First Aid - Meuhedet

Falls and bruises

Falls frequently produce bruising, appearing as purple-red marks on the skin. What can you do?
	Small contusion - apply a cold compress to prevent swelling. If the pain continues for more than 24 hours or becomes worse, take the child to be examined.
	Shallow cuts - rinse with running water and soap, and apply a dry, sterile bandage.
	Sometimes the injury bleeds. If the bleeding doesn't stop or if the wound is deep, long, wide or jagged, take the child immediately to the doctor or to the emergency room to have it sutured. In any event, bandaging is essential to prevent infection.
	If movement of the joint is affected or there is swelling in the injured area, raise the limb and apply cold compresses. If the pain increases or swelling appears in the injured area, have it checked by a doctor. If there is any change in the shape of the injured area as a result of the blow, the patient should not be moved without proper immobilization.
	If there is a suspected fracture to the back or neck, the patient should not be moved without medical assistance.

It is every parent’s worst nightmare that something will happen to their child, and that they will fail do the right thing at the right time to save them, either due to lack of knowledge, misidentification of the injury and the action to be taken, or inability to function under pressure. To ease this concern, below are a number of possible situations and how to deal with them:

Inhaling or swallowing a foreign object

Infants and toddlers have a tendency to put everything that comes to hand into their mouths, as a way of exploring the world. In most cases this does not cause actual harm, but there is always the fear that a foreign object will be lodged in the esophagus or stomach.
Infants and children up to the age of four are liable to inhale objects into their respiratory system, since the valve that is intended to prevent aspiration of food into the lungs when we eat is not fully developed in these ages. Objects that are swallowed may leave the body naturally, but objects that have been inhaled can only be removed from the body by surgical means.
Foreign objects that get lodged in the esophagus or pylorus cause repeated vomiting, severe coughing, pain and difficulty swallowing. They must be removed orally, under full sedation. A child who has inhaled a foreign body is liable to suffocate. He will cough, clutch his throat, and may turn blue due to lack of oxygen. The veins in his neck and face may also stand out.

What can you do?

If the child is coughing, encourage him to continue to cough strongly in order to eject the object.

If he is not coughing, lay him down over your knees immediately, with his head hanging down (the head should be lower than the chest), and tap on the upper part of his back (between the shoulder blades) until the object is expelled. Sometimes the foreign object comes free, but remains in the child's mouth. To prevent it being swallowed again, ask the child to spit it out or put your finger in his mouth and remove it. Be careful not to push it in.

If an infant is choking, turn him face down on your arm, supporting his head and neck with your hand. Lower your arm so that his head is lower than the chest, and pat his back between the shoulder blades until the obstruction comes free. If you see the foreign body in the child's mouth, try to remove it very carefully so that it doesn't get pushed further into his throat.

If the child continues to choke, turns blue, or stops breathing - rush him to the hospital, while performing CPR. When dealing with an infant, be careful to exert only gentle pressure on his body.

An insured member who is a student going to the emergency room due to an injury at school or a school activity, with confirmation of this from the school.

Burns

A burn is defined as a lesion to the skin or mucous membrane caused by heat, cold, chemicals or electricity. In the event that an infant or toddler sustains a burn injury, he must be taken immediately to the doctor. If the burn is small and superficial, it should be cooled with cold water for 30 minutes. Do not put any kind of cream on the burn as this will make it harder for the doctor to diagnose.

What can you do?

Fire burn - if the child's clothes catch fire, roll him on the floor to put out the flames, and then remove his clothes. If the clothes do not come off easily, cut off the parts that can be removed.
Burns to the face and neck - cover with a damp bandage, as sterile as possible, and rush the child to the hospital.
If the injury is to a limb, remove any jewelry and elevate the injured limb to prevent swelling. Make sure that the child is breathing freely and that his heart rate is normal. If there is no heartbeat or breath sounds, begin resuscitation immediately.
A burn may cause the stomach to dilate, and as a result cause vomiting, so avoid giving the child anything to drink. If the abdomen is swollen, help the child lie in a position that will prevent him from inhaling vomit.

