急救 Emergency

急救 Emergency
  1. 過敏症
  2. 燒傷/燙傷
  3. 哽噎
  4. 界傷或割傷
  5. 耳朵的緊急處理
  6. 觸電
  7. 眼睛的緊急處理
  8. 昏厥
  9. 外來物進入鼻子
  10. 足踝扭傷或骨折急救方法
  11. 牙床出血
  12. 頭部受傷
  13. 中暑
  14. 被人或動物咬傷
  15. 昆蟲咬傷和刺傷
  16. 血糖過低
  17. 遇溺
  18. 流鼻血
  19. 中毒
  20. 被蛇咬傷
  21. 不省人事
  1. Allergic Reaction
  2. Burns and Scalds
  3. Choking
  4. Cut/Laceration
  5. Ear Emergencies
  6. Electric Shock
  7. Eye Emergencies
  8. Fainting
  9. Foreign Body in the Nose
  10. Fracture/Sprain Ankle
  11. Gum bleeding
  12. Head Injury
  13. Heat Stroke
  14. Human/Animal Bites
  15. Insect Bites & Stings
  16. Low Blood Sugar
  17. Near Drowning
  18. Nose Bleeding
  19. Poisoning
  20. Snake Bites
  21. Unconsciousness

過敏症

輕微過敏症

症狀
  • 紅眼
  • 打噴嚏,流鼻水,皮膚痕癢
  • 出紅疹或蕁痲疹
處理方法
  1. 安慰小童
  2. 嘗試找出致敏原因,避免日後再接觸
  3. 如果小童仍然感到痕癢,可用布冷敷患處
  4. 於兩小時內,繼續觀察小童是否出現嚴重過敏症病徵

嚴重過敏症

症狀
  • 全身出紅疹或蕁痲疹
  • 面部泛紅
  • 口和眼周圍腫脹
  • 呼吸困難
  • 吞嚥困難或流口水
  • 噁心或嘔吐
  • 腹痛
  • 失去知覺
處理方法
  1. 立即致電 999
  2. 安慰小童
  3. 嘗試找出致敏原因,避免小童日後再接觸
  4. 讓小童坐在一個舒適的地方,避免著涼
  5. 陪伴小童,每5分鐘檢查小童的脈搏、呼吸和清醒程度直至救護車到達
  6. 如果小童攜備抗敏藥,協助小童服食藥物。如小童呼吸困難應避免使用口服藥物
預防方法
  • 避免接觸會引起過敏反應的物品
  • 如果知道小童有嚴重過敏症的病歷,應攜帶下列物件:
    • 敏感紀錄的手鐲或病歷卡
    • 抗敏藥

燒傷/燙傷

燒傷/燙傷的處理方法

處理方法
  1. 撲滅傷者身上的火源
  2. 如衣服並沒黏附在被燒傷的部位,應立刻把衣服脫下
  3. 除下所有首飾
  4. 用大量冷開水沖洗傷口或蓋上一塊冰冷、乾淨的濕布約5-10分鐘或直至痛楚減輕
  5. 將被燒傷的手或腳承高置於心臟水平以上。如被燒傷的部位是面部,讓傷者坐在椅上
  6. 用一塊乾淨的布輕輕蓋在燒傷部位上
  7. 輕微的燒傷通常不用特別處理而能自癒
  8. 如遇以下情況,請即致電 999:
    • 燒傷部位面積過大或過深
    • 燒傷部位在面、手或關節處
    • 被燒傷患者呼吸困難或昏迷
  9. 切勿:
    • 在燒傷部位塗上藥膏或綑上黏性硼帶
    • 觸弄任何水泡或死皮
    • 除去已黏附在燒傷部位的衣服
    • 如果燒傷情況嚴重,切勿讓傷者進食
    • 將嚴重燒傷的部位浸在凍水中

化學品灼傷的處理方法

處理方法
  1. 先戴上手套和眼罩,除去已被化學品染污的衣服和首飾
  2. 立刻用大量清水清洗被化學品灼傷的皮膚或眼睛
  3. 對於細小的灼傷部位,先用一塊乾淨的紗布蓋上,然後再送傷者到急症室就診
  4. 對於較大的灼傷部位,先致電 999,然後用清水不斷衝洗被燒傷部位
預防方法
  • 在學校安裝煙霧警報器
  • 教導小童有關防火安全知識
  • 在學校的適當位置放置滅火筒
  • 認識學校裡的走火路線和進行火警演習
  • 在處理化學物品時須戴上保護眼罩和手套

哽噎

神志清醒的嬰兒 (一歲以下)

即時處理
  1. 用一隻手支持嬰兒的頭和頸,讓嬰兒面部朝下,頭部低俯於胸下,承托在你的大腿上
  2. 用手掌在嬰兒肩胛骨之間大力拍擊五次
  3. 承托嬰兒頭部,反轉平躺在你的手臂或大腿上,嬰兒面部朝上,頭微低於身
  4. 用兩隻手指在其胸骨下方擠壓五次,每次輻度為半吋至1吋。勿擠壓胸骨的尖端
  5. 重覆步驟1-4直至阻塞物被吐出為止
Conscious Infant

不省人事的兒童 (一歲以下)

即時處理
  1. 召喚救援,致電 999
  2. 把嬰兒頭部後仰及抬起下頷。清除看見的異物
  3. 進行人工呼吸
  4. 進行連續五次拍擊和五次擠壓的步驟 (如神志清醒的嬰兒中步驟 1 至 4)
  5. 每次完成拍擊和擠壓後,檢視其體內的阻塞物,如看見即清除
  6. 重覆步驟 4 和 5,直至阻塞物吐出
  7. 如阻塞物清除後,嬰兒仍沒有呼吸,應立刻進行心肺復甦法

神志清醒的兒童 (一歲以上)

