Emergency First Aid
All you need to know in a hurry from A-Z
1ANAPHYLAXIS (AN ALLERGIC REACTION)
Anaphylactic shock is a severe whole body allergic reaction to a substance such as some foods ( peanuts), stings or drugs. Anaphylaxis happens immediately after exposure to the allergen. It is severe and involves the whole body. It’s terrifying, but action must be taken immediately. CAUSES • FOOD Peanuts are a common allergy culprit in children, and even a trace of peanut can bring on anaphylaxis in an allergy sufferer. Other common food instigators are fish, shellfish and fruit, as well as certain spices, food colourants and additives. • STINGS Bees, wasps and
jellyfish. • DRUGS Particularly medicines like penicillin, anaesthetics and painkillers. SIGNS AND SYMPTOMS Symptoms develop quickly (often within seconds) and may include the following: • Anxiety. • Abdominal pain. • Abnormal (high- pitched) breathing sounds and/or wheezing. • Chest discomfort or
tightness. • Coughing. • Difficulty in breathing. • Difficulty in swallowing. • Dizziness or
light- headedness. • Hives, itchiness. • Nasal congestion. • Nausea or vomiting. • Palpitations. • Skin redness. • Slurred speech. • Swelling of the face, eyes
or tongue. • Unconsciousness. WHAT TO DO • Immediately call for emergency assistance. If you are aware that your child has life-threatening reactions to an allergen, your doctor should have prescribed an epipen, which needs to be used as directed.
• Lie your child down or cradle your child in your arms. If there is vomiting or bleeding from the mouth, turn your child onto his/ her side. Do not give anything to eat or drink. If there are no signs of breathing, start CPR (see pages 20 to 23). • Get emergency treatment for your child even if the symptoms start to improve. Your child will need hospitalisation for observation as it’s possible that symptoms may reoccur.
2BLEEDING
If your child is injured, your priorities are to get emergency assistance and limit blood loss. The first thing to do is to apply firm pressure on the wound with a clean cloth. Hold for 10 minutes or until the bleeding stops. Once bleeding has stopped, do not remove the dressing. Do this only in hospital. WHAT TO DO FOR MINOR BLEEDING • Gently wash the wound
with warm, soapy water. • Cover the wound with an antiseptic cream or ointment and apply a sterile dressing or plaster, depending on the size of the wound. • Wash the wound daily
and reapply the antiseptic cream and dressing until healing is complete. If the wound shows signs of infection ( becoming red, tender or producing pus), call your doctor. • If the bleeding doesn’t stop or the wound seems deep, especially if the edges of the wound do not come together by themselves, treat the wound as outlined here and take your child to the doctor. WHAT TO DO FOR SERIOUS BLEEDING • Get someone to phone the emergency services, or, if you are alone, first try to stop the bleeding and then take your child with you to the phone. • Cut away your child’s cloth
ing to expose the wound. • Apply pressure with a clean cloth or dressing. Do not use any medication on the wound until your doctor has seen it. • If there is any object in the wound, don’t remove it. Apply pressure on either side of it. • Lay the child down and raise the wounded area above the level of the heart, if possible. So, for example, for an arm wound, raise the arm above the head. • If blood seeps through the dressing, put another dressing on top and provide more pressure to stop the bleeding. • Keep the child warm
and calm. • If the blood is spurting in time to the heartbeat and is a bright red colour, an artery may have been cut. Apply direct pressure and elevate the affected area. • Call the emergency services as heavy bleeding can be life threatening.
NOSE BLEEDS
• If your child has a nose bleed, have him lean his head forward while sitting or standing. • Apply pressure and don’t
block the child’s nostrils. • Keep squeezing for 10 min
utes and then release your hold and check to see if there’s still bleeding. • If the bleeding hasn’t stopped, apply pressure for another 10 minutes and if it still continues, consult your doctor. • Encourage your child to spit out any blood in the mouth. He may vomit if he swallows any blood.
