First Aid & CPR

In This Section

Common Causes of Injury & Death in Babies and Children
How to Identify a Sick Child
Vomiting in a baby
When to take a baby / child to Hospital
What to Do When Faced with an Emergency
DRSABCD
Diagram – Correct airway position for baby and children
Position for a baby with Diagram.
Table: Normal BP, Pulse, and Respiratory Rate for Babies and Children
Quiz

Common Causes of Injury & Death in Babies and Children

During the first couple of years of life, babies are especially vulnerable to various injuries and accidents. Falls are among the most common causes of injury, occurring from changing tables, highchairs, infant seats, or as a result of being accidently dropped. Babies can also sustain injuries from sharp corners or objects within the home. Additionally, cuts and bites, whether from insects, pets or sharp objects, are frequent sources of harm.

Burns and scalds present another significant risk, often resulting from hot liquids, cooking appliances, or bath water that is too hot. Poisoning is a critical concern, particularly as babies start to explore their environment and may ingest harmful substances such as household cleaners, medications, or plants. Car accidents, including improper use of car seats or leaving infants unattended in vehicles, can lead to severe injuries or fatalities.

Drowning is a leading cause of accidental death in young children, highlighting the importance of constant supervision near water sources like bathtubs, pools, and even small containers of water. Fires and smoke inhalation pose serious threats, emphasizing the need for smoke alarms and fire safety plans. Sudden Infant Death Syndrome (SIDS) remains a tragic cause of death in infants, often linked to unsafe sleep practices.

How to Identify a Sick Child

Recognizing when a child is unwell and determining the appropriate response is crucial for parents and caregivers. Babies and young children often need medical attention for various reasons, ranging from routine immunizations to illness. However, knowing when to seek medical help can be challenging.

Signs that warrant a visit to the local GP include any signs of illness such as
Coughing, diarrhea, or vomiting.
Changes in feeding patterns, such as increased wakefulness during feeds, inability to complete feeds, or refusal to feed altogether, are also concerning.
Excessive sweating during feedings.
An unusual increase in sleeping, duration may indicate an underlying health issue.
Additionally, changes in skin colour, like paleness, bluish, or grey discoloration in the arms and legs, can be alarming.
Notable swelling or indentations in the soft spot on the top of the head.
Fever in a baby under 12 weeks old, and abnormal body temperatures that do not respond to warming or cooling measures require medical attention.
A decrease or significant increase in the number of wet nappies.
The appearance of unusual rashes.
Eye discharge (if one or both eyes are red, swollen, or leaking mucus) should prompt a GP visit.

Baby Vomiting

Vomiting in a baby, especially when forceful and shooting out rather than dribbling from the mouth, needs careful monitoring. However, routine spitting up due to the immaturity of the gastrointestinal tract is generally not a cause for concern.

When to Take a Baby / Child to Hospital

In more severe cases, immediate hospital attention is necessary. This includes.

inability to awaken the baby.
Acting strangely, becoming more withdrawn or less alert.
Limited movement or pronounced weakness.
The emergence of new moaning or grunting sounds with each breath.
Difficulty in breathing.
Bluish or grey discoloration of the lips, tongue, or face.
A temperature of 40.0° C are critical signs.
Increasing or severe persistent pain or irritability.
Large or deep cuts, uncontrollable bleeding.
Poisoning
Seizures
Burns or smoke inhalation.
Major mouth or facial injuries,
Head injuries with changes in consciousness.
Confusion
Severe headache.
Pupil size changes.
Repeated vomiting.
Near drowning incidents.
Ingestion of foreign matter (button batteries, magnets etc).
Persistent vomiting for more than 24 hours.

What to Do When Faced with an Emergency

Accidents and emergencies can happen unexpectedly, whether at home, work, or out in public. Being prepared and knowing how to respond is crucial. The first priority is always your own safety and being able to think appropriately. Unlike in movies, real-life paramedics do not run to emergencies because they need to avoid becoming injured themselves. Walking allows them to continually scan and assess the situation and patient.

DRSABCD

DRSABCD is a series of steps to help walk someone through the first aid process. It describes the sequence of stages that a first aid provider should work through when encountering a sick or injured person. It guides them through gauging what danger they’re in, assessing whether resuscitation is needed and deciding how and when to start CPR.

