Children - Emergency - 1x1 First Aid

1x1 of first aid for children

The procedure for child emergencies differs from adult emergencies only in a few details. Before starting out as a first aider, try to stay calm and take deep breaths. It is perfectly normal for you to feel excited in this situation. Take it step-by-step and remember your first aid skills. Remember: the only and worst mistake you can make is "DO NOTHING"!

Here are step-by-step instructions on what to do if the worst comes to the worst. It is based on current international recommendations.

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• Additional basic measures
• When should I make the emergency call?
• What is the difference between adult and child resuscitation?

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First things first: self-protection

In all emergencies, your own safety must be guaranteed. At least a brief risk assessment should be carried out before every rescue operation. Rescue from a body of water, for example, is an individual decision and depends on many factors, such as the water temperature. Self-protection has the highest priority. The best knowledge of first aid is of no use if you are harmed yourself.

If it is necessary and possible: Take the injured child out of the danger zone. Pay attention to your own protection. If you are at risk to yourself, call helpers such as the fire brigade, ambulance or police.

Then: emergency check

The emergency check is a quick examination of the injured or sick child. You check your consciousness and breathing and, if necessary, carry out initial life-saving measures. You will need around ten to 15 seconds for the emergency check. Pay special attention to breathing, as there is often a lack of oxygen due to insufficient breathing.

Proceed as follows:

Control consciousness

The child's state of consciousness is checked by speaking and physical stimuli. Speak to the child aloud, eg “Wake up!” And touch the child relatively firmly (eg on the inside of the upper arm).

• If the child responds (by answering, crying, or moving): leave them where you found them and call 911. Check the child's condition regularly until the emergency services are on site. More on this further down in the text.
• If the child does not react: Shout out loud for help so that other people can become aware of the situation and call 911. If you are alone, you must carry out the next two steps (check your breathing and, if necessary, start resuscitation measures) and only then call the emergency number yourself.

Control breathing

Carefully turn the child on their back and check that they are breathing:

• Infant (up to one year): In infants, the head is not hyperextended, but the chin is only slightly raised ("sniffing position"). Then the following applies: hear, see, feel for a maximum of ten seconds. Observe the chest for breathing movements, listen for breath sounds, and feel for chest movements.
• Child (from one year of age): Carefully straighten the child's head by placing one hand on the forehead and lifting the chin with the other. Then the following applies: hear, see, feel for a maximum of ten seconds, ie: bend your head over the child's face and look at the child's chest. Observe whether the chest rises and falls, hear whether you can hear breath sounds, and feel whether you can feel the child's breath on your cheek.

The next steps depend on whether or not you have noticed the child is breathing:

• If you can breathe: Lay the child on its side and then call the emergency number 144. Check the child's breathing regularly until the emergency services are on site. More on this further down in the text.
• If there is no breathing: start resuscitation immediately.

  Exception: If you have seen the child collapse, call the emergency number 144 immediately and only then start the resuscitation

If breathing has stopped: start resuscitation immediately

Respiratory failure is a dramatic event in a child. Therefore, start the resuscitation immediately by ventilating the child 5 times and then massaging the chest 30 times.

Note If you are all alone: First reanimate for one minute (or five cycles of alternating ventilation and chest compressions) before you call for help (emergency number 144).

Ventilate immediately

If breathing stops, the child is immediately ventilated 5 times. You always have to consider the size of the child:

• Infant (up to one year old): In the "sniffing position", mouth-to-mouth-nose resuscitation is carried out in the case of infants, with the helper's mouth tightly enclosing the baby's mouth and nose.
• Child (from one year of age): In children, mouth-to-mouth resuscitation is carried out with the helper tightly enclosing the child's mouth. The nose is closed with the index finger and thumb.

If ventilation is not working (the child's chest does not rise or fall while you ventilate them), it is possible that a foreign object is obstructing the airway. If you can see the foreign object, carefully remove it. If you cannot see a foreign object but you suspect it, do not search the child's throat with your fingers! Any object that may be present can slide even deeper and make the problem worse. Proceed as described; Chest compressions and repeated ventilation can help expel a foreign body that has been inhaled. More on the topic: Foreign bodies in the airways

Chest compressions

If the child continues to show no signs of life after the first ventilation (no breathing, no pulse), start with chest compressions:

• Press 30x with a frequency of 100 to 120x per minute.