INTERNAL BLEEDING
WHAT TO LOOK FOR • Bleeding from the nose, ears, mouth, vagina or anus. • If you suspect internal bleeding, call the emergency services immediately and treat the child for shock if signs of shock are present. Lay him down, keep him calm and cover him with a blanket.
EMBEDDED OBJECTS
• If an object (like a piece of glass) is embedded in the wound, don’t remove it as it may cause further bleeding. DO THE FOLLOWING • Cover the wound lightly with gauze. Surround it with bandage rolls that have been built up to the same height as the embedded object. • Once you have secured
the protective bandage
covering in place, you can now take your child to the hospital or call emergency services for assistance.
3BREAKS AND SPRAINS
Broken bones are very painful for your child and require medical treatment. Follow these instructions when you suspect your child has a broken bone: • Try to stabilise the affected area by applying a splint. In cases where the child has suffered any injury to a long bone such as the thigh, or the bone is sticking out of the skin, call for emergency assistance. • In most instances, a parent can splint the affected limb before transporting the child to a doctor or emergency department. • If your child is in such severe pain that you cannot move him/ her, or if you are unsure if moving your child is safe, call for assistance. AMPUTATION Amputated fingers and toes can sometimes be successfully reattached. The key is to get the child to hospital as soon as possible and to look after the amputated body parts correctly. • Call emergency services. The paramedics have the necessary training to care for your child. • Place a clean pad or sterile dressing on the injury and press on it gently to help staunch the bleeding. • If possible, raise the injured part above the head. • Place the severed part in a clean plastic bag or cover it in cling film. • Wrap it in something clean and soft, like a towel, and place it in another plastic bag filled with ice. • Do not freeze the severed
body part. SPRAINED ANKLE A sprain is actually a tear in the ligaments and tissues around a joint, causing pain and swelling. • Lay or sit the child down and gently remove his shoes and socks. • Keep the ankle raised. • Place a cold, damp cloth over the ankle. Put an ice pack on top to reduce swelling (a bag of frozen vegetables works well). • Put a thick layer of cotton wool around the ankle to provide support. • Bandage it in place. If you don’t have cotton wool, you can even use a pillow. • Have the injury assessed by your doctor or the emergency department. BACK AND NECK INJURIES If the child is conscious, encourage him to lie still in the position in which you found him. Stay with him, reassure him, and get someone to call the emergency services. If you think your child has sustained a neck injury, do not move him, no matter what position he is in. It could be very dangerous. Wait for the emergency services to arrive.
4BRUISES
Active toddlers and young children suffer many minor knocks and falls as they grow and become more mobile, often resulting in bruises. They seldom require any treatment. A cold compress placed on the area will help if the bruise is more serious.
If the child complains of excessive pain or cannot move the affected limb, seek medical attention.
Unexplained excessive bruising without any sign of injury or explanation needs medical investigation.
5BURNS AND SCALDS
Burns occur rapidly and may progress without emergency care. Whether the burn is caused by heat, electricity or chemicals, the treament remains similar. Burns are divided into three categories:
SUPERFICIAL BURNS are red and the skin may be blistered. PARTIAL THICKNESS BURNS are very painful and the skin is usually blistered. FULL THICKNESS BURNS leave the skin charred and black, or hard and white.
WHAT TO DO FIRST
• Remove the source of the burn and cool the burned area by flushing it with cool (not cold) water until the pain goes away. • If the child’s clothes are on fire, follow the STOP, DROP and ROLL procedure. Lie the patient flat down on the ground, then roll him over until the flames have all been put out. • Throw water downwards to stop any flames reaching the face. • If there’s no water nearby, wrap the child in a blanket to deprive the fire of oxygen, or roll him on the floor.
WHEN TO CALL EMERGENCY SERVICES
• If the burn area on the child’s body is larger than the child’s palm. • If you suspect the child has inhaled any smoke. • If the burn is on the face, genitals, joints, hands or feet. • If he was burnt by an electric shock. • If the burn is right around a limb no matter what the size.
