Save a Mate - first aid for teenagers

The appalling events of last Wednesday have once more brought to our attention the danger that sadly surrounds us - not in Afghanistan or Iraq but on our streets.

As the mother of three young male adults I have been aware for many years of street violence, not in the same vein as last Wednesday - but there all the same.  All three of my sons have been mugged not once but several times and one of my sons had stitches because of a stabbing.

Our children are and have adapted to this way of life. They are well aware of the situation, more so than us, and many of them, especially at night, plan their routes accordingly. Some of my boys' friends told me about their coping strategies. "I have two phones, so I can give them a phone that doesn't have my sum card with all my numbers on it," said one. Another said: "I never use white headphones as they are a dead giveaway that you have an iPod." A third volunteered: "I always keep smaller change in my pocket and I hide my wallet." Interestingly, I remember doing that in New York back in the '70s.
Is it inevitable that our children will be attacked?  I think for boys in London it is almost a right of passage

As a parent, our first reaction is to wrap our kids in cotton wool and never let them out of the house. But clearly this is not practical. So we move into mentor mode, and begin to discuss prevention with them. We talk about street crime, what to do to avoid it, what to do if approached, how to react with intelligence rather than with hormones or emotion, the "no-brainer" of choosing to give up your phone, iPod, wallet - anything rather than your life. In the event, my kids seem to be better versed and more rational than we could have possibly imagined. But then they have thought about it, talked about it, rehearsed it. We haven't.

But if we cannot really help them with prevention, what can we do? How can we provide real, useful help?
The fact is that most teenagers do not have a clue as to what to do if someone they are with suffers a serious injury. So if we cannot help them prevent an attack, at least we can help them limit the consequences.

Many years ago, when, my youngest was just an infant, he suffered from febrile convulsions. Neither my husband nor I knew what to do. We had no training, no information and no experience. Though our child grew out of the condition without any ill effects, one of the changes for me was to take a first-aid course.

And now I organise through my company Safe and Sound Save a Mate Training Courses.  We fully back the British Heart Foundation’s quest to ensure that all children leave school with basic first aid skills.  It has to be one of the most important skills that we can ensure that our children learn.   When one of my sons was at The Reading Rock Festival a few years ago and his mate passed out because he had taken a drug which had a bad effect on him, my son knew exactly what to do - but he was the only one who did know.

In an emergency we all need to react quickly and effectively because knowing what to do can make the difference between life and death.

Holiday Pool Drowning Accidents

I know my last blog was about secondary drowning and water safety water but the tragic news that 5 year old Chloe Johnson drowned in a hotel swimming pool in Sharm-el-Sheik has highlighted just how dangerous water can be for young children. We are coming into holiday season now and we all need to be extra vigilant with children and water. 

Each year millions of Brits go abroad for their summer holidays and stay in hotels or Villas. Swimming is one of the main activities but not all pools are that safe. More than half of the victims of drowning on holidays are under 4 years old.

  As a parent we  need to be extra vigilant with our  children. Many hotels do not have lifeguards on duty and those that do tend to see their role more of handing out beach towels than constant pool safety supervision. Do not leave young children to be supervised by other slightly older children. I have a very good friend, who when she was 9 years old her mother left her with her brother who was 5. He drowned and although the mother never blamed my friend I think it is something she has carried with her all her life.

When my three children were all under 7 we holidayed in a hotel in Spain.  Albeit this was a long time ago but I was appalled by the state of the swimming pool. I complained to the tour operator  both when we were there and when we returned.  Not only was it unsafe with no shallow end despite it being a children's holiday destination, there was no lifeguard supervision and it was also filthy!

At home if we take our children to the local swimming pool and   somehow we instinctively know that we must watch them at all times but when we go on holiday I think that perhaps we get into holiday mode and are a bit more carefree.  Holiday pool drowning  apparently tend to happen most on the first and last day of  a holiday because  parents may be less vigilant because of distractions surrounding arrival at the holiday destination and packing up to go home. Children  are excited and keen to explore and may easily slip away.

