First Aid Series: Emergency Response for Children - Part 1

As a nanny, being prepared for emergencies is crucial. This is the first part of our three-part series on essential first aid skills for children. In this article, we focus on two of the most critical first aid skills you need to master: CPR and Choking Response. These skills can mean the difference between life and death in emergency situations.

1. CPR for Children (Ages 1-12)

When to Perform CPR

• Child is unresponsive
  The child does not respond to your voice or touch, even when you call their name or gently shake their shoulder.

• Not breathing or only gasping
  Look for chest movement, listen for breathing sounds, and feel for breath on your cheek. Gasping is not normal breathing and indicates the child needs immediate help.

• No pulse or very weak pulse
  Check for a pulse on the side of the neck (carotid artery) or inside the upper arm (brachial artery). In children, a weak pulse is often easier to feel than in adults.

Step-by-Step CPR Process

1. Assess the Situation

   • Check if the scene is safe
     Ensure there are no immediate dangers like traffic, fire, or electrical hazards before approaching the child.
   • Tap and shout to check responsiveness
     Use a firm tap on the shoulder and call the child's name loudly to check for any response.
   • Call emergency services (911) immediately
     If possible, have someone else call while you begin CPR. If alone, call before starting compressions.

2. Begin Chest Compressions

   • Place child on a firm, flat surface
     A hard surface like the floor is essential for effective compressions. Never perform CPR on a bed or soft surface.
   • Position hands on the center of the chest
     Place the heel of one or both hands (depending on child's size) on the lower half of the breastbone.
   • Use one or two hands depending on child's size
     For smaller children, use one hand. For larger children, use two hands for more effective compressions.
   • Compress chest 2 inches deep
     Allow the chest to fully recoil between compressions to ensure blood flow.
   • Maintain rate of 100-120 compressions per minute
     This is roughly the beat of the song "Stayin' Alive" by the Bee Gees.

3. Give Rescue Breaths

   • After 30 compressions, give 2 rescue breaths
     Ensure the child's airway is open by tilting the head back slightly.
   • Tilt head back slightly
     This helps open the airway and allows air to enter the lungs more effectively.
   • Cover child's mouth and nose with your mouth
     For smaller children, cover both mouth and nose. For larger children, you may need to cover just the mouth and pinch the nose.
   • Give gentle breaths (1 second each)
     Watch for the chest to rise with each breath, indicating air is entering the lungs.
   • Watch for chest rise
     If the chest doesn't rise, reposition the head and try again.

4. Continue the Cycle

   • Repeat 30 compressions and 2 breaths
     This cycle should be repeated continuously until help arrives or the child shows signs of life.
   • Continue until:
     • Child shows signs of life
       Look for normal breathing, movement, or response to touch.
     • Emergency services arrive
       Be prepared to provide information about what happened and what you've done.
     • You are too exhausted to continue
       If you become too tired, call for help from others if available.

2. Choking Response

Signs of Choking

• Universal sign: Hands clutched to throat
  This is a clear indicator that the child is having trouble breathing and needs immediate help.

• Cannot speak, cry, or breathe
  The child may be silent or making high-pitched noises, indicating a blocked airway.

• Weak or ineffective cough
  A weak cough suggests the child is not able to clear the obstruction on their own.

• High-pitched noises while breathing
  These sounds indicate that air is struggling to pass through a partially blocked airway.

• Skin turning blue (cyanosis)
  This is a late sign of choking and indicates severe oxygen deprivation. Immediate action is required.

Step-by-Step Response

1. For Conscious Children

   • Stand or kneel behind the child
     Position yourself slightly to the side to ensure you can perform the thrusts effectively.
   • Wrap your arms around their waist
     Ensure your arms are secure but not too tight, allowing for effective thrusts.
   • Make a fist with one hand
     Place the thumb side of your fist against the middle of the child's abdomen, just above the navel.
   • Place fist thumb-side against middle of abdomen
     This position helps to create the necessary pressure to dislodge the object.
   • Grasp fist with other hand
     Use your other hand to hold the fist in place, ensuring it doesn't slip during thrusts.
   • Give quick, upward thrusts
     Perform firm, quick thrusts inward and upward to help expel the object.

2. For Unconscious Children

   • Lower child to the ground
     Place the child on their back on a firm surface to prepare for CPR if needed.
   • Begin CPR
     Start chest compressions and rescue breaths as described in the CPR section.
   • Check mouth for object before breaths
     Look for any visible objects in the mouth that can be safely removed.
   • Remove visible object if possible
     Use a finger sweep only if the object is visible and can be easily removed.

Practice What You've Learned

Additional Resources

• Download First Aid Quick Reference Guide
• Watch Video Demonstrations
• Join First Aid Workshop

Remember: These skills require regular practice to maintain proficiency. Consider taking a certified first aid course and refreshing your knowledge every two years.