FIRST AID FOR MINOR BURNS
• Gently run cool (not cold) water over the affected area until the pain goes away. • Cover with a sterile dressing or a clean plastic bag to prevent infection. • Do not apply cotton wool or cloth that has fluff that will stick to the burn. • Don’t apply butter, ice or anything to the area except for recognised burn relief dressings like a hydrogel dressing. • Never pop the blisters, as they have a job to do: they protect against infection and help the healing process.
SMOKE INHALATION
• Smoke inhalation is very dangerous and is a common result of fires. • Get yourself and your child into fresh air as soon as possible. Crawl along the ground where the smoke is less thick. • Call emergency services and the fire department for help. • If your child is unconscious or not breathing, lay the child down and open the airway by tilting his head back, lifting the chin gently with one hand and placing the other on his forehead. • Check for breathing. If the child is breathing, place him in the recovery position. If the child is not breathing, follow the ABC of resuscitation (from page 20).
FIRST AID FOR SERIOUS BURNS
• Call the emergency services for assistance. While you are waiting, continue with these steps: • Remove or cut away any clothes from the burnt area, unless the clothes are stuck to the skin. Remove any jewellery over the burnt area. • Hold the burnt area under running water until the pain goes away, or cover it with a cloth or sheet soaked in water. • Do not put any lotion,
butter, petroleum jelly or anything on the wound besides a hydrogel dressing.
FIRE SAFETY
It’s a good idea to discuss with your staff and family what you would do in the event of a fire. Burglar bars can trap people inside, so consider your escape route carefully. • Your first priority is to get your family out and to safety, so don’t waste time trying to save your possessions. • If you can, close the door of the room where the fire is. • Lay blankets or towels, preferably soaked in water, along the gap at the bottom of the door. • If there is smoke, stay down and crawl out. • On your way out, close the doors behind you. • Before opening any door, check if there is a fire behind it. Feel the door with the back of your hand. If it is hot, do not open. • If you can’t escape, open a window and shout for someone to call the fire department. If it is possible, and only without endangering yourself, soak the walls and doors nearest the fire with water. • Never go back into a burning house.
6CHOKING
Choking can simply be defined as when an object (food, toys or anything small) gets stuck in your windpipe or trachea. To prevent this, small children should not play with small items, for example, anything that can fit through the inside of a toilet roll tube.
SIGNS OF CHOKING
• They cannot breathe or speak. When choking, the person can’t make a sound. • They appear anxious or
severely uncomfortable. • They start turning a bluish
colour. • When you ask them if they are choking, they may indicate they are by nodding. • They may clutch at their
throat. • They may be trying to
cough. If the person has an object stuck in their airway, but they are able to still breathe or speak, then all you can do is get them to a medical facility to have it removed. It is when there is absolutely no air moving that you are dealing with a life-threatening medical emergency.
IF A CHILD OR ADULT IS CHOKING
• Firstly, try to encourage them to cough. Forceful coughing can successfully expel many objects. • If this doesn’t work, stand or kneel behind them to perform the Heimlich manoeuvre. • Wrap your arms around them, and make a fist with one hand. Place your fist against their stomach, just above the belly button. • Place your other hand over your fist. Position your body up against them. • Give a series of five hard, forceful squeezes. You are trying to force the air out of the victim, in an attempt to dislodge the object. • If this doesn’t work, then you can try using a series of back blows to expel the object: • Position the patient with their head as low as possible. • Hit them forcefully between the shoulder blades. Repeat this action five times. • Keep repeating Heimlich thrusts and back blows until the object is released.
IF A BABY IS CHOKING
• Lay the infant face down along your arm, with the head lower than the rest of the body. • Give five hard slaps to the
baby’s back. You should do this with the intention of shaking the object loose, so don’t be too gentle. • If the object doesn’t come out, turn the baby onto his back. While supporting the entire body, place two fingers on the middle of the chest. Give up to five hard chest thrusts. • Keep repeating black slaps and chest thrusts until the object comes out. Keep checking in the mouth to see if you can see the object. If you can see it, pull it out. • If the object does not come out in the first few seconds, call for professional help. Don’t try to retrieve the object if you cannot see it.