This also goes for Villas with pools.  You need to ensure that when you hire your Villa that there is a fence around the pool and there is a shallow end for young children with easy access. I have stayed in Villas before where the pool is completely unsuitable for young children and wish I had asked more questions before I booked. 

Should you ever have to deal with a drowning it is incredibly important that you start CPR immediately (for  CPR training  go to www.safeandsound.uk.net) and do not stop until help arrives - as I pointed out in my last posting you can keep a young child or baby alive for much longer than an adult by giving CPR. You only stop when help arrives or you are too exhausted to carry on.

Below is some information I hope you find of interest from RoSPA.

Key facts are supplied by Rospa

Toddlers (0 - 3 years) - Two to three years are most at risk. In many cases the toddler wandered away from parents and fell into an unsupervised pool.

Young children (4-5 years) – Some drownings happened after the child was last seen playing in the water, or playing near to water. In many cases parents were unaware of the problem until the child was found in the water (most commonly a hotel swimming pool).

Older children (6-9 years) - In all of these cases the children were swimming.

Parental supervision - Drowning children don’t cry out for help and wave to be rescued - they disappear under the surface – often unseen and unheard. Adults need to be vigilant whenever a child is in or near a pool.

Lifeguards - Many hotel pools will not have lifeguards on duty. Of those that do have lifeguards – their roles are often combined with other duties. Many pools will have ‘pool attendants’ who give out towels and make sure the site is clean. Their main response is usually after the event has happened as opposed to the UK where a lifeguard’s main role is focused to prevent incidents occurring before the event.

Holiday villas - If you book a private property – you will have to be the lifeguard. A number of holiday pool drownings have occurred in villas during the evening (or early morning) where the child has gone outside without their parent’s knowledge and ended up in the pool. It is impossible to be awake and supervise all the time. Check to see if your villa has safety barriers (permanent or otherwise) that will stop young children from getting into the pool without your help.

Key points for parents to consider

Before you go:

· Check the safety arrangements in advance

· Teach children never to swim alone

· Be cautious about booking villas that do not have safety fencing

· Take a first aid course – know how to resuscitate a child

· Ask your travel company if the hotel pool has a lifeguard

When you are there:

· Actively supervise all young children near water

· Choose pools that are fenced with locking gates

· Even if a pool has a lifeguard – know where your children are, and what they are doing in the water

· Let children take swimming classes whilst on holiday – they are a great way of gaining water confidence and learning essential water safety skills

· Inflatables are not a substitute for supervision or swimming ability

Rules for children:

· Water safety rules for children

· Never swim alone

· Do not dive into unknown depths of water, and only jump feet first into water

· Do not push or jump onto others

· Know where to get help in an emergency

Dry Drowning - Safety in or around water

I have to confess that  until a few years ago I was quite ignorant about dry drowning.  It is not something that come across very often.  It came to my attention when I read a story in the newspaper about a  10-year-old boy who died several hours after being in a swimming pool and the newspaper report had said that he had died from dry drowning. Hmm I thought - time to find out a bit more about this. 

And it is definately high on our first aid teaching agenda - it is so important.   www.safeandsound.uk.net

Your baby, child, or even an adult has a near drowning incident but recovers quickly and you think everything is ok so you don't get them checked out - the result can be disasterous  and in some cases fatal like the poor youngster in the news story.  

 So what  is dry drowning?

Dry drowning or secondary drowning is basically drowning without water. With dry drowning you are not drowning from an immediate immersion in water; it is more of a delayed effect of a small amount of water in the lungs.

This can trigger a reaction in the lungs which can be fatal, even 24hrs after the initial incident!

Why is this?

If enough water is inhaled then it can wash away the chemical (surfactant) which keeps part of the lungs (alveoli) open. Without this surfactant the lungs begin to collapse. Then the body’s fluids as well as those swallowed/inhaled may seep into the lungs. This prevents oxygen and carbon dioxide from being exchanged and effectively cause the patient to drown (asphyxiate). This can occur much later than the initial incident and without any more fluid being inhaled.

