Head and Neck Injuries

To move or not to move

One of the questions that always comes up on our Safe and Sound first aid courses is  --  "if you  think someone  may have broken their neck  should they be moved?"  Clearly the concern is that if you  move somebody with a supected broken neck then you  might paralyse them. But if they are not breathing or  are about to choke on their own vomit, then you have to move them, as it is your job as a first aid to help preserve life.

Reading Melanie Reid’s feature in the Saturday Times Magazine brought this question back to my mind. Melanie fell from her horse in 2010 and has been partially paralysed since the accident. Her weekly column in the Saturday Magazine is a ‘must read’. 

Melanie says, “I fell off my horse. The first job was to survive. And I managed that, thanks to the friends at the scene, paramedics, the crew of a Navy search and rescue Sea King, and the NHS at its most superb.” 

I don’t know if Melanie stopped breathing and yes she is paralysed, but alive and I also  don’t know whether she was glad that she was saved but  I suspect she is as she continues to fight for a recovery.

So what should you  do?

Suspect a spinal injury if someone has:

Had a blow to the head neck or back (especially resulting in unconsciousness).

Fallen from a height – like Melanie did from her horse

Dived into shallow water

Been in an accident involving speed – such as a car accident

Been involved in a ‘cave in’ accident – such as crushing or collapsed in a rugby scrum

Multiple injuries

Pain or tenderness in the neck or back after an accident - be careful not give pain killers before seeing a paramedic as they may mask other severe injuries

If in doubt treat the casualty as if they have a spinal injury.

What next?

If they are  conscious:

Reassure them and tell them not to move. Staying calm is so important in all first aid incidents. Because your anxiety ill transfer and even if you are  falling apart inside, the behaviour needs to show the opposite. 

Keep them in the position in which you find them. Don’t  allow them to move, unless they are in severe danger

Hold their head still with your hands. Keep the head and neck in line with the upper body.

Call 999/112 for emergency help. Keep them still and warm until help arrives.

 If they are unconscious

 If they are breathing normally this means the airway must be clear, so there is no need to tip the head back - you may have to gently tip it back and resuscitate if they are not!

Call 999/112 for emergency help

Hold the head still with your hands and keep the head and neck in line with the upper body.

If you have to leave the casualty, if they begin to vomit, or if you are concerned about their airway in any way, you should put them in the recovery position. KEEP THE HEAD AND NECK IN LINE WITH THE SPINE WHILY YOU TURN THE CASUALTY, Try to get help in doing this if you can.

Keep them warm and still. Constantly monitor breathing until help arrives. Only move them if they are in severe danger

I know this isn’t a very uplifting blog but I was reminded of the importance of knowing what to do when I read Melanie’s feature.  I hope you never have to use it – but at least should an emergency arise you will have some knowledge.  Better still come on one of our first aid courses and practice it yourself. www.safeandsound.uk.net

Heat Exhaustion and Heat Stroke - What To Do?

                                                                   

I am not complaining but..... It is hot hot hot. And this kind of heat can creep up on you so it is important to monitor your body's response to it.

We all know it’s important to drink water and slap on sun cream when the sun shines. But would you know what to do if someone had heat exhaustion or heat stroke?

So what is heat exhaustion?  It is when we sweat excessively and lose   water and body salts. Take a child that begins to feel poorly in the late afternoon or early evening after running around all day. 

Heat exhaustion occurs when the core body temperature rises above 38"C.   And if this is not treated it can quickly lead to heat stroke

So what are the signs and symptoms?

They include confusion, dizziness, and a loss of appetite, nausea, vomiting, stomach cramps and a pale and sweaty skin.   The child or adult may say they 'feel cold' but they will be hot to touch

How to treat this?

·        Move the adult or child to a cool shaded area. Remove excessive clothing and lay them down

·        Give them water to re-hydrate them. Oral rehydration solutions such as Dioralyte or isotonic drinks are best as they also replace lost body salts (if giving to someone else's children read the label and get consent from patents)  If a child does not want to drink then  try ice lollies. 

