How to First Aid Like a Doctor
Author: Dr. Martie Conradie (General Practitioner)
Accidents happen, right? And this is even more true for parents of little ones. In fact, sometimes I feel like my four-year-old attracts disaster wherever he goes! Over the years I have learnt that you cannot always control your family’s safety, but you can certainly act accordingly when accidents happen and likewise you can very easily make some serious mistakes if you are not prepared.
As a medical doctor, I want to share a few important first aid skills that every person can and should learn to master. That might seem daunting, but with the right preparation it is not as hard as it might seem. In my experience if you are prepared for the following 10 common household injuries you should be equipped to face most accidents that could happen to your family.
1. Burns
Children are prone to injury caused by burns from scalding or fire. Knowing what to do and what not to do when a thermal or burn injury occurs can help prevent a medical emergency.
The main aim after a burn is to cool the affected area as quickly as possible and to maintain it for at least 10 minutes. Burn wounds can seem minor initially, but if not cooled, the damage may spread deeper into or across more of the tissue. Cool running water is recommended and the temperature to aim for is 15-25°C (59-77°F). A cold pack may be used if it is wrapped in a towel first to prevent direct contact with the skin, but it should be used with care in the case of open wounds and not used for an extended period of time.
If there are open wounds (deep second degree or third degree burns) and they have been sufficiently cooled, these may be lightly covered with wet sterile bandaging material and then you should go to the doctor. Always have Hydro Gel or something similar in your house. I have had to treat a burn wound at home without it once and will never make that mistake again!
Treatments that are not recommended include the use of ice, milk, or butter since these might increase the risk of the damage spreading. Any open wounds are at a high risk of becoming infected and therefore it is advised not to break blisters, and to seek medical help early.
2. Cuts and abrasions
Sharp objects are like magnets for small kids! But even grown-ups are prone to the infamous salami or biltong cutting accident!
Fortunately, most cuts or abrasions are minor. In these cases, the wound can be disinfected using an antiseptic solution or antiseptic wipes and then covered with an adhesive bandage. A Quality first aid kit will provide a variety of different bandages to better suit any size cut. Strip Closures are also a very handy addition to the household first aid cupboard. These strips can help to seal a wound by applying it over the cut while pulling the two sides of the skin together after most of the bleeding has stopped. (Strip Closures are supplied in the Surviveware kits).
When a cut is more serious the most important thing to do is to stop the bleeding, but if the bleeding is not too severe you can also take the time to disinfect the wound as above. For wounds on the head, neck, and trunk it is advised to use direct pressure to stop the bleeding and this pressure may even have to be applied for 30 minutes to an hour. On the arms and legs, tight bandages may be used, but it is important to ensure that blood can still get to the distal tissue – nails should not turn blue in color! If an artery is involved, apply direct pressure and contact emergency services to avoid unnecessary delays. 
When you help someone to dress wounds or to stop bleeding it is important to wear gloves to protect yourself against possible contamination by blood-borne diseases.
Another thing to remember is that when the cut is from a dirty object, a tetanus immunization might be required.
3. Choking
There is probably no worse feeling as a parent than your child choking without knowing how to react. If the airway is blocked and the brain is deprived of oxygen, this can become a life-threatening emergency!
The three different treatments are:
- Heimlich Maneuver – where you stand behind a person and give abdominal thrusts. It is very important to note that it is not recommended to use on a child under ten years of age since it may cause internal injury.
- Strong back slaps – attempted first before Heimlich Maneuver, or chest compressions.
- Chest compressions – If strong back slaps do not dislodge a foreign object, chest thrusts are attempted. You can do five back slaps then five chest compressions and keep alternating until the object dislodges.
Do not put your finger blindly into the mouth since this could lodge the object in deeper.
If there is someone that can help, ask them to contact emergency personnel to prevent a delay in help if it should be required, but do not stop with attempts to dislodge the object.
Use the first aid booklet in the Surviveware Kit to read up in more detail about these approaches. Attending a first aid/CPR course is highly recommended, especially for child and infant CPR.
4. Drowning
This is probably one of the biggest fears of any parent. A good quality swimming pool net is an absolute must if you have a swimming pool. A child can drown in as little as 30 seconds. 
