CHILDREN AND INFANTS
Communication
To help an injured or ill child, try to imagine how the child might feel.
Try not to separate the child or infant from loved ones, if possible.
You need to reduce the child's anxiety and panic and gain the child's trust and cooperation, if possible.
Approach the child slowly.
Your sudden appearance may upset the child or infant.
Get as close to eye level of the child or infant as you can and keep your voice calm.
Smile at the child.
Ask the child's name and use it when you talk with him or her.
Talk slowly and distinctly, and use words the child will easily under stand.
Ask questions that the child will be able to answer easily.
Explain to the child and the parent what you are going to do.
Rea**ure the child that you are there to help and will not leave.
Characteristics of Children and Infants
Infants
Toddlers
Pre-schoolers
School-age
Adolescents
Interacting with Parents, Guardians and Caregiver
Communicating with Children Who Have Special Health Care Needs
Observing Children and Infants
Look for signals that indicate changes in the level of consciousness, trouble breathing, and apparent injuries and conditions. Ask a young child to point to any place that hurts. An older child can tell you the location of painful areas. If you need to hold an in fant, always support the head when you pick up the infant. If a child becomes extremely upset, conduct your check from toe to head instead of head to toe.
Common Childhood Injuries and Illnesses
Abdominal Pain
What to Look For:
- A sudden onset of severe abdominal pain or pain that becomes worse with time
- Excessive vomiting or diarrhea
- Blood in the vomit or stool
- Bloated or swollen abdomen
- A change in the child's level of consciousness, such as drowsiness or confusion
- Signals of shock
What to Do Until Help Arrives:
- Help the child rest in a comfortable position.
- Keep the child from becoming chilled or overheated.
- Comfort and rea**ure the child.
- Give care based on any conditions found.
Child Abuse
What to Look For
- An injury whose cause does not fi t the explanation of the parent, guardian or caregiver.
- Obvious or suspected fractures in a child younger than 2 years.
- Any unexplained fractures.
- Injuries in various stages of healing, especially bruises and burns.
- Bruises and burns in unusual shapes, such as bruises shaped like belt buckles or handprints or burns the size of a cigarette tip.
- Unexplained lacerations or abrasions, especially to the mouth, lips and eyes.
- Injuries to the genitalia.
- Pain when the child sits down.
- A larger number of injuries than is common for a child of the same age.
The signals of child neglect include:
- Lack of adult supervision.
- A child who looks malnourished.
- An unsafe living environment.
- Untreated chronic illness (e.g., a child with asthma who has no medications).
Giving Care
When caring for a child who may have been abused or neglected, your fi rst priority is to care for the child's injuries or illnesses. If you suspect abuse, explain your concerns to responding police officers or emergency medical services (EMS) personnel if possible. If you think you have reasonable cause to believe that abuse has occurred, report your suspicions to a community or state agency, such as the Department of Social Services, the Department of Child and Family Services or Child Protective Services.
Colic
A baby with colic may have a red face and tense, hard belly because the stomach muscles tighten during crying. A baby with colic also may clench his or her legs, feet and fists when crying.
Giving Care
Movement
White noise
You also can hold the baby using certain techniques to help relieve gas pain.
Conjunctivitis
Diarrhea and Vomiting
A health care provider should be contacted if:
- Diarrhea or vomiting persists for more than a few days.
- The child is not replacing lost liquids or cannot retain liquids.
- The child has not had a wet diaper in 3 or more hours or, if older, has not had any urine output for more than 6 hours.
- The child has a high fever.
- The child has bloody or black stools.
- The child is unusually sleepy, drowsy, unresponsive or irritable.
- The child cries without tears or has a dry mouth.
- The child has a sunken appearance to the abdomen, eyes or cheeks, or, in a very young infant, has a sunken soft spot at the top of the head.
- The child has skin that remains “tented” if pinched and released.
Giving Care
- If the infant will not tolerate his or her normal feedings or if a child is drinking less fluid than normal, add a commercially available oral rehydration solution specially designed for children and infants.
- Do not give over-the-counter anti-diarrhea medications to children younger than 2 years. Use these with the guidance of the health care provider in older children.
- Maintain the child's normal diet. Try to limit sugar and artificial sweeteners. In addition, encourage the child to eat items like bananas, rice, applesauce and toast.
Remember the following when caring for children and infants who are vomiting:
- For a very young child or infant, lay the child on his or her side so that the child does not swallow or inhale the vomit.
- Halt solid foods for 24 hours during an illness involving vomiting and replace with clear fluids, such as water, popsicles, gelatin or an oral rehydration solution specially designed for children and infants.
- Introduce liquids slowly. For instance, wait 2 to 3 hours after a vomiting episode to offer the child some cool water. Offer 1 to 2 ounces every half hour, four times. Then alternate 2 ounces of rehydration solution with 2 ounces of water every 2 hours.
- After 12 to 24 hours with no vomiting, gradually reintroduce the child's normal diet.
Ear Infections
Common signals of an ear infection include:
- Pain. Older children can tell you that their ears hurt, but younger children may only cry or be irritable or tug on the affected ear.