即時處理
  1. 進行五下腹部推壓法:
    • 從後抱著小童腹部。將你其中一個拳頭置於傷者肚臍上方、胸骨以下
    • 另外一隻手緊握拳頭,快速用力將拳頭向上及向內擠壓。連續擠壓 5 下
  2. 重覆以上步驟,直至小童吐出阻塞物或救護人員到場

不省人事的兒童 (一歲以上)

即時處理
  1. 讓傷病者平躺,手放兩旁
  2. 召喚救援,致電 999
  3. 托起小童下顎骨,如發覺口內有異物,把它清除
  4. 進行人工呼吸
  5. 若未能成功灌氣,進行五次腹部推壓法
  6. 重覆步驟 4-5,直至阻塞物被吐出
  7. 如阻塞物清除後,小童仍沒有呼吸,應立刻進行心肺復甦法
不省人事的兒童

界傷或割傷

及時處理方法
  1. 保持冷靜及安慰傷者
  2. 如果傷口是不深,可以用水喉水沖洗及輕輕抹乾
  3. 如果可以,儘量升高流血位置
  4. 可用已消毒的繃帶或清潔的布直接加壓在傷口
  5. 保持加壓狀態直至止血為止
  6. 止血之後,可用藥水膠布包紮傷口
如有以下情況,就要立即進行急救及尋求協助
  • 加壓都不能止血
  • 傷口需要縫合或傷口藏有不能容易清理的沙石
  • 如有一些物件包括刀、木棒或鈎等物體藏在傷口裡,千萬不要強行移除,可加護墊及繃帶包圍物件及固定位置
  • 懷疑有內出血及中風
  • 傷者有服用抗凝劑或有凝血問題,例如:血友病

耳朵的緊急處理

外來物進入耳朵的處理方法
  1. 安慰小童
  2. 如物件突出耳孔之外及容易拿出,可用手或鉗輕輕把物件拿出
  3. 把有問題的耳朵側置向下,並向地下的方向輕力搖動,利用地心吸力把物體滑出
  4. 如以上方法無效,即送小童到急症室就診
耳膜破裂的處理方法
  • 小童會感到劇痛,用乾淨的紗布蓋著耳朵以保持耳內清潔
  • 送小童到急症室就診

觸電

處理方法
  1. 關上電源
  2. 致電 999
  3. 在關掉電源前,切勿接觸觸電的小童
  4. 如未能切斷電源可踏在絕緣體上,例如:木箱、報紙,然後用木棍、木椅或膠地毯嘗試將小孩從電源處隔開
  5. 當肯定小孩已和電源隔離後,立刻檢查小孩的呼吸、心跳和清醒程度
  6. 檢查有否被灼傷 (詳見燒傷處理方法)
預防方法
  • 為了防止小童把手指或金屬物插進電掣內,用塑膠造的安全蓋覆蓋所有電掣
  • 更換所有破損的電掣和電線
  • 切勿在水源旁邊使用電器
  • 清楚知道學校裏保險絲和電流斷路掣的位置

眼睛的緊急處理

外來物進入眼內

處理方法
  1. 不要讓傷者揉擦眼睛
  2. 把傷者頭傾側移至洗手盆,受傷眼睛在下方,輕力把下眼簾向下拉,吩咐傷者盡量張開眼睛
  3. 小心用水或生理鹽水把微粒沖出
  4. 如不能把微粒沖出或眼部持續不適,請立即送傷者到急症室就診
  5. 如微粒已嵌入眼睛內,不要嘗試拿出,應立即送傷者到急症室就診

化學品灼傷眼睛

處理方法
  1. 在協助傷者前,應戴上手套和眼罩
  2. 把傷者頭部傾側,受傷眼睛在下方。用開水或生理鹽水清洗15-30分鐘
  3. 用乾淨的毛巾(或紗布)蓋著傷者雙眼以減少眼部活動,不能揉擦眼睛
  4. 立刻送傷者到急症室就診,並告訴醫護人員化學品的名稱

眼部瘀傷

處理方法
  1. 用布包裹冰塊敷在受傷的眼睛上,約5-10分鐘
  2. 送傷者到急症室詳細檢查眼睛
預防方法
  • 當使用電動器具和化學物品前應戴上保護眼罩

昏厥

引致昏厥的原因
  • 長時間站立
  • 突然改變身體姿勢,例如:突然由仰臥轉為站立
  • 嚴重痛楚、焦慮、悲痛、恐懼
  • 低血糖
  • 大量出血
  • 嚴重脫水
  • 服用過量藥物或酒精
  • 中暑
  • 抽搐
  • 心臟或血液循環有問題,例如心率不正、心臟病發、中風
  • 如處於悶熱、潮濕或空氣不流通的房間,會增加昏厥的機會
處理方法
  1. 讓小童躺下,並抬高雙腿
  2. 把小童的頭轉向一側,令舌頭不會向後滑進喉嚨裡而阻礙呼吸
  3. 鬆開小童在頸和腰部的衣服
  4. 保持小童體溫適中及保持氣管暢通,並監察呼吸情況
  5. 檢查有否明顯的受傷或出血
  6. 如3分鐘內未能回復清醒,即致電 999
預防方法
  • 慢慢地由坐立的姿勢轉為站立
  • 不要穿著一些緊貼頸部的衣物
  • 不要太急速轉動頭部或長時間靜止站立
  • 確保空氣流通並避免出席太多人聚集的地方

外來物進入鼻子

處理方法
  1. 讓小童用口部呼吸
  2. 如知道那一邊的鼻孔受阻,先用手輕按正常那邊的鼻孔,然後讓小童輕力把空氣從受阻的鼻孔中噴出
  3. 如以上方法無效,請送小童到急症室就診
  4. 切勿嘗試用工具探鼻孔,因為有可能把阻塞物推進喉部,甚至進入肺部,阻塞呼吸

