It’s every parent’s biggest nightmare: A child has a sudden medical emergency or injury when there’s no medical help around. How can you help prevent such a situation from occurring and deal with it effectively if it does? First, take a tour of your home from a child’s point of view — on your hands and knees — and remove or remedy any obvious hazard. Second, be prepared. “Every parent should have formal first-aid training, including CPR and rescue breathing,” says Larry Baraff, M.D., professor of pediatrics and emergency medicine at the University of California at Los Angeles School of Medicine.
Even before you enroll in a childbirth education class, take infant CPR and basic first aid. To find a class near you, call your local hospital or check the white pages of your phone book for the local branch of the American Red Cross. The YMCA also offers classes; call (888) 333-YMCA to find one near you.
In the meantime, with advice from Baraff; Baxter Larmon, Ph.D., M.I.C.P., associate professor of medicine at the UCLA Emergency Medicine Center; and Brad Schwartz, M.D., F.A.C.E.P., a San Diego emergency physician and director of OnCall Healthcare Communications, a 24-hour telephone nurse advice center, here’s how to treat four of the most common emergencies that infants experience.
Choking is among the leading causes of accidental death for children under the age of 1.
Child may be hyperagitated — jumping up and down and/or gesturing wildly — or unable to cry or talk. Fingers and lips may be blue-tinged, with the discoloration spreading to the arms, neck and chest.
What to do:
If baby is 1 year or younger and conscious:
If the infant is coughing forcefully, allow him to continue coughing to try to expel the object. If he does not stop coughing in a few minutes; begins to cough weakly; makes a high-pitched wheezing sound; cannot cough, cry or breathe; or becomes unconscious, call 911 immediately and follow the steps below until the child stops choking or help arrives.
If baby is 1 year or younger and unconscious:
1) Lay the infant face-up on a firm surface, tilt his head back slightly and lift his chin. Open his mouth and look for a foreign object. If you find one, pull it out — but only if it is in the mouth and can be pulled out easily, without the potential of pushing it in farther. Don’t stick your fingers down the infant’s throat to try to pull the object out.
2) If you do not find an object in the infant’s mouth, place your mouth over his mouth and nose to form a seal. Give two gentle breaths, watching his chest. If his chest doesn’t rise, he’s probably choking.
3) If possible, have someone else call 911. If you’re alone, carry the infant to the phone and call 911 while you follow the next steps to expel the object:
- Cradle the infant upside-down with one arm supporting his chest, his head resting in your hand.
- Strike him between the shoulder blades five times.
- If the object isn’t expelled, lay the infant on his back again. Place two fingers on his breastbone, one finger width below the nipples. Using your fingers, give five quick downward thrusts to the chest at a depth of 1/2–1 inch.
4) See if he is breathing: Tip the infant’s head back and give two breaths, watching to see if the chest rises. If he isn’t breathing, repeat from step 3 until the object is expelled or help arrives.
- Never feed a child under 3 years of age hot dogs, hard candy, nuts, grapes, popcorn or raw carrots. Keep items that are easy to choke on, such as coins, beads, disc batteries, pills and vitamins, and small toys and balls, out of reach.
- Cut up any food not soft enough to dissolve in the mouth, such as meats, into fingertip-size pieces.
- Supervise children while they eat. Make them eat slowly.
- Anything smaller than a pingpong ball (other than food) can choke a child and should be kept out of reach.
- Never give balloons to infants or young children. They are extremely easy to choke on.
Every year, more than 1 million children under the age of 5 are unintentionally poisoned. More often than not, whatever these children ate or drank, they found at home. “Alcohol, plants, bleach, furniture polish, paint — all can kill a child quickly and need to be kept out of reach,” Larmon says.
Look for: Empty or spilled pill bottles, signs of vomiting and burning around the mouth, the odor of chemicals.
What to do:
1) Call poison control immediately. To find your local poison control center, look in the white pages of your phone book under “poison” or call 911 and ask the operator to connect you.
2) Do not induce vomiting or try to dilute the substance by giving your child milk or water to drink unless told to do so by medical personnel.
Prevention: Buy child-resistant packaging whenever possible. Lock potential hazards, such as laundry and cleaning supplies, cosmetics, all medicines, gasoline, charcoal, fertilizers and trash, in a cabinet out of children’s reach.