CHEST THRUSTS
• If five back slaps are unsuccessful, hold the baby’s head with your other hand and turn him face up to lie along your opposite arm, while resting his body on your thigh. • Keep the baby’s head positioned lower than his body, with the back of his head resting in the palm of your hand. If there’s no obvious foreign object visible in the mouth, place two fingers on the centre of the baby’s chest, just below an imaginary line between the nipples, and give up to five quick downward chest thrusts. Press down approximately half of the diameter of the baby’s chest (about 4cm).
REMEMBER
If at any time the baby, child or adult becomes unresponsive, place them gently onto the floor. Begin CPR (as described on pages 20 to 23). Get someone to call emergency services. When giving breaths, take a moment to look in the mouth and see if you can see the object, and remove it if possible. Perform CPR until help arrives.
7CRUSHED HAND/ FINGERS
• First release the trapped fingers or hand from the door or drawer as quickly as you can. • If the skin of the fingers is not broken, hold the fingers under cold running water, or hold an ice pack or a bag of frozen vegetables wrapped in a dishcloth or towel against them. • If the child has difficulty moving his fingers, there may be fractures. See a doctor. • See a doctor if there is
a deep cut, severe pain, deformity or blood under the nail. • If there are wounds to the hand or fingers, cover them with a clean, sterile dressing and elevate the hand.
8DROWNING
Remember that it doesn’t take long for a child to drown; neither does it take much water (anything from as little as 2cm of water can cause drowning).
Always keep an eye on your child if you are near water – even if he can swim. Drowning doesn’t just occur in swimming pools; even a shallow pond or water feature can pose a risk, as can a toilet or a bucket of water.
SAVING A DROWNING CHILD
• If a child is in trouble in the water, approach him cautiously from behind. If he is old enough to understand, talk to him and quickly move closer to him. • Tell him, if he can understand, to stretch his arms away from you. • Grab a piece of clothing or cup a hand under his chin. Pull him back to the shore
A doctor should check any child who has had a near drowning immediately, even if his life is not in danger.
or to the edge of the pool. • If the child is not breathing, start CPR and call emergency services immediately. Tell them you are doing CPR on the patient. • If he is breathing, turn him onto his side and stay with him until the emergency services arrive.
9 EYE INJURY
This can be extremely painful and it may be quite difficult to calm your child down enough in order for you to see the extent of the injury. Do not force the eye open. If the child cannot open the eye without forcing it, medical attention is needed.
WHAT TO DO
• Hold his head still and use a clean pad to cover the injured eye. If an object is stuck in the eye, be careful not to push it further into the eye. Put a pad on either side of the object. • Hold the pad in place with a clean bandage wrapped around the child’s head. Do not put any pressure on any objects stuck in the eye. • Bandage both eyes only if there is an object in the other eye too. • Call the emergency services for help.
BLACK EYE CAUSED BY BLEEDING, LEADING TO BRUISING
A black eye is quite often a minor injury, but it can also appear when there is significant eye injury or head trauma. A visit to your doctor or an ophthalmologist can rule out any serious injury.
WHAT TO DO
• Apply cold compresses intermittently – on for five to 10 minutes, and off again for 10 minutes. Cover the ice with a towel or cloth to protect the delicate skin of the eyelid. If there is no ice available, use a can of cooldrink wrapped in a cloth. • Take your child to the doctor to have the injured eye assessed. • Prop the child’s head up with an extra pillow at night, and encourage him to sleep on the uninjured side of his face for comfort.
SOMETHING IN THE EYE
If there is something embedded in the eye, don’t touch it. Take your child to the doctor or emergency department immediately. Dust, grit and sand often find their way into eyes and are usually easy to remove. Only try to remove something in the eye by flushing with water, as any other method could result in injury. If it does not flush out after the first attempt, seek medical assistance. Don’t let your child rub his eyes; rather make him blink repeatedly.
