Knowing How to Use an AED Can Save a Child’s Life

We have a problem in this country, sudden cardiac arrest. Approximately 450,000 people die each year from sudden cardiac arrest (SCA) in the United States. It can happen to anybody, anywhere, anytime and without any warning, so helping a person suffering from cardiac arrest is all about what you do immediately following the persons collapse. The best “save” rates have been reported when using an automated external defibrillator or AED to deliver an electric shock or defibrillation within three minutes of the patient’s collapse. Early defibrillation in conjunction with C.P.R has been found to be the only definitive treatment for sudden cardiac arrest. For every minute that a person in cardiac arrest goes without being successfully treated by defibrillation the chance of survival decreases by 7 percent per minute in the first minutes, and decreases by 10 percent per minute as time advances beyond 3 minutes, so starting life saving measures such as CPR and using the AED as soon as it arrives it essential.

Symptoms of Sudden Cardiac Arrest include:

• Collapse
• Lack of pulse
• No breathing
• Unconsciousness

With time being of the essence and the average response time for emergency services being 10 to 12 minutes (which may not be fast enough for a patient because after approximately three to five minutes irreversible brain damage may begin to occur if there is no defibrillation), having access to an AED and knowing how to use it is very important. So how do you use an Automated External Defibrillator? As we said before, AED’s are very user friendly and speak in plain English and will walk you through the entire process, even reminding you to call for help if you haven’t already done so. In the basic life support class we have a pneumonic that helps people remember the 4 basic steps to using an AED: P.A.A.S. This stands for Power, Attach, Analyze, and Shock.

• Power: Most AED’s turn on when open but some may have a power button.
• Attach stands for attaching the defibrillator pads to the chest of the patient to match the pictures that are provided on the pads.
• Analyze means to let the machine analyze the patient’s heart rhythm and determine if the patient needs to be defibrillated,
• Shock means to manually press the shock button and shock the patient if and when the machine says it’s time to do so.

Now as we said before, having the proper training will make this whole process much smoother but is not a requirement. I would however recommend it.

Where to find an AED? AED’s either held by trained personnel who will attend events or are public access units which can be found in places including corporate and government offices, shopping centers, airports, airplanes, restaurants , casinos, hotels, sports stadiums, schools, and universities, community centers, fitness centers, health clubs, theme parks, workplaces and any other location where people may congregate. In many areas, emergency vehicles are likely to carry AEDs, with some units carrying an AED in addition to manual defibrillators. Some areas even have dedicated community first responders, who are volunteers tasked with keeping an AED and taking it to any victims in their area. AEDs are also increasingly common on commercial airliners, cruise ships, and other transportation facilities and with advances in technology and policy requiring AED’s to be placed in more and more places AED’s are becoming more accessible as well as more affordable.

Automated External Defibrillators are truly miracle machines and are changing people’s lives for the better and I hope this article has given you a basic understanding of how to use one should the time come. I encourage everyone to take a certified AED instruction course and really become familiar with these machines and the process involved in using them because you never know when you could be called to action and as we said before, there is nothing better you can do in a cardiac arrest situation than using an AED.

Thank you and Have a Safe and Happy Holiday Season.

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Editor’s Note: Sudden cardiac arrest among young athletes is nowhere near as common as it is across the general population, however when it occurs, it is unexpected and the results are often tragic. It’s estimated that between 6,000 and 8,000 young people experience sudden cardiac arrest (or SCA) each year, and only about one in 10 survive. An AED can save their life, however today only 15 states require them on school campuses. Not all of those require them to be present on athletic fields. Parents that means its up to you. Be observant. During the sports season, look out for signs that your child may be struggling. And talk to your school about AED’s. Source: Nemours Children’s Hospital

Who Here Is Certified in CPR or Basic First Aid? Ask The School!!

It’s a simple question really. How many people at your child’s school are certified in life saving CPR and basic first aid? The answer may surprise you. I am often on the other side of this question training the administrators and teachers in cpr and first aid, and praising them for spending the time and money to go beyond the bare minimum and make sure their entire staff is trained and the children are safe, but putting my oldest child in school for the first time this year made me curious to know the answer to this question.