足踝扭傷或骨折急救方法

原因
  • 從高處墜下
  • 單車意外
  • 直接撞擊
  • 兒童被虐待
  • 運動而引起的骨折
徵狀
  • 骨頭或關節明顯移位
  • 四肢運作受到限制
  • 腫漲
  • 強烈的痛楚
  • 麻木
  • 流血
急救
  1. 檢查傷者的氣管及血液循環,如有需要,開始施以人工呼吸
  2. 令傷者保持鎮定並尋求醫生協助
  3. 仔細檢查傷者其他傷處
  4. 如果能即時找到醫生,可請醫生進一步治療傷者的骨折
  5. 如果皮膚因骨折受損,不要用口吹傷口處或接觸傷口。在可行的情況下,清理及沖洗可見的污物及其他污染,但不要過於大力擦,在固定傷處之前用消毒的布料先行覆蓋
  6. 可用夾板固定傷口的位置,可行的固定物料包括捲好的報紙或木板。﹝記著不要過緊, 以防止壓力引致血液不流通﹞。可以用冷包敷傷口,減輕其痛楚及腫脹
  7. 包紮好傷口之後,檢查傷口附近的血液循環
  8. 盡量不要移動傷者,讓傷者平躺著,把腳部托高過頭部, 如果血液循環不足而又沒有醫護人員在場,你可嘗試讓傷者把手腳放到休息的位置。這樣可以自我控制的動作,減少因腫脹、痛楚及組織因血液供應減少而引起的破壞
  9. 以褸或毛氈蓋著傷者,如果懷疑傷處是在頭部、頸部或背部就不要移動傷者
  10. 如果骨折令到皮膚有破損及有流血的情況出現,放一塊乾及清潔的布蓋著止血。如果流血的情況繼續,可以直接加壓在流血的部位。除非有生命的危險,否則如果傷口在手腳末端,不要用止血帶去止血
不要
  • 不要移動傷者,除非受傷的地方已經固定好位置
  • 如非必要,不要移動盆骨、髖骨或上腿骨有骨折的傷者。可以用「衣服拖行法」。你可以用衣服把傷者拉到安全地方﹝例如拉傷者肩膊位的衣服,或拉傷者的皮帶或褲,不要拉傷者的手腳﹞ ‧ 如懷疑傷者的脊椎有受傷,不要移動傷者
  • 如懷疑傷者的脊椎有受傷,不要移動傷者
  • 除非傷者的血液循環有問題,否則不要嘗試把傷者移位的骨頭或關節拉直
  • 如懷疑傷者有頸椎受傷,不要嘗試移動其位置
  • 不要測試移位的骨頭或關節是否失去功能
  • 不要放任何東西進入傷者口部
如果有以下情況,就要立即打電話尋求醫生協助
  • 傷者有骨折或骨頭移位,或嚴重流血情況
  • 不能固定傷者的骨折情況
骨折的預防
  • 溜冰、踏單車或滾軸溜冰時要配戴以下保護物:
    • 頭盔
    • 護肘
    • 護膝
    • 護脛
  • 小孩的活動環境要確保安全
  • 教導小孩「安全」的概念,及如何照顧自己
  • 小心照顧小孩
  • 留意四周的警告提示,避免跌倒
相關網址

牙床出血

處理方法
  1. 用一塊吸過冰水的紗布蓋住傷口和施加壓力
  2. 喝冰凍的水以減低腫脹
  3. 送小童到牙醫處診理
如牙齒被撞擊折碎
  1. 收集所有牙齒碎片
  2. 用凍的紗布蓋住傷口
  3. 送小童到牙醫處診治
如牙齒被撞脫
  1. 按著牙冠而非牙根位置
  2. 將牙齒嵌回齒槽內,並叫小童用手固定位置或將牙齒放在一杯牛奶或生理鹽水中。切勿用水喉水,因為水中含有的氯氣會破壞牙齒。切勿刷洗牙齒
  3. 送小童到牙醫處診治

頭部受傷

處理輕微的頭部受傷

處理方法
  1. 冰敷受傷的部位
  2. 提醒家長觀察小童24小時
    • 昏睡或失去知覺
    • 不正常的行為
    • 鼻、耳或口流血
    • 言語或視力不清晰
    • 軟弱無力或四肢痲痺
    • 嚴重的頭痛或頸部不靈活
    • 多次嘔吐
    • 抽搐
  3. 如果發現小童有以下徵狀,應立即送小童往急症室就診:

處理嚴重的頭部受傷

處理方法
  1. 致電 999
  2. 檢查小童的呼吸、脈膊和知覺
  3. 讓小童休息,俯臥在平面上。不要移動或扭動其頸部或脊椎
  4. 如果發現頭部有流血的跡象,不要在傷口使用直接按壓法。要用乾淨的毛巾去敷蓋傷口
預防方法
  • 教導小童
    • 橫過馬路前要先停下及觀察四週的情況
    • 不要在街道上隨意奔跑
    • 當發脾氣時不應把頭撞向硬物
    • 不應把小童單獨留在室內高處,例如:梳化、檯或床上
    • 不應在樓梯放置雜物
  • 當踏單車、溜冰、拳擊時,須戴上頭盔

中暑

中暑是一種可致命的急症。中暑情況發生時,身體溫度有可能超過攝氏42度

處理方法
  • 昏迷或失去知覺
  • 精神紊亂
  • 體溫上升
  • 沒有汗出
  • 皮膚發紅
即時處理
  1. 打電話尋求協助或打 999
  2. 把小童移到一個清涼,有遮蔭的地方
  3. 除去或解鬆小童的衣服
  4. 可用冷水輕敷小童
  5. 如果他/她清醒,可每隔 15 分鐘給他/她喝凍水
  6. 千萬不要用冰水或冰墊替小童冷卻身體
  7. 一直陪伴著小童,直至得到醫療協助
  8. 通知小童家長或監護人
預防方法
  • 如有酷熱警告,就要減少或停止所有學生的戶外活動,例如:體育課、小息及學校旅行
  • 當學生需要在炎熱天氣下活動時,確保他們有充足水份飲用及有帽或雨傘遮擋陽光
  • 重新安排遊戲時間﹝例如:足球活動﹞可延遲到黃昏或氣溫較低的天氣下進行