WHAT TO DO
• Gently pull down the lower lid and ask the child to move the eye around until you can see the object. • Pull the upper lid down over the lower lid. Get your child to blink. • Tilt the child’s head so the affected eye faces downward. Pour a small amount of sterile ( boiled and cooled) water from a jug into the eye. His reflex will be to close his eye when you do this, so you may have to physically keep it open to wash it out. • Do not fiddle with the eye if these steps have not worked. If flushing does not dislodge a foreign body, it will probably be necessary for a medical practitioner to flush the eye. Close both eyes and take the child to a doctor. • Since a particle can scratch the cornea and cause an infection, the eye should be examined by a doctor if there continues to be any irritation afterward.
CHEMICALS IN THE EYE
• Wash the eye gently under running water. Make sure the water doesn’t run from the affected eye into the other eye. You may have to hold the eyelid open. • Cover the eye with a sterile dressing. • Seek medical assistance.
SEEK MEDICAL ASSISTANCE IF YOUR CHILD EXPERIENCES THESE SYMPTOMS
• Increased redness. • Drainage from the eye. • Persistent eye pain. • Any changes in vision. • Any visible abnormality of
the eyeball. • Visible bleeding on the white part of the eye (sclera), especially near the cornea.
10HEAD INJURY
A potentially serious head injury must always receive immediate attention.
EXTERNAL HEAD INJURY
The skull is well designed to protect the brain and most childhood falls result in injury to the scalp only. The scalp is rich with blood vessels, so even a minor cut to the scalp will bleed profusely. The “egg” or swelling that sometimes appears on the scalp results from leaking fluid or blood under the scalp and may take days or even weeks to disappear.
WHAT TO DO
Call the emergency services if your child or infant has lost consciousness, even momentarily. While you wait for them to arrive: • If the fall occurred with great force (down stairs or off a changing table), if the child is unconscious or dazed, or paralysed, spinal injury is a possibility. Don’t move the child at all. Call emergency services. • Try to keep a child with a
head injury calm and still. • Lay him down, while at the same time keeping his head and neck still. • For minor bumps apply an ice pack (or a cold cooldrink can wrapped in a cloth) to the area for 20 minutes. • Cover the wound with a dressing and press gently to control bleeding. You will recognise a serious cut because the edges peel apart and won’t stay together. If you are in any doubt about the seriousness of the head injury, go to the emergency department or call emergency services. • Following a head injury, every child should be observed for any abnormal behaviour or symptoms. Look out for vomiting, continuous crying, irritability and a very sleepy child. • If the incident has occurred close to bedtime or naptime and your child falls asleep soon afterwards, check him every few hours for disturbances in colour or breathing, or twitching limbs. • If his colour and breathing are normal, let your child sleep. But if his colour and/ or breathing are abnormal, or if you are not comfortable with your child’s appearance (always trust your instincts), sit your child up. Your child should fuss a bit and attempt to resettle. If he does not protest, try to awaken him fully. If he cannot be awakened, call the emergency services.
CONCUSSION
• After a blow to the head, watch for unusual behaviour, dizziness or vomiting. • Encourage your child to
rest. • If he’s not fully back to normal in half an hour, he may have concussion or a more serious head injury. • If the child loses conscious
ness, even if only for a very >
short time, he needs to receive medical attention. • If you are in doubt about the seriousness of the injury, rather call an ambulance.
SUSPECTED SEVERE HEAD INJURY
A child should receive immediate medical attention if he displays any of the following symptoms after a head injury: • Blurred vision. • Neck pain. • Confusion. • Blood or clear, watery liquid coming from the ears or nose. • Pupils of different sizes. • A loss of consciousness. • A fit or seizure. • He can’t remember what
happened. • He’s sleepy and you can’t
wake him easily. • Vomits persistently. • Not speaking or walking
normally. • Has a deep cut, or one that won’t stop bleeding, despite intervention. Call for medical assistance if any of these symptoms apply. At the hospital your child will be examined and, on occasion, may need a CT scan that will show if there are any signs of brain injury or bleeding in the brain. Your child may need to be admitted to the hospital.