As a concerned parent I placed a call to Miami Dade public schools and was alarmed to find out that at a public school here in Dade county only two people are required to be certified in CPR and basic first aid. This is a dangerously low number considering that some of the schools here in Dade County have over 5000 students. Not to mention what would happen if one or both of these people calls in sick or goes on vacation? Then you run into the possible situation of having nobody on campus that day required to be trained. Not good. With the normal everyday injuries at schools, the knowledge of basic first aid is a must and add to that the growing number of sudden cardiac events in schools around the country and you will see that having a basic knowledge of first aid and cpr together is also a must and therefore the bare minimum of safety by some schools just will not do.

What would cause a school to keep only the bare minimum of people trained in something so important? Is it that the administrators and staff don’t care about the children’s safety and only do the bare minimum because they have to? Of course not. The answer as usual is money. Now obviously what needs to happen is the schools need to increase the number of people trained in cpr and basic first aid, but like anything else training costs money and with school budgets shrinking by the day and teachers coming out of their own pockets more than ever to make up for the lack of funds, asking a school to budget in training for an entire staff just does not seem possible. So what can you as a concerned parent do? Well if you are certified to train the staff in cpr and first aid then you can do as I have done and donate the training to the school and staff for free, or you can do as some parents here in Dade county have done and that is to raise the funds for the training themselves by having a bake sale or a car wash or some other fundraising event and hire a company to come out to the school and train the entire staff. I cannot think of a better use for that money than the safety of our children.

The bottom line is no matter where you live the people looking after your children, whether it is a school, a daycare or even grandparents need to be trained and know how to react when your child needs help. So go ahead and do as I did and ask the question as to who is certified here and what can I do to help? And if you are in the south Florida area, shoot me an email, I’d be glad to help.

Be Safe.

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Editor’s Note: In the aftermath of some of the recent tragedies experienced at U.S. schools it is even more important to know that the folks looking after our kids know CPR and basic first aid. This post first ran in September 2011. We thought it was time to run it again…

What You’ll Want to Have In Your Baby’s First Aid Kit

More than 1 million children a year are involved in an accident in the home. Most aren’t serious, but it’s sensible to make sure your first aid box contains the essentials.

Choose a waterproof, durable box that’s easy to carry. It’s much easier to take the box to the child than the child to the box. The box should have a childproof lock and be tall enough to carry bottles of lotion.

Keep the box out of the reach of children, but handy for adults. You don’t want to be hunting for your first aid kit when a child is injured and frightened.

Either buy a first aid box, which is green with a white cross**, or, if making up your own box, write “First Aid” on it so that, if you aren’t around, other people know what it is. If someone else is caring for your children, let them know where the kit is kept.

First aid manual

An easy-to-use guide can help refresh your memory when panic and a crying child make it hard to remember what to do. Or you could print out a first aid guide and keep it with your first aid box.

Painkillers and babies

Make sure you have an age-appropriate painkiller, such as paracetamol (*acetaminophen) or ibuprofen, which can be used for headaches and fevers. You will also need a measuring spoon or, for younger children, a no-needle dosing syringe. Always follow the dosage instructions on the label.

Dressings for babies

• Sticking plasters (*Band-aids). Buy them in a variety of sizes for minor cuts, blisters and sore spots.
• Adhesive tape (*Medical tape). This can hold dressings in place and can also be applied to smaller cuts.
• Bandages. Crepe (*Wrap compression) bandages are useful for support or holding a dressing in place. Tubular bandages are helpful when a child has strained a joint and needs extra support. You can also buy triangular bandages that can be used for making a sling.
• Sterile gauze dressings. These are good for covering larger sore areas and cuts.

Antiseptic cream or spray

Antiseptic cream or spray can be applied to cuts, grazes or minor burns after cleaning to help prevent infection. Some may also contain a mild local anaesthetic to numb the pain.

Antihistamine cream

This can reduce swelling and soothe insect bites and stings.

Thermometer

• Digital thermometers. Digital thermometers are quick to use, accurate and can be used under the armpit (always use the thermometer under the armpit with children under five). Hold your child’s arm against his or her body and leave the thermometer in place for the time stated in the manufacturer’s instructions.
• Ear (or tympanic) thermometers. Ear thermometers are put in the child’s ear. They take the child’s temperature in one second and do not disturb the child, but they’re expensive. Ear thermometers may give low readings when not correctly placed in the ear, so read the manufacturer’s instructions carefully and make sure you understand how the thermometer works.
• Strip-type thermometers. Strip-type thermometers that you hold on your child’s forehead are not an accurate way of taking their temperature. They show the temperature of the skin, not the body.
• Mercury-in-glass thermometers. Mercury-in-glass thermometers are no longer available to buy**. They can break, releasing small shards of glass and highly poisonous mercury. If your child is exposed to mercury, get medical advice immediately.

