout)
7. Batteries
8. Anti freeze
9. Hydrocarbons (petrol, kerosene, motor oil, lighter fluid)
NHS Helpline – 0845 4647

Treatment for Poisoning
For all types and routes of poisoning the following rules
apply.
• 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, toilet
cleaners 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 body
Identify how they can be treated and explain how
to manage casualties who have been poisoned.

Learning Outcomes
9.1. Identify severity of
bites and stings
9.2. Explain how to manage bites and stings.

BITES
BITES AND STINGS CAN BE CATEGORISED
AS POISONS BECAUSE THE SKIN PUNCTURED
AND EITHER GERMS, VENOM, BACTERIA ETC
ARE 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
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

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, storing
and sharing information.

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