11INSECT BITES AND STINGS
In most instances, insect bites cause a local reaction (redness and swelling). In some instances, the child may have an allergic reaction, and in cases of severe allergy, an anaphylactic reaction (see page 26).
WASPS AND BEES
• If a wasp or bee stings your child, don’t try to remove the sting with your fingers, as this will force more poison into the flesh. • Use a blunt, flat object like a plastic ruler, credit card or butter knife to scrape over the area. Use a motion that is flush with the skin.
TICKS
• To remove a tick, cover it with petroleum jelly. Using tweezers, hold it as close to your child’s skin as possible and pull it straight out with steady pressure. Apply disinfectant to the area of skin. • Watch for symptoms of tick bite fever, such as headaches, nausea and flu- like symptoms. • Put some bath oil in your child’s bath for the next couple of nights in case you have missed any other ticks. • Be sure to look between your child’s toes and through his hair for any other ticks.
SPIDERS AND SCORPIONS
• Spiders can give quite nasty, painful bites. Scorpions can cause painful stings, too. However, relatively few spiders and scorpions are dangerous. • If a thick-tailed scorpion stings your child, seek immediate medical attention. These scorpions have potent venom and a sting can be fatal if untreated.
12POISON
A child who has swallowed a poisonous substance needs immediate medical attention.
SIGNS AND SYMPTOMS
• Burns or redness around
the mouth. • Empty or half empty bottles or containers lying nearby. • Pieces of plants or berries
in his mouth. • Drowsiness and/or uncon
sciousness.
COMMON POISONS
• Oven, drain and toilet
cleaners. • Paint stripper. • White spirits or methylated
spirits. • Bleach. • Anti-freeze. • Paraffin. • Rat or insect poison. • Washing powder and disin
fectant. • Pills or medicines.
OTHER POISONS
Common garden and houseplants that are poisonous: Oleander, Foxglove, Wisteria, Elephant Ear, Azaleas, Arum Lily.
SWALLOWED POISONS
• Assess what has been swal
lowed, when and how much. • Call for medical assistance. Call the poison centre or your doctor to get immediate emergency advice. The numbers are on page 50. • Remove any visible objects
from the child’s mouth. • DO NOT try to make him vomit. If he swallowed something corrosive (like bleach), it will burn on the way back up. • Keep the container of the product he’s swallowed with you and tell the paramedics exactly what the child has taken. • DO NOT give him anything to drink as this may disperse the poison more quickly around his body.
13TOOTH INJURY
A dislodged baby tooth can be replaced, but a permanent tooth will grow in its place anyway. A permanent tooth can often be saved if prompt action is taken. Remember that the delicate tissue covering the root, called the peridontal ligament, must be protected to ensure successful reimplantation. Take your child to the dentist for this.
A DISLODGED PERMANENT TOOTH
• Hold the tooth by the top,
not the root. • If the child is cooperative and old enough not to swallow the tooth, replace the tooth in its socket. • Have the child bite down on a gauze pad to keep the tooth in place. • If the tooth can’t be reinserted, take it with you to the dentist. • Give the child a gauze pad or clean handkerchief to bite down on. This will help to reduce the bleeding. • Go to the dentist. If the incident happened after hours, go to your closest emergency department.
BROKEN PERMANENT TOOTH
• Collect all the bits of tooth and rinse the mouth with clean water. • Hold a cold compress on
the tooth. • Take your child to the den
tist right away.
14 SHOCK
When there is a significant drop in blood pressure, your child may go into shock. This can be dangerous.
CAUSES
• A loss of blood or body
fluids. • Spinal injury. • Poisoning. • Severe allergy (to food or a
sting). • Severe infection.
SYMPTOMS AT FIRST
• Rapid pulse, grey colour
ing, sweating. • Nausea, vomiting, thirst. • Weakness, dizziness. • Rapid or shallow breathing. • Anxiety.