Calamine lotion

This can help to soothe itching irritated skin, rashes (including chickenpox) and sunburn. There are gels and mousses available for chickenpox rashes as well.

Baby first aid accessories

• Pair of scissors for cutting clothes, and also plasters and tape to size.
• Tweezers to remove thorns and splinters.
• Ice packs or gel packs can be kept in the fridge and applied to bumps and bruises to relieve swelling. A packet of frozen peas is just as good, but wrap it in a clean tea towel before applying it to skin. Direct contact with ice can cause a “cold burn”.
• Saline solution and an eye bath. This is useful for washing specks of dust or foreign bodies out of sore eyes.

Antiseptic wipes

Antiseptic wipes are a handy way to clean cuts and grazes and help prevent infection. To use them, take a fresh wipe and clean the wound, gently working away from the centre to remove dirt and germs.

Remember to keep your first aid box up to date. Replace items when stocks have been used and check use-by dates of all medicines. Throw away anything past its use-by date. You can take any out-of-date medicines to a pharmacy to be disposed of safely.

Editor’s Note: *clarification provided for our US readers.

** U.S. First Aid Kits are often white with a red cross or red with a white cross

** Mercury-in-glass thermometers are not available for purchase in the U.K. and in a number of States within the U.S., however they may still be purchased legally in some States. For more specific information about individual State’s mercury laws, click here.

 

Urgent Care or ER for Kids? Resources to Help Decide

My husband recently had an “incident” with one of our dogs, Nelson, and ended up being bitten. Now I should clarify that we have two wonderful dogs who are both very sweet and are absolutely full members of the family. Nevertheless, Nelson, – who we’ve had since he was a puppy – weighs in at 100 pounds and is EXTREMELY fond of food, or anything remotely resembling or smelling of food.

This incident happened because Nelson got a food soaked paper towel and had retreated with it under a corner table – his usual “safe” space. My husband got plenty of doggy warnings not to come near – and yet he insisted on trying to drag Nelson out and get the paper towel. The result was a series of impressive and bloody puncture wounds on his fingers. This was also rather ironic since he’s known among family and friends as the “dog whisperer” – and was rated as such in a quiz from an excellent post on dog bites which ran on this site last November.

As a result, he spent over an hour in the ER getting checked out, filling out paperwork about our dog, and…incurring over $600 in costs to us. It was only later, when we took our son to our local Urgent Care center for a sprained ankle, that it occurred to us that maybe Urgent Care could have taken care of the dog bite issue. My husband went to the ER because he thought he might need stitches. In the end he didn’t need them – but it turns out that our Urgent Care does stitches for minor cuts and injuries – at a much lower cost. If we’d only known this, he would have gotten the care he needed for about $500 less!

Given this incident, it seemed like a good idea to take stock of what Urgent Care typically offers, especially with respect to children. Urgent care is ideal in “non-emergency situations” for after-hours care or when you can’t get in to see your regular doctor. But what is “non-emergency”? Apparently a minor broken bone is non-emergency, since our Urgent Care handles these and has onsite x-rays. But it’s not always so easy to determine the difference between “urgent” and “emergency”. Thankfully some excellent web resources can help with that. The Children’s Hospital Colorado has a nice overview of when go to urgent care versus the emergency room. Head straight to the ER if your child’s skin or lips have turned blue, your child is unresponsive or difficult to arouse, or your child is having serious trouble breathing. Urgent care can usually handle simple cuts, injuries or illnesses – including fractures (unless the bone is sticking out!). The full guidance can be found on their website.

Seattle Children’s Hospital has a very handy review on their website, listed by condition or issue – and they have a nice downloadable version which you can print out (scroll down to the bottom of their webpage). Further below is a snapshot of some of the guidancethey provide.