被人或動物咬傷

處理方法
  1. 用肥皂及清水清洗患處,去除口水及殘留物
  2. 如患處腫脹,冷敷被咬部位 5-10分鐘
  3. 如患處出血,用清潔的布直接按壓在患處上,直至止血為止。並將患處承置高處
  4. 送傷者到急症室診治
  5. 檢查傷者的破傷風注射紀錄,看是否需要接受加強劑
  6. 如被動物咬傷,應找出寵物最近一次注射瘋狗症針的日期
  7. 如被人類咬傷,而致皮膚有傷口,請知會咬人者與及被咬傷者的家長,告之其子女可能和他人有血液上的接觸
預防方法
  • 教導小童不要觸怒動物
  • 教導小童不要咬別人
  • 不要把手放進正在抽搐的病傷者口中

昆蟲咬傷和刺傷

處理方法
  1. 用肥皂及清水清洗被咬傷的部位
  2. 用布包裹冰塊敷在傷口數分鐘
  3. 如皮膚發癢,應塗上抗敏感藥
  4. 如所咬傷的部位在口部或在蟄傷後兩小時內出現嚴重過敏徵狀,應立即求醫 (參考嚴重過敏症部份)
預防方法

在戶外活動時:

  • 保持食物和飲品容器完全遮蓋 (蜜蜂喜歡甜的食物,例如汽水)
  • 避免使用噴髮水或香水
  • 避免穿上花圖案或深色的衣物。選擇穿著淺色的衣物
  • 穿著可以遮蓋手和腳的緊身衣物。避免赤足走路
  • 使用適當的驅蟲劑 (參考登革熱的防蚊措施部份)

血糖過低

症狀
  • 軟弱無力
  • 顫抖
  • 頭痛
  • 出冷汗
  • 心跳加速
  • 視力模糊
  • 神志昏亂
  • 不省人事
處理方法
  1. 給小童進食一些含糖份的飲料或小吃
  2. 如果情況沒有改善,請致電 999
  3. 如小童失去知覺,請根據不省人事處理方法處理

遇溺

處理方法
  1. 嘗試先用木棍或伸手拉出水中的小童,如不成功,把繩拋向遇溺小童,然後拉回岸邊
  2. 如要下水拯救,應從後接近小童
  3. 抓著小童的衣服或托著小童的下巴,面向天把他拉回岸邊
  4. 提醒小童不要抓著救生員,保持和小童談話以穩定他的情緒
  5. 檢查呼吸和脈搏,若有需要應進行心肺復甦法
  6. 除去濕透的衣服,並為小童蓋上乾毛毯或衣服保暖
  7. 致電 999
  8. 置小童於復原臥式姿勢
預防方法
  • 不要單獨留小童於水邊、游泳池或水池中
  • 如果沒有有經驗的成年泳者帶領,小童不應單獨游泳
  • 教導小童下水前應先檢查水深
  • 老師應參加急救和水上安全課程

流鼻血

處理方法
  1. 讓小童坐下,頭部向前傾
  2. 用拇指和食指輕力按壓鼻子柔軟部位
  3. 連續按壓 5-10 分鐘,用口呼吸
  4. 使用冰凍物件 (例如:毛巾包著冰塊) 按壓在鼻子附近
  5. 如流鼻血超過 20 分鐘,立刻到急症室診治
流鼻血停止後的護理
  • 保持鼻孔濕潤,例如冬天可使用霧化器,特別在冬天的時候
  • 不要挖鼻孔或大力磨擦鼻子
  • 一星期內不要吃亞氏匹靈或喝太熱的飲品

中毒

毒物可經由口腔、肺部、眼睛、皮膚或由皮下注射進入人體

症狀
  • 小童口中發現藥物或其他異物
  • 在口的邊緣或皮膚上發現灼傷
  • 呼出氣體有異味
  • 異常出汗
  • 嘔吐/噁心
  • 腹痛
  • 休克/昏厥
  • 咳嗽/呼吸困難
處理方法
  • 吞食毒物
    1. 戴上手套檢查小童口腔,清除餘下毒
    2. 檢查小童口腔時,不要引起嘔吐或讓小童服食任何東西
    3. 立刻致電 999
    4. 如可能,請找出
      • 小童年齡和體重
      • 小童吞下的東西
      • 吞下物的數量和吞食時間
    5. 把吞下物放進容器內,並一併和小童送到醫院
  • 吸入毒物
    1. 致電 999
    2. 如情況安全,用一塊濕布蓋著口和鼻。立即把小童從氣體、煙霧中救出。把窗和門打開來驅散煙霧
    3. 切勿使用明火,因為有些氣體易燃
    4. 小童被救離危險環境後,檢查氣管和脈搏,並隨時準備施以心肺復甦法
    5. 如有皮膚燒傷,立刻進行急救
預防方法
  • 把清潔劑、化學品、藥物放在小童不能接觸的地方或放於鎖好的櫃內
  • 教導小童遠離有毒的危險品。並在所有盛載毒物的器皿上加上「危險」標誌

被蛇咬傷

處理方法
  1. 致電 999
  2. 安慰小童
  3. 用肥皂及清水清洗傷口
  4. 停止活動,並把被咬傷部位放置於心臟以下的水平,以減低毒液的流動
  5. 把被咬處附近的首飾例如:戒指、手 錶除下
  6. 不應:
    • 冷敷傷口
    • 用口嘗試把毒液吸出
    • 用刀切割傷口
    • 嘗試用硼帶或布綑著被咬傷的手或腳來阻止毒液的流動
    • 給予小童口服任何食物或藥物