LATER
As oxygen supply to the brain decreases, the child may yawn, gasp for air, get very thirsty and become anxious. Eventually, he will lose consciousness.
WHAT TO DO
• Call the emergency servic
es immediately. • Treat any obvious cause,
such as bleeding (page 27)
or burns (page 31). • Lie him down with his legs higher than his chest and undo any tight clothing on his neck, chest or waist. • Turn him onto his left side if he’s unconscious or vomiting. • Reassure him and stay near him. Talk to him in a calm, comforting tone to try ease anxiety. • Put a blanket over the child
to help keep him warm. • Do not, under any circumstances, give the child anything to drink. • Keep checking his breathing and pulse, and prepare to give him CPR if indicated (see pages 20 to 23).
ELECTRIC SHOCK WHAT TO DO
• Break the electrical current before you touch your child. If you touch him, you will get a shock too. Switch off the current at the mains or pull the plug out. If you have to move him manually to break the current, stand on something made of non- conducting material like wood or plastic and push him with something non- conductive, for example, a broomstick. • Examine your child. He may be in shock, be burnt or have lost consciousness. • Check for burns (see
page 31). • Electrical burn injuries are often more serious than they appear and can cause internal damage, so your child should be seen by a doctor right away. • If your child is unconscious, place him on his side and call an ambulance. • If necessary, start CPR (see
pages 20 to 23).
15 SWALLOWING A FOREIGN OBJECT
A foreign object that was swallowed can get stuck along the gastrointestinal (GI) tract. This can lead to an infection or blockage or even a tear in the GI tract.
Small children (age one to three) are most likely to swallow a foreign object. These items may include a coin, marble, pencil eraser, buttons, beads, other small items or a battery.
If the object passes through the oesophagus (food pipe) and into the stomach without getting stuck, it will probably pass through the entire GI tract.
Approximately 75% of children who have an impacted foreign body will have it
at the level of the upper oesophageal sphincter.
OBJECTS THAT CAN BE DANGEROUS TO SWALLOW
• Coin- sized button batteries can be found in many household devices such as car remotes, electronic candles, watches, singing greeting cards and other electronic devices. Small coin-shaped batteries can cause serious harm if they do not pass through the body quickly, as the chemicals inside can leak out and burn the surrounding tissue, or they can cause a small electric current which can also do harm. • Objects that are small enough to swallow, but larger than about 18mm across, may get stuck on the way down in small children. • Objects that are pointed such as open safety pins, toothpicks, stiff wire, fish and chicken bones can pierce the gut, so if you think your child may have swallowed one, the child needs to be seen by a doctor as soon as possible.
SIGNS AND SYMPTOMS
If you see your child swallowing something and you cannot stop it happening, or your child may have swal- lowed something, look for these signs that there could be a problem requiring emergency treatment: • Choking. • Coughing. • No breathing or breathing trouble (respiratory distress). • Wheezing • Trouble swallowing food. • Drooling. • Pain in the chest or neck. • Noisy breathing.
Sometimes, only minor symptoms are seen at first. The object may be forgotten until symptoms such as inflammation or infection develop.
WHAT TO DO
If there are any symptoms: • Do not give the child any
thing to eat or drink. • Do not try to make the
child vomit. • Take the child to be seen by a doctor as soon as possible, or take the child to a hospital emergency department. • If the object was likely to be dangerous ( battery, pointed object, tablets, poison, lead sinker, coin), take the child to a doctor as soon as possible or call the emergency services on 082-911. • If the object was small, smooth and not likely to be poisonous (small marble, small coin or button), and there are no symptoms, it is probably reasonable to wait for a while and watch the child, but take the child to a doctor if there are any concerns. • Watch the child's poo to
see if the object is passed. • If it has not passed in several days, and you are sure that the child did swallow something, take the child to your doctor for advice. • Do not give the child laxa
tives or extra fibre. • In severe cases, surgery may be needed to remove the object.