The symptoms include:

Lethargy

Difficulty in breathing

Pain when breathing (especially when taking deep breaths)

Coughing

Possible wheezing

Symptoms are sometimes exacerbated when lying flat.

In young children, submersion in cold water (10 degrees C) can stimulate a reaction known as the 'Mammalian Diving Reflex'. This causes the child  to enter into a similar state to hibernation whereby the body slows its breathing and heart rate. This is good news as it can increase a child’s chances of survival.

One of our trainers who is also an A & E nurse recalls a situation when she was involved in the resuscitation of a toddler who had drowned in the family pond.   The accident happened in February on a cold but sunny winter morning.  The two older children of the family went out to play in the garden but didn't realise the toddler had followed them.  After approximately 20 minutes, dad spotted the toddler face down in the pond.  He retrieved him and started CPR, as luckily he had been trained.  An ambulance was called and when it arrived the paramedics started more advanced life support and brought him to the emergency department.  On his arrival this little boy was significantly hypothermic and was resuscitated for almost an hour before his heart spontaneously re-started.  The child made a full recovery.

You may just want to jump on in to rescue somebody but It is important to remember that you should only enter the water if you are sure you will not become a casualty yourself.  

How to treat burns in young children

We all know that accidents can happen at any moment.  It is impossible to watch our children all the time and there will always be that unguarded moment. But at the same time we don’t want to wrap children in cotton wool – after all scrapes and bruises are part of growing up. We just want to keep them safe and sound.

That said, accidents  are the single greatest cause of death among children and young people in the UK and put more children in hospital than any other cause. Many accidents can be prevented by putting the right safety measures in place and by learning basic first aid which can help stop a minor injury becoming a major one and even make the difference between life and death.

I talk with  parents and nannies daily answering questions about child safety and interestingly there are still some very strange myths out there about what to do.  For example recently a child minder on one of our paediatric first aid courses thought that butter should be put on a burn and when I asked other nannies on the same course a few put their hands up in agreement.  There were a  others who thought that toothe paste should be put on burns to cool them.

Of course none of these are correct. One of our trainers who is also a paediatric senior sister in a London  hospital,  sees many children in her casualty ward who have suffered a burn  and says that some parents are still not sure how to handle this sort of injury;  “They  need  to familiarise themselves with what to do , because immediate action can make a big difference to the outcome.” she says: “If parents know what to do when a child suffers a burn or scald, we would have far less need for skin grafts and plastic surgery.”

If there is any question of electrocution, the golden rule is not to touch the victim until the mains current is off and the child is no longer in touch with the source of electricity . If a burn  is from a fire, a hot surface, electric current or boiling water in the kitchen, the same rules apply. A young child’s burn should always be seen by a doctor, preferably in an accident and emergency ward.

So here are a few tips of how treat a burn 

If your child suffers a burn or scald

Treatment

·         Cool burn with cold running water for at least ten minutes. If cold water is not available, use another cold,, harmless liquid, such as milk

·         Get medical help for any burn or scald which is larger than a 50p coin

·         Remember to keep calm and give lots of comfort and reassurance to the child

·         DO NOT remove burnt clothing which has stuck to the skin. Burnt clothing is sterile and will protect the wound.

·         Remove carefully any jewellery, belts, restrictive clothing or footwear (that is not stuck to the skin) from the injured area before it begins to swell

·         Cover the burn with a clean, dry, non fluffy dressing and secure loosely.  A plastic bag or piece of cling film are ideal

·         DO NOT put butter oil or any sort of grease or lotion on a burn or scald – these can cause further damage and increase the risk of infection

·         DO NOT apply sticking plasters or any other type of adhesive dressing to the skin – they will cause pain and damage when removed

·         DO NOT break blisters – you may introduce infection into the wound

·         DO  NOT give the child anything to eat or drink with the exception of painkillers

·         Give the recommended dose of children’s painkiller syrup