When it comes to mishaps, most little ones have their fair share. They are poor risk assessors and don’t have the motor skills to match their enthusiasm for discovery! While most parents can deal with a skinned knee, a more serious accident is a different matter. Most would lose their cool and fall to pieces. But if you arm yourself with knowledge you’ll be better equipped to handle the stress of an emergency.

Some general principles

* Stay as calm as possible.

• Always follow a routine like the St John Ambulance’s “DRABC” (right).
• Call 000 if you need immediate help, or delegate someone to do it for you.
• Stay with your child until help arrives.

What is DRABC?

These DRABC steps are most important to follow when a child is unconscious:

Danger Check for danger (to you or to your child). For example, don’t stay in the middle of the road after an accident, or near a fire.

Response Is she conscious? Try to rouse her by talking to her or touching her. If you can’t wake her, put her in the recovery position (bend far leg towards you, roll far arm across her body, roll her whole body towards you until she is lying on her side, turn chin up and mouth down) and call 000.

Airway Check her nose and mouth for anything that might be blocking her breathing (a piece of food or even some vomit). Remove the item if you can by using a finger to scoop it out.

Breathing Is her chest rising and falling? Can you feel breath on your cheek if you hold it close? If not, start expired air resuscitation (EAR – this is similar to cardiopulmonary resuscitation (CPR) but without the chest compressions).

Circulation Is there a pulse? The best place to feel for a pulse is in the neck or the wrist. It can be really hard to feel a pulse, even for a doctor. If you can’t feel a pulse, it’s best to assume there isn’t one. If there is no heartbeat, start CPR straight away.

When should I call 000?
The Australian Resuscitation Council (ARC) guidelines say that calling for help should always come before CPR, except when someone is drowning.
Deep cuts
Cuts come with the territory of being a child. The skin is an incredibly fast healing organ. From the moment your child’s skin tears it sets about righting the break and knitting itself back together. Two things can really get in the way of that process happening nicely: infection and a cut so deep that the edges would take ages to knit together if left to their own devices. So the two mainstays of treating cuts are preventing infection and making sure the wound edges are close enough together to do their thing! That’s where stitches come in. If the wound edges are too far apart or so deep that they fall apart, your child will need either a non-suture form of healing augmentation such as steri-strips (available from your chemist) or in worse scenarios, sutures or stitches.

Keep the wound clean, by washing it with running water. Use an antiseptic cream and cover it with a dressing.

Burns and scalds
Prevention is always better than cure when it comes to burns and scalds. Keep hot cups of tea well out of reach, boiling saucepans should have their handles turned away from little ones and never iron while your baby’s awake! “If the worst happens and you have to deal with a burn, run the area under cold tap water for at least 20 minutes,” says Robyn Galway, general manager of training at St John Ambulance. If there has been a burn through clothes, try to remove the clothing as soon as possible.

If the burn looks large, severe or your child is having trouble breathing, call 000. Keep the burnt area covered until the ambulance arrives or until you get to the emergency department. Forget about any creams as they can make the burn worse. A sterile, non-stick dressing is the best thing to cover and protect burnt skin. In the home, clear plastic wrap is a good substitute. If neither are at hand, use a clean, non-fluffy damp cloth. Keep your child warm as they can go into shock at this time.

Choking hazards
Young children tend to put everything in their mouths so choking is a real risk, especially at meal times. The first sign that something has gone down the wrong tube is a cough. A good strong cough is a good sign. Weak coughing or breathing difficulties require fast action. If your child is old enough, firmly tell her to cough. This may be enough if the offending item hasn’t gone too far.
“Firstly, do not do a blind finger sweep of the mouth,” warns Dr Elizabeth Cotterell, emergency physician at Sydney Children’s Hospital. “It’s most likely to push it further into the airway.”
Call 000, sit with her and wait for the ambulance to arrive. If your child isn’t breathing, call 000 or get someone to.
If your baby is choking, place her on your forearm, face-down with her head lower than her trunk. Support her neck and head by firmly holding the jaw and turning her head to the side. Use your thigh or lap to support your arm.
If she’s too big, place her face-down on your lap, head towards your feet

and straighten your knees keeping your feet on the ground so her head is lower than her trunk. Give her up to five rapid blows between her shoulders with the heel of your hand. If this doesn’t work try doing up to five chest thrusts (compressions). If your baby is still not breathing, start CPR immediately. Alternate between CPR and back blows until the ambulance arrives.

“But for older children who are choking we never give the Heimlich manoeuvre,” Robyn says. Instead use the same five sharp back blows.

Bumps to the head
The first thing to consider is whether your little one is conscious. Believe it or not, crying is a really good sign. It means your child is awake and feeling pain. On the other hand, if she’s conscious but seems dazed, falls asleep and is difficult to rouse, or vomits, you will need to call 000.

Similarly, all unconscious children need an ambulance immediately.

Anaphylaxis

This is a severe form of an allergic attack, and can be life-threatening because it can cause a child to stop breathing. If your child has allergies, you should have been sent off to a first aid course and then issued with an EpiPen (a syringe of adrenaline used to treat anaphylaxis). If you don’t know what to do or don’t have an EpiPen, call 000 immediately.

Electrocution
Again prevention is better than cure, so make sure your power points have child protectors on them to

stop little ones sticking things into sockets. Have an electrician check for an electrical safety switch. If your child does get electrocuted, the best response is to turn off the power. If you can’t do that, stand on a dry, insulated surface, such as a rubber mat or newspaper, and use a non-metal object to move your child away from danger. Then call 000 and follow DRABC (see previous page) until help arrives.

Drowning
Incredibly, more than 50 children under 5 years of age still drown each year in Australia. But it’s not just swimming pools and beaches that are the problem – baths and buckets
of water can also be lethal. With drowning, you need to move quickly to get oxygen back into the body, and particularly the brain. If you find your child drowning, remove her from the water as quickly as possible. If you are without help and your child is not breathing, perform one minute of CPR and then call 000. Continue resuscitation until help arrives. If she starts breathing, place her in the recovery position (see previous page) and keep her warm.

Imagining this situation, you can see why you really need to know how to do CPR properly. Don’t put off learning how to for even another day…

Common causes of hospital-treated injuries of children up to 5 years of age*

• Falls
• Accidental poisoning
• Burns and scalds
• Bicycle injuries
• Pedestrian injuries caused by car

Common deaths from injuries in children up to 5 years of age*

• Drowning
• Transport injuries
• Assault

EMERGENCY CONTACT NUMBERS

Ambulance 000
Poisons Information Centre 13 11 26
Note down your GP’s number