Sunburn - the most common type of burns among children. In addition to the reddening of the skin and the pain, a child with sunburn is liable to suffer from heatstroke and dehydration. When there are signs of sunburn, give the child plenty of liquid to drink and put him into a bath of lukewarm or cold water with a little baby oil. To ease the stinging sensation and pain caused by sunburn or jellyfish sting, apply a slightly acidic liquid such as lemon juice or vinegar diluted in water, or yoghurt. If you suspect that your child has heatstroke - go straight to the emergency room for a rehydration infusion.

Electrical burns - burns from a source of voltage appearing in two different places on the body, indicating the passage of the current from its entry to its exit from the body. Damage to tissues is considerable and is not always visible, and therefore it is important that a physician examine the child and ensure that no real damage has been caused. In case of an electrical burn, it is necessary to act quickly: if the child is holding an electrical appliance, disconnect it from the current. Electric shock can cause loss of consciousness, cardiac arrest and respiratory arrest. If the child is not breathing, perform CPR and bring him to the hospital as quickly as possible. If the child is conscious, ensure that he has not suffered any burns from the electrocution. Electrocution may also cause fractures. Any limb that you suspect may be fractured should be immobilized before bringing the child to hospital.

Chemical burns - burns caused by contact with hazardous chemicals. In the event of such a burn, all the clothes should be removed and the child should be rinsed off with large quantities of running water. The burning process continues as long as the chemical is in contact with the skin. After rinsing off the active chemical from the body, wrap the patient up to maintain body heat, and bring him to the hospital immediately. It is important for the caretaker to avoid contact with the chemical as well.

Blow to the head

A severe blow to the head is liable to be accompanied by a headache and local swelling. Falling backwards and sustaining a blow to the skull may cause concussion. The child will usually start crying immediately, but in some cases he may lose consciousness.

What can you do?

If there is a wound, clean the area and check the size. A large wound should be examined by a physician, who will decide whether it needs to be stitched. In most cases there will be a lot of bleeding even from a small cut, because of the density of blood vessels in the head.
If the child loses consciousness or complains of dizziness, appears shocked or vomits, he may be suffering from concussion. Signs of concussion may appear even several hours after the fall (up to 48 hours), and therefore a child who has received a blow to the head should be monitored carefully. With an infant or toddler, keep a careful watch on his alertness for at least an hour after the injury.

Bites and stings

Bites - if the child has been bitten by a dog or other animal: immediately wash the area of the bite thoroughly with soap and warm water for 15 minutes. Go to the nearest emergency room, explain the situation and receive the appropriate treatment. Make sure you identify the animal responsible so that it can be caught and examined, and go to the local health office to decide on continued treatment.

Stings by scorpions, snakes, bees and so on - remove the sting using tweezers, a teaspoon or match or other similar aid, to reduce the quantity of toxin penetrating wound (other than in the case of snakebite). If the injured person stops breathing, start resuscitation and send somebody to get medical help. If symptoms such as a rash, pallor, weakness, vomiting, nausea, stupor, or tightness in the chest appear, urgently seek medical assistance.
With regard to snakes, scorpions and so on - if possible, catch them so that they can be identified and the appropriate medical treatment can be given. In the event of snakebite, avoid moving the affected limb and cool the site of the bite until medical treatment is received. Bring the injured person to the nearest medical facility as quickly as possible.

Electric shock

Disconnect the source of electric current or move the injured person away using a cloth or a wooden object. Don't use your bare hands. The injured person may need resuscitation (see under Resuscitation). Take the injured person to be examined by a doctor.

Choking

Check whether there is a foreign body obstructing the airways (in the mouth, the pharynx and the nostrils) and try to remove it.

Do not waste precious time on trying to extract the object unless it can be done easily. It may be too slippery for you to grasp with your fingers.