A lack of oxygen must be prevented and therefore it is important to follow the usual A-B-C (airway-breathing-circulation) resuscitation procedure when it has been confirmed that the person is not breathing. The below description is meant as a barebones guideline in the case of a child drowning and there are minor changes to what is done for adults, but this does not replace the need for caretakers to learn how to do CPR correctly by attending a certified course.
The steps:
- Take the child out of the water
- Ask someone to call for help if you are not alone, but do not delay the start of CPR
- Check for breathing and responsiveness – place your ear next to the child’s mouth and feel if air moves over your cheek and check if the chest is moving
- If the child is not breathing, start rescue breathing:
- Place the child on a firm surface on his or her back. If a head or neck injury is suspected, move the head, neck, spine and hips together and keep them aligned when rolling the child over.
- Tilt the child’s head back and lift the chin but be careful not to tilt the head too much for a baby. Only open the jaw if a neck injury is suspected and do not tilt the head.
- Form a tight seal with your mouth over the child’s mouth and pinch the nose closed. For an infant, your mouth will be placed over the mouth and nose.
- Blow a one-second breath into the child’s mouth and look to see that the chest is rising when you do this.
- In the Surviveware kits a CPR breathing mask is supplied which assists to create a tight seal, so if there is someone nearby they can give it to you if available, but do not waste time to find it. Also have a look at the CPR pouch with instructions which will be helpful. Repeat this for a second time.
5. Start chest compressions:
For a baby:
- Put 2 fingers on the breastbone and press down about 1.5 in/ 4 cm then release the pressure and let the chest rise completely
- Do 30 compressions (at a rate of 100 compressions per minute)
- Check to see if the baby has started breathing.
For a child:
- Put the heel of a hand on the centre of the chest at the nipple-line and put your other hand on top of that hand
- Press the chest down about 2in/5cm and then release the pressure, allowing the chest to rise completely
- Do 30 compressions (at a rate of 100 compressions per minute)
- Check to see if the child has started breathing
6. Repeat the steps
- 2 breaths then 30 chest compressions
- Continue until the child starts breathing or emergency personnel arrive.
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5. Sprains and breaks
Falling off the jungle gym or during backyard sports can easily result in an accident.
If an injury occurs, using an ice pack and applying conforming bandages could help to alleviate pain. Another recommendation is to elevate an injured limb to reduce swelling. Sometimes it is difficult to distinguish between a sprain or a fractured bone and therefore a doctor should be consulted.
In most cases when a bone is fractured, it is easy to assist the person to get medical help by transporting them to the nearest medical facility, but to minimize pain, a limb may be stabilized. It is best if the person can keep it in a stable position him or herself to limit the risk of displacing a fracture further by moving the limb forcefully. 
To support an arm until medical treatment can be obtained, a sling can be made using triangular bandages. Splints can be very useful when it is difficult to obtain medical care immediately, such as during a hike.
If a neck, back, pelvis or thigh fracture is suspected, it is advised to let the person remain at the scene until emergency workers arrive.
6. Poison
Every household has some items which are dangerous to children. Whether it is a box of rat poison or ingestion of medicine or household products, the side effects from ingesting some of these might lead to anything from severe discomfort to more serious toxic effects.
If the following symptoms are present, contact emergency response immediately: drowsiness or unconsciousness, difficulty breathing, agitation or restlessness, and seizures.
If a potentially harmful product was ingested, contact Poison Control immediately. In some cases, they might advise on measures that could be taken at home.
Try to determine what the child swallowed to be able to provide the doctor with as much information as possible. Also read the information provided on the labels of substances or medications that were ingested if available, since it might advise on immediate management. In cases of corrosive substances (such as bleach) rapid administration of large amounts of liquids such as water or milk is advised. In this case, do not induce vomiting since it might cause more corrosive damage. Foaming substances (such as dishwashing liquid) are usually treated by slowly giving large amounts of liquids. When things such as tablets or plants were ingested, induction of vomiting is recommended.
When a child is not breathing or has no pulse, it is more important to start CPR while awaiting medical assistance than to try to treat the poison.