• In all children, the pressure point is in the lower half of the sternum.

  • Infant (up to one year old): press with one or two fingers depending on the size of the child.
  • Child (from one year): Depending on the size of the child, press with one or both hands.
• The indentation depth should be at least a third of the chest diameter.
• Do not lean on the child's chest! The chest must be relieved after each compression.

Ventilation and chest compressions in a ratio of 2:30

After the cardiac massage, ventilate the child again twice, then perform cardiac massage again 30 times. Do this until professional help arrives or until the child shows signs of life (moving, starting to cry, opening eyes, etc.).

If a defibrillator is available nearby, ask those present to fetch it. Until the defibrillator is available, continue resuscitation. Automatic defibrillators contain instructions on where to place the contact points on the patient. Then follow the defibrillator's instructions.

If you are breathing: Correct positioning

Sick or injured children with existing breathing must be correctly positioned until the emergency services arrive.

Storage when unconscious and breathing is present

As with adults, the following applies: unconscious children must be brought into the stable side position. With this position you prevent suffocation, because if you are not conscious there is a risk that the person concerned inhales saliva or blood or the tongue slips into the throat. If the stable side position is not feasible, positioning should be as similar as possible.

This is how the stable side position works:

• First place the arm at a right angle on the side to which the person concerned is turned.
• Then pull up the opposite knee and place the wrist of the other arm on it.
• In the next step, turn the affected person to the bent arm.
• As a final step, stretch your head over and open your mouth. This allows blood, vomit or mucus to drain away.

Note People who suspect a spinal injury should be moved as little as possible. If you are unconscious, you should also lie on your side in a stable position.

Storage with awareness and breathing available

In general, care must be taken to position the person affected as he / she wishes - if she / he is able to provide information. Depending on the injury or illness, certain positions are preferable:

• Raised upper body: for shortness of breath, heart problems, head injuries, heat emergencies.
• Raised legs: with allergic reaction, bleeding, collapse, burn, hypoglycaemia.
• Stable side position: if there is a risk of vomiting.
• Tightened legs: for abdominal injuries, severe abdominal pain.

Additional basic measures

Until the rescue workers arrive, you can also do the following:

• Keep calm.
• Injured children get cold very quickly. Therefore, cover up the child.
• Heavy bleeding must be stopped quickly. Press on the wound to stop, or at least slow down, blood loss. Children get into shock very quickly.
• Reassure the child so that they don't panic, which can make the situation worse.
• Make the child feel safe. Consoling and calming down helps (almost) always, even with pain.
• Take pain seriously and don't trivialize it.
• If there is no suspicion of a spinal injury, pick up the child.
• Maintain skin contact with the child.
• Distraction often helps with a stuffed animal or a cuddly toy.

When should I make the emergency call?

The emergency call is particularly important in an emergency situation. The following applies to children who are sick or have had an accident:

• If other helpers or bystanders are present besides you, ask them to call the emergency service as soon as you have noticed the emergency situation. In the meantime, you can continue with all steps of the emergency check-up and resuscitation.
• If you are all alone: First, do the emergency check-up and, if necessary, start the resuscitation. After five cycles of alternating ventilation and chest compressions, take a short break and dial the emergency call or get help.

Describe the situation on the emergency telephone as slowly and with concentration as possible. The following information is particularly important:

• Where is the emergency location? The more precise the better.
• What happened Illness, injury.
• How many people are affected? Number of injuries, for example in a traffic accident.
• Who is calling? Own name with telephone number for callback.

You don't need to remember these questions. You will be actively provided by the employee of the rescue coordination center!

The most important emergency numbers are:

• Salvation 144
• Police 133
• Fire Department 122

What is the difference between adult and child resuscitation?

• Cardiovascular arrest in children is usually the result of a breathing problem (e.g. swallowing objects, infections of the upper respiratory tract). Therefore, start the resuscitation with the resuscitation (ventilate 5 times at the beginning). In adults, you start - in contrast to this - with cardiac massage.
• The pressure point for resuscitation is slightly lower in infants (a finger's breadth below the center of the chest). For all other age groups and adults, the pressure point is in the middle of the chest.

Do not dial 144 for children until after one minute of resuscitation. For adults, dial the emergency number immediately after recognizing the respiratory failure.

More on the topic: First aid measures for adults