- Loss of appetite.
- Trouble sleeping.
- Fever.
- Ear drainage.
- Trouble hearing.
A health care provider should be contacted if:
- The child's signals last longer than a day.
- You see a discharge of blood or pus from the ear. This could indicate a ruptured eardrum.
- The child's signals do not improve or get worse after he or she has been diagnosed by a health care provider.
Giving Care
Fever
In a young child, even a minor infection can result in a high fever, usually defined as a temperature 103° F and above. Fevers that last a long time or are very high can result in seizures
Older children with fever will often:
- Feel hot to the touch.
- Complain of being cold or chilled.
- Complain of body aches.
- Have a headache.
- Have trouble sleeping or sleep more than usual.
- Appear drowsy.
- Have no appetite.
Infants with fever will often:
- Be upset or fussy, with frequent crying.
- Be unusually quiet.
- Feel warm or hot.
- Breathe rapidly and have a rapid heart rate.
- Stop eating or sleeping normally.
Taking a Temperature
A rectal temperature gives the most reliable reading for children younger than 5 years. You also may take an oral temperature for children age 3 and older. A child's or an infant's temperature also can be taken in the ear (known as the tympanic method) or under the armpit (known as the axillary method).
When to Call 9-1-1
Call 9-1-1 or the local emergency number if the child or infant has signals of life-threatening conditions, such as unconsciousness or trouble breathing. Also, call if this is the first time that a child has had a febrile seizure, the seizure lasts longer than 5 minutes or is repeated, or the seizure is followed by a quick rise in the temperature of the child or infant.
A health care provider should be contacted for:
- Any infant younger than 3 months with a fever (100.4° F or greater).
- Any child younger than 2 years with a high fever (103° F or greater).
- Any child or infant who has a febrile seizure.
Foreign Objects in the Nose.
Injury
Severe bleeding must be controlled as
quickly as possible. Because a child's head is large and heavy in proportion
to the rest of the body, the head is the area most often
injured. A child injured as the result of force or a blow
also may have damage to the organs in the abdominal
and chest cavities
Meningitis
Signals of meningitis include the following:
- Fever
- Irritability
- Loss of appetite
- Sleepiness
- In addition, older children may complain of a stiff neck, back pain or a headache.
When to Seek Professional Medical Care
Poisoning
Heat Rash
If the child or infant develops heat rash, give care by:
- Removing or loosening clothing to cool down the child or infant.
- Moving the child or infant to a cool location.
- Cooling the area with wet washcloths or a cool bath and letting the skin air-dry.
Diaper Rash
Seek care from a health care provider if diaper rash:
- Develops blisters or pus-fi lled sores.
- Does not go away within 2 to 3 days.
- Gets worse.
Give care for diaper rash in toddlers and infants by applying a thick layer of over-the-counter zinc oxide or petroleum jelly to the affected area.
To prevent diaper rash and help it to heal:
- Keep the area as dry as possible by changing wet or soiled diapers immediately.
- Clean the area with water and a soft washcloth. Avoid wipes that can dry the child's skin.
- Pat the skin dry or let it air dry.
- Keep the diaper loose so wet and soiled parts do not rub against the skin.
Sudden Infant d**h Syndrome
When to Call 9-1-1
What to Do Until Help Arrives
EMERGENCY CHILDBIRTH
Take comfort in knowing that things rarely go wrong. Childbirth is a natural process. Thousands of children all over the world are born without complications each day, in areas where no medical care is available.
When to Call 9-1-1
If a woman is giving birth, call 9-1-1 or the local emergency number immediately. Give the EMS call taker the following important information:
- The woman's name, age and expected due date
- How long she has been having labor pains
- Whether this is her fi rst child
If a woman is giving birth:
- Talk with the woman to help her remain calm.
- Place layers of clean sheets, towels or blankets under her and over her abdomen.
- Control the scene so that the woman will have privacy.
- Position the woman on her back with her knees bent, feet flat and legs spread wide apart.
- Avoid contact with body fluids; wear disposable gloves and protective eyewear if possible.
- Remember, the woman delivers the baby, so be patient and let it happen naturally.
- The baby will be slippery; use a clean towel to receive and hold the baby; avoid dropping the baby.
- Keep the baby warm; have a clean, warm towel or blanket handy to wrap the newborn.
CAUTIONS:
- Do not let the woman get up or leave to find a bathroom (most women want to use the restroom).
- Do not hold the woman's knees together; this will not slow the birth process and may complicate the birth or harm the baby.
- Do not place your fingers in the vagina for any reason.
- Do not pull on the baby
OLDER ADULTS
Checking an Older Adult
To check an injured or ill older adult, attempt to learn the person's name and use it when you speak to him or her. Consider using “Mrs.,” “Mr.” or “Ms.” as a sign of respect. Make sure that you are at the person's eye level so that he or she can see and hear you more clearly.
- May be confused.
- Speak slowly and clearly.
- May be afraid of falling.
- Look for a medical identification (ID) tag
- May not recognize the signals of a serious condition
Common Injuries and Illnesses in Older Adults
Confusion