Always get medical advice, even if the child or adult recovers quickly.

Heat stroke is a much more serious condition and results in failure of the temperature control area of the brain.  Our sweating mechanism fails and the body is unable to cool down. The body temperature can reach dangerously high levels (over 40"C).

The symptoms for this can include severe confusion and restlessness, a lowered level of consciousness and a possibility of fitting. Flushed, hot dry skin (no sweating), a throbbing headache, dizziness, nausea, vomiting.

So how to treat this? 

·   Move the child or adult  to a cool, shaded area

·    Call 999/112 for emergency help

·    Cool rapidly. Remove outer clothing and wrap in a cold, wet sheet, Keep it wed and cold until the temperature falls to normal levels, then replace with a dry sheet. Take care not to cool down too quickly

    

I hope this isn't too scary but really so much better to be forwarned

You can also always attend one of our first aid courses www.safeandsound.uk.net

Registering Nannies and Au Pairs with Ofsted

 

                                                                

"Why do I need to register with Ofsted?" asked a nanny on the phone today. 

 "You don't need to register however if you are looking for work then you will stand a better chance of finding a job if you are registered." I amswered

 "Why?" she asked

"Because a family can only claim back their tax credits if they employ an Ofsted registered nanny.”

"But then surely they should pay for me to be registered" was her retort.

 Of course there might be some truth in this but with the economy in decline and families thinking twice about employing nannies, I explained that it might be sensible for her to take the initiative and pay to get herself registered.

She sighed "So how do I do it?" 

Luckily Safe and Sound has written a guide for nannies and parents.  We did this  after  many many calls  from confused nannies, au pairs and parents who had called Ofsted and been directed to their site - but find the site muddled and confusing.  And when they tried to talk to someone at Ofsted they still did not understand.  I am not sure Ofsted really understand themselves.

So here is our Safe and Sound Guide to the Voluntary Ofsted Registration for child carers looking after children in other people's homes. 

Parents who employ an Ofsted registered nanny can receive some financial contributions towards their childcare costs. There are two types of financial support available: employer-supported childcare vouchers and working tax credits.

You can find out more about what this means for you financially by going to: www.taxcredits.inlandrevenue.gov.uk

The Registration Process

Step 1

Nannies and Au Pairs complete the initial online application form (CR1) available at http://www.ofsted.gov.uk/resources/application-forms-for-childcare-register-forms-cr1-and-cr2Ofsted.gov.uk

You can also apply by phone (0300 123 1231) or post. 

Step 2

Ofsted will send out an invoice and a request for further information including the following documents:

1.    A valid paediatric first aid certificate

2.      Evidence of an appropriate childcare qualification covering the Common core skills and knowledge (for further info go to http://www.ofsted.gov.uk/resources/factsheet-childcare-common-core-skills-and-knowledge)

3.    A valid nanny insurance certificate

4.      A completed CRB application form (Ofsted will carry out the CRB check as part of the registration process)

Step 3

Submit the documents at a local post office where the applicant’s identity will be verified. Once Ofsted has checked all documentation, carried out the CRB check, and is satisfied the applicant meets their criteria; they will issue a certificate of registration with a unique registration number.

How much does it cost to register?

Ofsted registration fee (includes CRB check)                        £103

Safe and Sound Paediatric First Aid course                  £114 (£100*)

Safe and Sound Common Core Skills course                £135 (£120*)

*If both courses are booked together the discounted rates apply

Nanny Insurance                                                                     Approximately £65

Who should be expected to cover the cost?

Whilst parents benefit financially, Ofsted registration may enhance a nanny or au pair’s professional qualifications and employability and so both parties benefit from registration. There are no hard and fast rules as to who should pay for what but as a professional childcarer it is not unreasonable to expect nannies to pay for their first aid training and insurance. It is worth mentioning that if the parents do pay for the registration it is considered a benefit in kind and should be declared as such.

How long does it take to get registered?

Once your application and supporting documents have been submitted, you need to allow approximately 12 weeks to get your registration certificate through.

Good Luck