不省人事

原因
  • 可能由某些疾病或意外引起
  • 包括所有引起昏厥的原因 (詳見昏厥部份)
處理方法
  1. 致電 999
  2. 檢查呼吸和脈膊
  3. 如小童仍有呼吸及不是懷疑脊骨受傷,把小童轉向一側,把他的頭部輕微後仰以暢通氣管
  4. 如懷疑脊骨受傷,請不要移動傷者
  5. 保持小童溫暖,直至醫護人員到場
  6. 不要讓傷病者飲食

Allergic Reaction

Mild Allergic Reaction

Symptoms
  • Red, watery eye
  • Itchy, sneezing, runny nose
  • Rash or hives especially over face and neck
Management
  1. Reassure the child
  2. Try to identify the allergen and avoid further contact with it
  3. If the child develops an itchy rash, apply cool compresses
  4. Watch out for any delayed symptoms of severe allergic reaction for up to 2 hours

Severe Allergic Reaction

Symptoms
  • Rash or hives all over the body
  • Flushed face
  • Swelling around the mouth, eyes
  • Difficulty breathing or wheezing
  • Difficulty swallowing or drooling
  • Nausea or vomiting
  • Abdominal cramps or pain
  • Loss of consciousness
Management
  1. Call 999 immediately
  2. Reassure the child
  3. Try to identify the allergen and avoid further contact with it
  4. Sit the child up in a comfortable position and cover with a coat or blanket
  5. Accompany the child and monitor pulse, breathing and level of consciousness every 5 minutes until emergency crew arrive
  6. If the child has emergency allergy medication on hand, assist the child in taking or injecting the medication. Avoid oral medication if the child is having difficult breathing
Prevention
  • Avoid contact with known triggers
  • If there is a known history of severe allergic reaction, the child should:
    • Have an emergency kit which contains an antihistamine, adrenaline injection and doctor's instruction on how to use the emergency kit. Teachers should assist the child in taking the medication or giving the injection according to the instruction.
    • Carry a Medic Alert bracelet or card which clearly states his or her allergy

Burns and Scalds

Management of heat burns/scalds

Management
  1. Stop the burn source
  2. Remove clothing from burnt area immediately if it doesn't stick to burnt area
  3. Remove jewellery
  4. Flush the burn with large amount of cool running water or cover with a clean, cool, wet cloth. Do this for at least 5-10 minutes or until the pain is relieved.
  5. If the arm(s) or leg(s) are burned, elevate them above heart level. If the burn is on the face, have the child sit up.
  6. Cover the area loosely with a small clean dry cloth
  7. Minor burns will usually heal without further treatment
  8. Call 999 if:
    • Burn is large or deep
    • Burn is on face, hands, feet or a major joint
    • The child is having difficulty breathing or unconscious
  9. Do Not:
    • Do not apply any ointment, adhesive bandages to a burn
    • Do not disturb any blisters or dead skin
    • Do not remove clothing that is stuck to the skin
    • Do not give the child anything by mouth, if there is a severe burn
    • Do not immerse a severe burn in cold water

Management of chemical burns

Management
  1. Wear gloves and goggles. Remove clothing and jewellery if exposed to chemicals.
  2. Rinse chemicals off skin, eyes immediately with large amount of water
  3. If the burnt area is small, apply a clean bandage and bring the child to A&E.
  4. If the area is large, ring 999 while continue to flush the burned area with water
Prevention
  • Install smoke alarms in your school
  • Teach children about fire safety
  • Place fire extinguishers in key locations in your school
  • Know about and practice fire escape routes in your school
  • Wear protective eyewear and gloves when handling chemicals

Choking

Conscious Infant (Under 1 year old)

Immediate Care
  1. Support the head and neck with one hand. Straddle the infant face down over your forearm, head lower than trunk, supported on your thigh.
  2. Deliver 5 back blows, forcefully, with the heel of the hand between the infant's shoulder blades.
  3. While supporting the head, turn the infant supine head lower than trunk.
  4. Using 2 or 3 fingers deliver 5 chest thrusts in the breastbone (sternum) region. Depress the sternum ? to 1 inch for each thrust. Avoid the tip of the sternum.
  5. Repeat both back blows and chest thrusts until foreign body is expelled or the infant becomes unconscious.
Conscious Infant

Unconscious Infant (Under 1 year old)

Immediate Care
  1. Shout for help. Call 999.
  2. Perform tongue-jaw lift. If you see the foreign body, remove it.
  3. Attempt rescue breathing.
  4. Perform the sequence of 5 back blows and 5 chest thrusts as described for conscious infant.
  5. After each sequence of back blows and chest thrusts, look for the foreign body and, if visible, remove it.
  6. Repeat steps 4 and 5 until the object is dislodged
  7. If the infant is not breathing after the object is removed, begin the ABC's of CPR

Conscious Child (Over 1 year old)

Immediate Care
  1. Perform 5 abdominal thrusts (the Heimlich manoeuvre):
    • Reach around the victim's waist. Position one clenched fist above navel and below rib cage
    • Grasp fist with other hand. Pull the clenched fist sharply and directly backward and upward under the rib cage quickly. Perform a series of up to 5 thrusts.
  2. Continue uninterrupted until the obstruction is relieved or emergency crew arrive.