Lay the baby (up to the age of a year) over your forearm or thigh, face down and with his head hanging down. Tap the baby firmly and quickly between the shoulder blades four times. If the object has not been ejected, repeat the action. If this still doesn't help, begin mouth-to-mouth resuscitation. If there is no pulse, it is also necessary to carry out heart massage. Continue doing this until the baby is brought to a medical facility or until he begins to breathe by himself.

For children and toddlers over the age of one, use the Heimlich maneuver. This maneuver is carried out by laying the patient on his back and applying 6 to 10 rapid pressures to the upper abdomen, while leaning over the patient. Place your hand above the navel and below the child's rib cage: pressure is applied with the palm of the hand. If the foreign body is not expelled as a result of the pressure, open the child's mouth and try to extract the obstruction with your fingers. Be careful not to push it further in. If this too is unsuccessful, give the child mouth-to-mouth resuscitation for a few seconds, and then repeat the Heimlich maneuver.

Resuscitation

Tilt the child's head back to allow air flow unobstructed by the tongue.

Clean his mouth and remove any foreign object - if this can be done easily.

If he does not start breathing again, place your mouth over the child's mouth and nose. Blow four rapid, gentle breaths. Breathe into the child's mouth and nose every three seconds (a total of 20 breaths a minute). Blow short and gentle breaths, removing your mouth between each breath and listening for air coming out of his lungs. Repeat until the obstruction has been freed.

If there is no pulse - carry out heart massage: Lay the patient down on his back, on a firm surface. With infants, pressure should be applied to the sternum, in line with the nipples, to a depth of between 0.5 cm – 1 cm, at a rate of 100 times a minute. For children, apply pressure to the lower third of the sternum at a rate of 80 times a minute. Rate of compressions: 5 compressions for each breath.

Teeth, eyes, fractures

Teeth can be saved - therefore, if a tooth is knocked out by a blow, look for the tooth, and if it is dirty rinse it gently in running water, without rubbing. Return the tooth gently to its place in the gum and hold it in place. If you can't do this, keep the tooth in milk or cold water until you reach the doctor. You have to get the doctor within 30 minutes. Broken tooth - find the broken part, only if it can be found quickly. Go to the dentist at once.

Eyes - do not press on the eye, apply drops or use cream without consulting a doctor. Cover the injured eye with a sterile bandage (without pressure) and take the patient to hospital.

Fractures - any change in the shape of the injured part usually means that the patient should not be moved without proper immobilization. If there is a suspected fracture to the back or neck, the patient should not be moved without medical assistance for fear of causing paralysis. Sprain (dislocation) - if there is a problem moving the joint or swelling in the affected area, raise the injured limb and apply cold compresses only.
If the pain increases and/or there is swelling in the affected area, consult a physician.

Fits and fainting

Fainting - lay the injured person on his back, and loosen the clothing around his neck. Turn his head to the side and make sure his mouth is clear. Do not give him anything to drink or eat. Cover him to maintain body heat. If he does not come around within a minute or two, call for medical help.

Fits - lay the patient on his side, head turned down. Do not give him anything to drink or eat. Use cold compresses. Rinse the child with cold water, using a sponge (in all cases of fitting, especially when caused by a high temperature, call the doctor).

Nosebleed

Sit the patient down and apply pressure to the sides of the nose with the thumb and finger for between 5 and 10 minutes. If the nosebleed continues, go to a medical facility.

Poisoning

Bring the material or plant that has caused the poisoning with you. If the child is fully conscious, give him milk or water to drink to dilute the poison in his stomach (other than in the case of poisoning by petrol, acid etc., or corrosive materials such as bleach, cleaning materials etc).
In any case of poisoning or suspected poisoning, obtain medical assistance immediately.

Irritants in the eye

hold the eyelid open and rinse the eye with running water. Remove contact lenses, if any. Rinse the eye for 15 minutes with running water (make sure the water is flowing gently) or with a pipette. Don't allow the injured person to rub his eyes or use any kind of eye drops. Cover the eye with a sterile bandage. Go to the doctor for continued treatment.