8. Animal bites
Kids love playing with their pets! And ever too often it ends up in a scratch from the cat or a nip from the dog when your dog and child tried to go for the same ball. Injuries from pets can range from a slight abrasion to severe injuries when the face and neck are involved.
When injuries are severe, remove the child from the animal as safely and quickly as possible and stop the bleeding by applying pressure. An emergency call should be made, or the child should be taken to receive medical attention immediately.
Fortunately, most injuries are minor, but even a small bite can easily become infected and it is advised to see a doctor as soon as possible. While waiting to go to the doctor, you can clean the wound with soap, water, and wipes. If it is still bleeding, you can put pressure on it using sterile gauze or a clean cloth. Once the bleeding has stopped, you can apply an antibacterial ointment and cover with an adhesive bandage.
Vaccination against Rabies should be given, especially when the animal’s vaccinations are not up to date. If children are not up to date with their tetanus immunizations or have not received a tetanus vaccine in the past 5 years, a booster vaccination is recommended.
9. Bumps and bruises
Your child can go from hero to zero when riding a bike.
These are mostly minor injuries and disinfecting a bruise or putting an ice pack wrapped in a cloth on a bump is enough. It can also help to relieve pain if the injured part is elevated and bandaged, but not too tightly.
The bump causing most concern is the bump on the head. If in doubt, always call the doctor. Call the doctor if there is one of the following:
- More sleepiness than usual
- Nausea or vomiting
- Loss of consciousness after the injury
- Confusion or memory loss
- Continuous or worsening dizziness
- Changes in behavior
- Persistent head or neck pain
In children under one, be extra careful and seek medical attention no matter what.
For any fall it is advised to monitor a child carefully for 24 hours. It is acceptable to wake the child once or twice during the night to make sure there is no difficulty in waking up, but it is not necessary to keep a child from taking a nap or sleeping.
10. Thorns
Any parent needs to be able to treat a thorn in the foot or a splinter in the finger. The steps to follow are mostly obvious, but we often forget to clean the wound.
Treatment should include:
- Clean the area with mild soap and water or using skin cleaning wipes, such as supplied in the Surviveware kits
- Tiny splinters might work their way out over a few days, but for a larger splinter the next steps could be followed
- Clean a small needle and tweezers with alcohol or an alcohol wipe such as supplied in the Surviveware kits
- If you can see the end of the splinter, grip it with the tweezer and slowly pull it out.
- If there is not a tip of the splinter to grip, follow the path of the splinter with the needle and open the skin slightly until there is a tip to grab with the tweezer to remove.
- Clean the wound again with a disinfectant swab and apply an adhesive bandage with some antibacterial ointment
The help of a doctor might be required if:
- the entire splinter cannot be removed
- the wound is bleeding heavily or is very deep
- the wound is becoming infected or swollen
- Ask the doctor if a tetanus booster is necessary.
Kids love exploring in the garden, and sometimes they are just in the wrong place at the right time.
So, what to do if stung?
- Immediately look for the stinger. Carefully remove it by flicking or scratching it out with a fingernail or sharp object, but do not squeeze it as it allows more venom to be released.
- Apply ice or cold compresses to the area.
- When stung in the head or neck area, observe that the swelling does not result in difficulty breathing. If the swelling seems to worsen, seek medical attention as soon as possible. Antihistamines may be given if available.
- Sting wipes will relieve some of the pain and itching.
If you know your child is allergic to bee stings, seek medical attention. A person that is allergic to bee stings should always have self-injecting adrenaline or antihistamines with them to be used immediately if a sting occurs. Such a person should wear a wristband indicating that they are allergic.
Preparation is the key to the successful handling of any household injury. You need to ensure that you are not only prepared in the techniques mentioned above but you also have the correct tools for the job. You should ensure you have a well-equipped first aid kit at home and refill any items used. Make sure that you are comfortable with the contents so do not let your kit lie in the cupboard gathering dust. The last thing you want is to find out you do not have the medicine and tools to perform basic first aid treatments when you need it the most! Always remember that medical attention should rather be sought earlier to prevent complications.
Our kids are explorers by nature, and we can only do our best to protect them against accidents and injuries. Buying a well-equipped first aid kit such as the Surviveware First Aid Kit is a good first step to provide for the safety of your family.