Unconscious Child (Over 1 year old)

Immediate Care
  1. Position victim on back, arms by side.
  2. Shout for "Help". Call 999.
  3. Do not perform blind finger sweep in children up to 8 years old. Instead, perform a tongue-jaw lift and remove foreign body only if you can see it.
  4. Perform rescue breathing. If unsuccessful, give 5 abdominal thrusts (the Heimlich manoeuvre).
  5. Repeat sequence: perform finger sweep, attempt rescue breathing, perform abdominal thrusts, until successful.
  6. After obstruction is removed, begin the ABC's of CPR, if necessary
Unconscious Child

Cut/Laceration

Immediate Care
  1. Keep calm and reassure the victim.
  2. If wound is superficial, wash it with running water and pat dry.
  3. Elevate the bleeding area if possible.
  4. Apply pressure directly on the wound with sterile bandage or clean cloth.
  5. Maintain pressure until the bleeding stops.
  6. When the bleeding stopped, bind the wound dressing with adhesive tape.
Seek emergency assistance/medical care if...
  • Bleeding is not controlled by the application of pressure.
  • The wound might need suturing up, or embedded gravel or dirt cannot be removed easily with gentle cleaning.
  • An object such as a knife, stick or hook etc becomes embedded in the body. DO NOT remove it, apply pads and bandages around the object and tape it in place.
  • Internal bleeding or shock is suspected.
  • The victim takes anti-coagulants or has a bleeding disorder, such as hemophilia.

Ear Emergencies

Management of foreign body in the ear
  1. Reassure the child
  2. If the object is sticking out and easy to remove, gently remove it by hand or with tweezers
  3. Try using gravity to get the object out by tilting the head to the affected side. Shake it gently in the direction of the ground to try to dislodge it.
  4. If this method fails, bring the child to A&E.
  5. Do not reach inside the ear canal with tweezers. This may push the object farther into the ear canal and cause trauma.
Management of ruptured eardrum
  1. The child will have severe pain. Place sterile cotton gently in the outer ear canal to keep the inside of the ear clean
  2. Bring the child to A&E

Electric Shock

Management
  1. Turn off power
  2. Call 999
  3. Do not touch the child who is in contact with electricity until power source is shut off
  4. If you can't turn off the source of current, stand on an insulator e.g. a wooden box, folded newspapers and try to separate the child from the source of electric current using a broom, wooden chair or rubber doormat
  5. Once it is safe for you to touch the child, check for breathing, pulse and consciousness.
  6. Check for burns (Refer to section on Burns)
Prevention
  • Cover all electric sockets with plastic safety caps so children can't stick their fingers or a metal object in the sockets
  • Replace worn cords and wiring
  • Never use an electrical appliance near water
  • Know the location of fuse boxes and circuit breakers in your school

Eye Emergencies

Management of foreign body on eye surface
  1. Keep the child from rubbing the eye
  2. Tilt the child's head over a basin with the affected eye down and gently pull down the lower lid, encouraging the child to open his or her eyes as wide as possible.
  3. Gently pour tap water/lukewarm water or sterile saline across the eye to flush out the foreign body
  4. If a foreign body is not dislodged by flushing or if eye discomfort continues, bring the child to A&E immediately
  5. Do not attempt to remove a foreign body that appears to be embedded in any part of the eyes
Management of chemical exposure
  1. Wear gloves and if possible, goggles
  2. Immediately rinse the eye with tap water or saline for 15 - 30 minutes. Tip the head so the affected eye is below the unaffected eye.
  3. Cover both eyes with a clean towel or bandage and avoid any rubbing of the eyes. Even if only one eye is affected, covering both eyes will help prevent eye movement
  4. Bring the child to A&E immediately. Give the exact name of the chemical to medical staff.
Management of black eye/blunt injury
  1. Apply cold compresses intermittently: 5-10 minutes on, 10-15 minutes off
  2. Bring the child to A&E to rule out injury to the eye
Prevention
  • Wear protective plastic glasses when using power tools and working with toxic chemicals

Fainting

Causes of fainting include
  • Prolonged standing
  • Sudden change in body posture e.g. standing up suddenly from a lying down position
  • Severe pain, anxiety, emotional distress, fear
  • Low blood sugar
  • Bleeding
  • Severe dehydration
  • Drug or alcohol overdose
  • Heat stroke or heat exhaustion
  • Convulsion
  • Heart or circulatory problems e.g. abnormal heart rhythm, heart attack, stroke
  • Risk for fainting increases if you are in hot, humid weather or in a stuffy room
Management
  1. Lie the child down with the head below the level of the heart. Raise the legs
  2. Turn the child's head to the side so the tongue doesn't fall back into the throat
  3. Loosen clothing around neck and waist
  4. Keep the child warm. Keep airway clear and monitor breathing
  5. Look for any obvious injury or bleeding
  6. Call 999 if the child does not regain consciousness after 3 minutes
Prevention
  • Get up slowly from a sitting position.
  • Don't wear tight-fitting clothing around the neck.
  • Avoid turning head suddenly or standing in one place for too long without moving
  • Stay out of stuffy rooms and hot, humid places. Ensure good ventilation and avoid overcrowdings during assembly
  • Ensure students have good hydration

Foreign Body in the Nose

Management
  1. Ask the child to breathe through the mouth
  2. Once it is determined which nostril is affected, gently press the other nostril closed and have the child blow gently through the affected nostril. Avoid blowing the nose too hard.
  3. If this method fails, bring the child to A&E
  4. Do not probe the nose with other tools. This may push the object down to the back of the child's throat where it may be aspirated.