The DRSABCD acronym stands for Danger, Response, Send for help, Airway, Breathing, CPR, and Defibrillation, easily remembered as Dr’s ABCD. It is a fundamental approach to handling emergencies:

Danger: Ensure the area around you is safe before offering help. This means removing any immediate threats to yourself and others. Stay composed and calm, taking deep breaths if necessary to maintain your focus.
Response: Check for injured or unconscious individuals. Look for movement and attempt to communicate by asking simple questions or gently touching their arm if safe to do so. Only move an injured person if absolutely necessary. Reassure them to prevent further movement and discomfort. If they are responsive, make them comfortable and monitor their condition until help arrives.
Send for Help: Call emergency services (e.g., 000) using your phone. Stay calm and follow the operator’s instructions. Provide details about the emergency, your location, the person’s approximate age, and the nature of the injury or illness. If you are in an area without service, seek help or send someone else to do so if it is safe.
Airways: If the child is breathing normally, their airways are clear. If not, check their mouth for foreign objects, such as toys or food, which can obstruct their airway. Use forceps or a hooked finger to remove visible objects, placing the baby face down on your forearm if needed. Do not push objects further down the throat. For liquid obstructions like vomit or blood, use gentle suction or roll the baby onto their side to let fluids drain out.
Breathing: Assess breathing by placing your hand on the baby’s chest and your ear close to their mouth and nose. Look for chest movement, listen for breath sounds, and feel for air against your cheek. If the baby is breathing, place them in the recovery position and monitor. If not, begin CPR.

Correct airway position for baby and children

CPR: Check for a pulse can be achieved in 2 ways- 1) Radial Pulse – Use the first finger (your Index finger) and middle finger of your hand and place the pads of these fingers on the inside of the wrist, at the base of your thumb. Press lightly and feel the pulse. 2) Carotid Pulse – by placing the index and middle finger just to the side of the windpipe, in the soft hollow area. This pulse is felt in the common carotid artery. If a pulse is not found place the baby on a firm surface and use two fingers to compress the chest between the nipples. Perform 30 compressions at a rate of two per second, pressing the chest down about one-third of its depth. Tilt the baby’s head to a neutral position, cover their mouth and nose with yours, and give gentle breaths, watching for chest rise. Continue with 30 compressions followed by two breaths, aiming for 100-120 compressions per minute, until help arrives or the baby starts breathing. If the baby begins breathing, place them in the recovery position and monitor their breathing.
Defibrillation: Defibrillation involves using an Automated External Defibrillator (AED) to deliver a shock to a person’s heart to restore a normal rhythm. AEDs are commonly found in public spaces and are designed to be used by anyone, even without medical training. If a child needs CPR, using an AED can be lifesaving.
- Get the AED: Locate and retrieve an AED from places like schools, gyms, public buildings, or clinics as quickly as possible.
- Turn on the AED: Follow the machine’s voice and visual prompts. Dry the child if wet and move them away from water sources. Use paediatric electrode pads or switch to the paediatric setting if available. If not, use the adult pads.
- Follow instructions: Place the electrode pads as instructed, typically one on the centre of the chest and one on the back if using adult pads on a small child. The AED will analyse the heart rhythm and advise if a shock is needed.
- Administer shock: If prompted, press the button to deliver the shock. Follow any further instructions from the AED, including when to resume CPR. Continue following AED prompts and providing CPR until emergency services arrive.

Recovery Position for a Baby.

The upper airway in infants is easily obstructed because the trachea (windpipe) is soft and can be distorted by an excessive backward head tilt or chin lift.
In infants, therefore, the head should be kept neutral and maximum head tilt should not be used. The lower jaw should be supported at the point of the chin with the mouth maintained open.
There must be no pressure on the soft tissues of the neck. If this does not provide a clear airway, the head can be tilted backwards very slightly with a gentle movement.

It is also recommended for a baby up to one year of age to place a towel or nappy underneath the shoulders as shown in the diagram below, to assist in opening up the Baby’s airways.

Table: Normal BP, Pulse, and Respiratory Rate for Babies and Children

Age	Approximate Weight (kg)	Systolic BP (mmHg)	Heart Rate (Beats/minute)	Respiratory Rate (Breaths/minute)
Term	3.5	60-95	120-170	25-60
3 months	6	60-105	115-170	25-60
6 months	8	75-105	110-170	20-55
1 year	10	70-105	105-150	20-45
2 years	12	70-105	95-150	20-40
4 years	15	75-110	80-150	17-30
6 years	20	80-115	75-140	16-30
8 years	25	80-115	70-130	16-30
10 years	30	85-120	60-130	15-25
12 years	40	90-120	65-120	15-25
14 years	50	90-125	60-115	14-25
16 years	60	90-130	60-115	14-25
17+ years	65	90-135	60-115	14-25

Activity

Watch this video on DRSABCD

Quiz

Name the common causes of injury and death in babies and children?

Respiratory failure

Falls from change table, highchair, infant seats or accidently dropped.

Cuts and bites

Burns and scalds

Poisoning

Car Accidents

Drowning

Fire and smoke

SID

Determine if the symptom requires a visit to the hospital or a GP

1. Bluish or grey discoloration of the lips, tongue, or face.
2. Near Drowning.
3. Diarrhea or vomiting.
4. Noticeable swelling in the soft spot on the top of the head.
5. Increased weakness with limited movement.
6. Unusual or unexplained rash.
7. Unusual increase in sleeping duration.
8. Difficulty in breathing.
9. Temperature of 40-degree Celsius.
10. Changes in the number of wet nappies.