Buyer Beware

One thing I learned from my research on this topic is that the services offered by Urgent Care centers are not yet standardized, especially for children. This is essentially a new industry and the rapid growth of these types of centers has spawned – as described by a doctor at Johns Hopkins in this article – “a mishmash of clinics, some offering fairly sophisticated care, while others providing only the most rudimentary.” And general Urgent Care centers are sometimes uncomfortable treating more serious pediatric concerns. This field is so new that the American Academy of Pediatrics only just established a sub-committee on pediatric treatment in urgent care in 2015. So, probably the best advice is to check out what services your local Urgent Care center provides – ideally in advance of needing them! – and follow your instinct if you think the ER is really the better bet.

CPR Training Required for High School Graduation

I know it is summer and the last thing any of us want to think about is school and all the work our kids have to put in to graduate. If you are the parent of a high school student that is trying to figure out what courses will be best to take and what will be needed to ensure graduation then looking ahead to this upcoming school year and the growing movement of required CPR training in schools for graduation is a must. Currently 24 states have legislation that require high school students take the CPR training in the school to be eligible to graduate and many more states have pending legislation on the way.

The American Heart Association statistics tell us that every hour in the United States 48 people will suffer an out of hospital cardiac arrest and that 9 out of 10 of those people will not survive, however if proper CPR measure are begun by a trained bystander then the odds of that person surviving can double or even triple; and since these people are suffering a cardiac arrest outside of a hospital this means they will be having them in every day situation like being at work, home, school, and places where care would normally take too long. Having many more trained people in these everyday places can have an immediate impact and help save lives now. The program that is teaching the CPR program in the schools is called “CPR IN SCHOOLS” and is monitored by the American Heart Association and can be found online at www.heart.org/cprinschool.

The bottom line is that there is never a bad time to learn CPR because you have no idea when you will need to use it and whether or not your children are required to take it in school, it is always a worthy investment that can pay dividends long after your children have graduated and who knows, the life they save may be yours.

Thank you and Have a Great and Safe Summer.

Photo credit: Northern Ireland Executive; CC license

What Should I Do If A Baby Is Choking?

If a baby is choking, you need to assess the situation quickly to see how best you can help.

This information applies to babies aged under one year old. For information relating to adults and older children, see What should I do if someone is choking?

Choking happens when a person’s airway suddenly gets blocked so they cannot breathe. Their airway can be partly or fully blocked. In babies, choking is often caused if they put small objects in their mouths, which then get stuck. It can also be caused by food getting stuck.

Choking in Babies Under One Year Old

A baby who is choking will be distressed and may be unable to cry, cough or breathe.

• Lie the baby face down along your forearm or thigh, with their head low. Support their head.
• Give up to five firm slaps to the baby’s back between the shoulder blades with the heel of your hand. (The heel is between the palm of your hand and your wrist.)
• Stop after each slap to check if the blockage has cleared. Look inside the baby’s mouth and remove any obvious blockage. Do not poke your fingers into the baby’s mouth unless you can see and reach the blockage. You may push it further in.
• If the airway is still blocked, give up to five chest thrusts (see below).
• Stop after each thrust to check if the blockage has cleared.

If the baby’s airway is still blocked after three cycles of back slaps and chest thrusts, you should:

• Dial 999 (UK) or 911 (US) for an ambulance immediately. Do not leave the baby – take him or her with you to the phone
• Continue with the cycles of back slaps and chest thrusts until help arrives

Chest Thrusts for Babies Under One Year Old

In babies under one year old, chest thrusts are used in an emergency to clear a blockage from their airway. Important: do not use abdominal thrusts with babies under one year old.

• Lie the baby along your forearm on their back, with their head low. Support their back and head.
• Give up to five chest thrusts. Using two fingers, push inwards and upwards (towards the head) against the baby’s breastbone, one finger’s breadth below the nipple line.
• Check if the blockage has cleared after each thrust, by looking inside the baby’s mouth and removing any obvious blockage. Do not poke your fingers into the baby’s mouth unless you can see and reach the blockage as you may push it further in.

Complications

Once the baby’s airway is cleared, some of the material that caused the blockage can sometimes remain and cause complications later. If the baby still has a persistent cough or difficulty swallowing, they need to see a health professional urgently. You should take the baby to A&E, an NHS Walk-in Centre or your GP if it’s during GP hours (UK).*

*In the US, take the baby to the ER, an urgent care clinic, or your primary care physician, if during office hours.

Further information:

• Where can I find out about basic first aid?
• What should I do if someone is choking?
• Accidents and first aid
• Accidents to children in the home
• Ambulance service
• British Red Cross: how to deal with choking

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