Fracture/Sprain Ankle

Causes
  • Fall from a height
  • Bicycle accidents
  • Direct blow
  • Child abuse
  • Stree fractures caused by exercise
Symptoms & signs
  • A visible out-of-place or misshapen limb or joint
  • Limitation or unwillingness to move a limb
  • Swelling
  • Intense pain
  • Numbness and tingling
  • Bleeding or laceration (open fracture)
First Aid
  1. Check the victim's airway, breathing, and circulation. If necessary, begin rescue breathing or bleeding control.
  2. Keep the victim still, provide assurance, and call for medical help.
  3. Examine the victim closely for other injuries.
  4. In most cases, if medical help can respond quickly, allow the medical personnel to take further action on the fractured bone.
  5. If the skin is broken by a fractured bone, don't breathe on the wound or probe it. If possible, lightly rinse to remove visible dirt or other contamination, but do not vigorously scrub or flush the wound. Cover with sterile dressings before immobilizing the injury.
  6. Splint or sling the injury in the position in which you found it. Possible splints include rolled up newspaper or strips of wood. (Make sure to pad any hard splinting material to prevent a pressure sore). Immobilize the area both above and below the injured bone. Ice packs may be applied to ease pain and swelling.
  7. Check the circulation of the affected area after immobilizing -- press firmly over skin that is beyond the fracture site. (For example, if the fracture is in the leg, press on the toes). It should first blanch and then "pink up" in about two seconds.
  8. If circulation appears inadequate (pale or blue skin, numbness or tingling, loss of pulse) and trained personnel are not quickly available, try to realign the limb into a normal resting position. This can be tested with voluntary movement. It should be done as soon as possible (within three hours of injury) to reduce swelling, pain, and damage to the tissues from lack of blood.
  9. Make an effort to prevent shock. Lay the victim flat, elevate the feet about 12 inches above the head, and cover the victim with a coat or blanket. However, do not move the victim if a head, neck, or back injury is suspected.
  10. If an open fracture is present and bleeding is encountered, place a dry, clean cloth over the wound to dress it. If the bleeding continues, apply direct pressure to the site of bleeding. DO NOT apply a tourniquet to the extremity to stop the bleeding unless it is life-threatening.
Do Not
  • DO NOT move the victim unless the injured area is completely immobilized.
  • DO NOT move a victim with an injured hip, pelvis, or upper leg unless it is absolutely necessary. If you must move the victim immediately, use the "clothes drag" technique. This is done by pulling the victim to safety by his clothes (such as the shoulders of his shirt, by the belt, or by the pant-legs) rather than pulling on possibly injured limbs.
  • DO NOT move a victim with any suspected spine injury.
  • DO NOT attempt to straighten a misshapen bone or joint or to change its position unless circulation appears hampered.
  • DO NOT try to reposition a suspected cervical spine injury.
  • DO NOT test a misshapen bone or joint for loss of function.
  • DO NOT give the victim anything by mouth.
Call immediately for emergency medical assistance if
  • The victim has a dislocation or broken bone, or if there is severe bleeding.
  • You cannot completely immobilize the injury at the scene by yourself.
Prevent the risk of fracture incidents
  • Wear the following protective gear while skiing, biking, and roller blading:
    • Helmets
    • Elbow pads
    • Knee pads
    • Shin pads
  • Create a safe environment for young children.
  • Teach safety. Help children learn how to look out for themselves.
  • Supervise children carefully. There is no substitute for adequate supervision, no matter how safe the environment or situation appears to be.
  • Avoid falls by observing posted warnings.
Related Website

Gum bleeding

Management
  1. If there is bleeding, put cold water on a piece of gauze and apply pressure to the site
  2. Offer the child an ice pop to suck, to reduce swelling
  3. Bring the child to a dentist
If a permanent tooth is chipped
  1. Collect all the pieces of the tooth
  2. Give the child a cold compress to hold on the injured tooth
If a permanent tooth is knocked out
  1. Hold the tooth by the crown, not the root
  2. Place the tooth gently back in socket and have child hold it in place or place in glass of milk/normal saline. Avoid using tap water which contains chlorine, which may damage the root. Do not scrub the tooth.
  3. Bring the child to a dentist

Head Injury

Management of mild head injury
  1. Apply cold compress or ice wrapped in a towel to the bump
  2. Ask parents to watch the child closely over the next 24 hours
  3. Bring the child to A&E immediately if the child develops any signs of internal injury:
    • Drowsiness or unconsciousness
    • Abnormal behaviour
    • Bleeding from the nose, ear or mouth
    • Disturbance of speech or vision
    • Weakness or paralysis
    • Severe headache or neck stiffness
    • Vomiting (especially more than once)
    • Seizure
Management of moderate to severe head injury
  1. Call 999
  2. Check for breathing, pulse and consciousness
  3. Have the child rest, lying flat. Do not move or twist the neck or spine
  4. If there is bleeding from the scalp, do not apply direct pressure to the bleeding site. Cover the wound with a clean cloth
Prevention
  • Wear a helmet when biking, roller-blading or boxing
  • Teach the child:
    • To stop and look both ways before crossing a street
    • About the dangers of running into the street without first looking
    • Not to bang his or her head against something hard during a temper tantrum
  • Don't leave a child alone on a high place like a sofa, changing table or bed
  • Keep stairs free of clutter

Heat Stroke

Heatstroke is a life-threatening emergency. It occurs when body's core temperature rises: it may exceed 42°C.

Signs and symptoms
  1. Fainting or unconsciousness
  2. Confusion
  3. Elevated body temperature
  4. Lack of sweating
  5. Red or flushed skin
Immediate Care
  1. Call for help, or call 999
  2. Move the student to a cool, shady place.
  3. Remove or loosen the child's clothing.
  4. Sponge the student with cool water.
  5. If he/she is conscious, give him/her a glass of cold water every 15 minutes.
  6. Don't cool with freezing cold water or ice packs.
  7. Keep staying with child until medical help arrives.
  8. Inform child's parents/guardian.
Prevention
  1. If the heat health hazard warning is announced, decrease/suspend outdoor physical activities for all students such as PE lessons, recesses and school picnic.
  2. When student are out in the heat, make sure they have plenty fluid to drink, hat or umbrella.
  3. Reschedule game time (e.g. football game) to late afternoon when the temperature comes down.

