Emergencies

Accidents can-and do-happen, even in the most careful and well-prepared households. Knowing what to do when the unthinkable occurs can literally mean the difference between life and death for your child.

We strongly recommend that the primary child-care provider in the family (as well as anyone else who cares for children on a regular basis) complete a good hands-on course in emergency first aid that includes infant and childhood cardiopulmonary resuscitation (CPR) procedures. There is simply no substitute for the instruction and practice you will get in a good first aid course.

The following are general guidelines to follow in responding to any emergency, no matter what its nature.

What to Do in an Emergency

Stay calm. Take a moment to assess what has happened. It won’t help your child if you scream or panic. Your child needs you to be a calm and reassuring presence.

Make sure your child is breathing and check for a pulse. For an infant under one year, check for a pulse on the artery by placing the tips of your first two fingers on the infant’s inner arm above the elbow. For a child older than one year, check for a pulse on the carotid artery, located at the side of the neck. Touch your first two fingers to the Adam’s apple, and run your fingers across the neck to the depression between the Adam’s apple and the large neck muscle. Allow five to ten seconds to feel for a pulse. If your child is not breathing or does not have a pulse, read Cardiopulmonary Resuscitation (CPR). Begin performing CPR at once.

Check for bleeding and for obviously broken bones.

Try to determine what has happened. If your child can respond, ask. If not, observe the surroundings. For example, is there a bottle of pills or cleaning compounds nearby? Is the child lying on her back under a tree? If the person is unknown to’ you, is she wearing a Medic Alert bracelet that identifies a specific medical condition? The few moments you take to assess the situation are vitally important. After close observation, you’ll have a better sense of whom to call and what to do. Without careful assessment, you are more likely to panic and do the wrong thing.

If you suspect a head, neck, or spinal injury, do not pick up or move the child, even to offer comfort. Moving someone with a possible head, neck, or back injury can worsen the damage. Unless there is a threat that the child will vomit and choke, it is best to leave her in the same position in which you found her. Rely on medical personnel to know how to stabilize the child so that transport to the hospital will be safe.

Call for emergency help. When calling for emergency help, speak distinctly. Give your name, the address you’re calling from, your phone number, and your assessment of the situation. Don’t rush. If you remain calm, you will save time in the long run. If you give clear, distinct, precise information so that the operator can route emergency help to your location quickly, you won’t have to repeat your message. Try to relate enough of the problem so that the people who respond to your call will be prepared to deal with it when they arrive. You don’t have to know exactly what’s wrong; just convey as clearly and completely as you can what you have observed and what your assessment of the situation is.

Stay with your child. Try to stay with your child until emergency personnel arrive, or until the situation is resolved. If possible, have someone else place the call for emergency services. Your child needs to feel the reassurance of your presence. Talk to her, using simple explanations to describe what’s happening. Fear of the unknown makes matters worse. If you are sure that she has not suffered an injury to her head, neck, or back, hold your child close. Otherwise, just gently touch and soothe. As you do so, carefully observe any changes in your child’s condition, such as shifts in breathing or heart rate, or changes in her level of pain or consciousness. Certain emergencies will require your immediate intervention.

Be alert for signs of shock. Shock is a serious condition that results from a sudden and life-threatening drop in blood pressure, which in turn impairs circulation and threatens the brain’s oxygen supply. Shock can occur after any trauma to the body, whether from near-drowning, severe injury, major blood loss, or overwhelming infection.

A child suffering from shock may become pale and sweaty, possibly drowsy, confused, and/or disoriented. Shock is usually accompanied by profound weakness, dizziness, faintness, and a cold sweat. The pulse may be weak and feeble.

If you suspect shock, lay your child down on her back and put pillows under her feet to raise her feet higher than her head. Loosen tight or constricting clothing, and cover your child with a blanket. The goal is to insure normal breathing while maintaining normal body temperature and adequate blood circulation to the brain.

If emergency personnel are not already on their way to you, seek emergency medical attention for your child immediately.

Emergency Preparedness

Even the most careful and loving parents can’t prevent all emergencies. You can and should, therefore, take measures in advance to prepare you to act quickly and effectively should an emergency arise.

Have a list of emergency telephone numbers handy. This can save precious time in any emergency, for you or for anyone else who is caring for your children. We urge you to take this precaution now, while you are thinking about it. Post emergency telephone numbers near every telephone in your home. If there is no 911 emergency service in your area, these numbers should include that of your local hospital for ambulance/paramedic service. Also post numbers for your local fire department, Poison Control Center, police, and your child’s doctor and dentist. If your telephones can be programmed to automatically dial certain numbers, program these numbers into the telephones (but keep written lists handy in case a phone becomes unprogrammed).

Designate surrogates who will act in your stead should an emergency arise when you cannot be reached, and include their telephone numbers in the emergency list. Designate adults you trust, perhaps your child’s grandparents, perhaps good friends, to make decisions in any emergency involving your child. If you have established a close and caring relationship with your child’s health care provider, you might wish to give him or her the legal authority to make any necessary medical decisions involving your child.

Empower your designated surrogates to act for your child by giving them written permission to act for you, such as a limited power of attorney. Your surrogates should keep this important document where it can be found easily if they must respond to an emergency, and you should give copies to your child’s physician. Should an occasion ever arise when you cannot be reached immediately, your designated surrogates will be able to act. Written permission from a parent or designated guardian is sometimes required before certain life-saving measures can be taken.

Provide your child with a Medic Alert bracelet if she has a special medical problem, to ensure that she will receive the right care if something happens away from home. If your child is allergic to penicillin or other medication, sulfites, or bee stings, for example, it will enable her to receive prompt and appropriate treatment for an allergic reaction. Without a Medic Alert bracelet, a teenager with diabetes who is suffering from the typical symptoms of low blood sugar could be misdiagnosed as being intoxicated and fail to receive necessary treatment. Medic Alert information is especially important for a young child who may not be able to communicate well, or for any child who has a disorder that can cause the loss of consciousness. Without Medic Alert information, health care personnel could be working in the dark and wasting precious time. Medic Alert is the only emergency medical identification service endorsed by the American College of Emergency Physicians, the American Hospital Association, and every national pharmacy association. For more information, call Medic Alert at 800-432-5378.

Have the primary child-care provider in the family take a good course in emergency first aid that includes infant and childhood Cardiopulmonary Resuscitation (CPR) (CPR) procedures. We hope that you will never be called upon to use these skills, but there is simply no substitute for the hands-on training and practice in these life-saving techniques that such a course provides.

As soon as your child is old enough to understand, teach her to respond to emergencies. Children as young as three years old have been known to use the telephone to summon emergency help. Teach your child how to dial 911, if that service is available in your area (or, if not, how to dial 0 for operator) for emergency assistance, and have your child practice this skill. Use a toy telephone or simply hold the disconnect button down on your regular phone and practice with your child so that she becomes accustomed to the procedure. Also, make sure your child can recite her full name, address, and telephone number.

Take steps to minimize the danger of accidents and injuries occurring in your home and outside. For suggestions, see
Home Safety.

From Smart Medicine for a Healthier Child by Janet Zand, N.D., L.Ac., Robert Rountree, MD, Rachel Walton, RN, ©1994. Published by Avery Publishing, New York. For personal use only; neither the digital nor printed copy may be copied or sold. Reproduced by permission.