Human/Animal Bites

Management
  1. Wash the bitten area with soap and water to remove any saliva and other debris
  2. If the wound is swollen, apply cold pack or ice wrapped in a towel for 5 to 10 minutes
  3. If the wound is actively bleeding, apply direct pressure with a clean, dry cloth until the bleeding subsides. Elevate the area of the bite.
  4. Bring the child to A&E
  5. Check the child's immunization record for tetanus as a booster injection may be necessary
  6. For animal bite: find out the date of the pet's last rabies vaccination
  7. For human bite: if the skin is broken, parents of the student who was bitten and the student who was biting should be notified that their child may have been exposed to blood from another student
Prevention
  • Teach children not to provoke or tease animals
  • Teach young children not to bite others
  • Never put your hand near or in the mouth of someone who is having a seizure

Insect Bites & Stings

Management
  1. Wash the bite site with soap and water
  2. Apply a cold pack or ice wrapped in a towel for a few minutes
  3. For itchiness, apply topical antihistamine (anti-allergic cream)
  4. Seek medical help immediately if a sting is in the mouth or if there are signs or symptoms of severe allergic reaction which may present up to 2 hours after the sting (Refer to section on Severe Allergic Reaction)
Prevention
  • Keep food and drink containers tightly covered (Bees love sweet food e.g. soft drinks)
  • Avoid wearing hairspray or perfume during outdoor activities
  • Avoid floral-patterned or dark clothing. Choose white or neutral colours
  • Wear snug clothing that covers arms and legs. Don't go barefoot.
  • Use appropriate insect repellents (Refer to section on Dengue Fever for prevention measures against mosquitoes)

Low Blood Sugar

Symptoms
  • Fatigue
  • Trembling
  • Headache
  • Cold sweats
  • Rapid heart rate
  • Blurred vision
  • Confusion
  • Unconsciousness
Management
  1. Give the child a snack or drink containing sugar
  2. Call 999 if early signs of low blood sugar do not improve after the child has eaten a snack or drink containing sugar
  3. If the child loses consciousness, follow the management of an unconscious child (Refer to section on unconsciousness)

Near Drowning

Management
  1. First try to reach the child with a pole or extended hand. If you can't reach him or her, toss a throw rope to the person, and pull him or her to shore.
  2. If you decide to enter the water, approach the person carefully and from behind. Try to calm him or her as you slowly move closer.
  3. Grab a piece of clothing or cup one hand under the child's chin and pull the person on his or her back to shore.
  4. Tell the child to extend his or her arms away from you. Continue talking to the child to reassure him or her.
  5. Once on land, check for pulse and breathing. Start rescue breathing and cardiopulmonary resuscitation if necessary
  6. Remove wet clothes from the child. Cover the child with warm and dry blankets or clothing
  7. Call 999 and put the child in recovery position
Prevention
  • Never leave a child alone near water, swimming pools or any large container of water
  • Never allow children to swim alone or to swim too far from shore without the company of an experienced adult swimmer
  • Teach children to check the depth of water before diving in.
  • Take first aid and water safety courses

Nose Bleeding

Management
  1. Sit with the child's head leaning forward
  2. Gently squeeze the soft portion of the nose using thumb and forefinger
  3. Hold for 5-10 uninterrupted minutes, breathing through the mouth
  4. Apply cold compresses (such as ice wrapped in a towel) to the area around the nose
  5. Bring the child to A&E if bleeding does not stop after 20 minutes
Self-care tips after the nose has stopped bleeding
  • Do things to keep the nostrils moist such as:
    • Use a cool-mist vaporizer or humidifier, especially in the winter.
    • Put a dab of petroleum jelly inside the nostril.
  • Don't pick or rub the nose.
  • Don't take aspirin or drink very hot beverages for one week

Poisoning

Poisons can be swallowed, inhaled, absorbed through the skin or eyes or injected

Symptoms
  • Pills or unknown substance in child's mouth
  • Burns around mouth or on skin
  • Usual breath odour
  • Sweating
  • Vomiting / nausea
  • Abdominal pain
  • Dizziness or fainting
  • Difficulty breathing/ coughing
  • Seizures
Management
  • For poisoning by swallowing:
    1. Wear disposable gloves and check the child's mouth. Remove any remaining "poison".
    2. Do not induce vomiting or give anything by mouth
    3. Call 999 immediately
    4. If possible, find out:
      • Age and weight of the child
      • What the child swallowed
      • How much & when it was taken
    5. Send ingested material with its container (if available) to the hospital with the child
  • For inhalation poisoning:
    1. Call 999
    2. If it is safe to do so, rescue the child from the danger of the gas, fumes or smoke. Hold a wet cloth over your nose and mouth. Open windows and doors to remove fumes.
    3. Avoid lighting a match as some gases may ignite
    4. After rescuing the child from danger, check for breathing and pulse. Perform rescue breathing and cardiopulmonary resuscitation if necessary.
    5. Perform first aid for skin burns or eye injuries
Prevention
  • Store all cleaners, chemicals, medicines out of reach of children or in cabinets with childproof latches
  • Teach children about the dangers of substances that contain poison. Label all poisons.

Snake Bites

Management
  1. Call 999
  2. Reassure the child
  3. Wash the bite with soap and water
  4. Restrict movement and keep the bitten area below heart level to reduce the flow of venom.
  5. Remove any jewellery e.g. ring, watches near the bitten area.
  6. Do Not:
    • Do not apply any cold compresses to a snake bite
    • Do not try to suction the venom by mouth
    • Do not cut into the snake bite with a knife
    • Do not try to isolate the venom by applying a bandage or piece of cloth around the arm or leg
    • Do not give the child anything by mouth
    • Do not raise the site of the bite above the level of the child's heart

Unconsciousness

Causes
  • Can be caused by any major illness or injury
  • Include all causes of fainting (Refer to section on Fainting)
Management
  1. Call 999
  2. Check for breathing and pulse. If necessary, perform rescue breathing and cardiopulmonary resuscitation.
  3. If the child is breathing and a spinal injury is not suspected, roll the child on his or her side and gently tilt the head back to keep the airway open.
  4. If spinal injury is suspected, leave the child as he or she was found.
  5. Keep the child warm until emergency crew arrive
  6. Do not give an unconscious child any food or drink