As parents, our greatest fears are those that involve illness, pain, injury, or discomfort for our children. Unfortunately, all of these are inevitable at some point. When they do happen, we can only hope to remain calm and have some clue about what to do in an emergency. In any occurrence that requires medical attention, you should immediately contact your physician or emergency medical services. We do not intend this article to replace medical consultation or advice. However, we hope that this feature can provide guidance on how to respond in the moments following an incident, should medical care be delayed or unavailable.
A moderate fever is usually not harmful unless it rises above 39 degrees Celsius/102 degrees Fahrenheit. Be sure that your child is not overdressed when with fever. Remove extra layers of clothing, do not cover in blankets and provide extra hydration. It is usually not recommended to give babies under six months of age, or below a certain weight range any type of over the counter fever reducers. Do not give children under the age of 6 months, plain water. Instead, offer additional breast milk or formula.
22 Insect Bites or Stings
For a mild reaction to a bug bite or sting, wash the area with soap and water, then apply a cool compress. If it is on the arm or leg, you can elevate it to reduce swelling and pain. Apply a hydrocortisone cream for the pain. Use calamine lotion or lotions containing oatmeal or baking soda to soothe itching. If necessary, use Tylenol, ibuprofen, or an antihistamine to further relieve symptoms. If the symptoms of the bite or sting do not disappear in a day or two, contact your physician. Call for emergency medical help, if the person has a known allergy to the bite or sting or if it is a scorpion sting. If the person is having difficulty breathing, has swelling of the lips, eyes, or throat, has dizziness, rapid heartbeat, hives, nausea, cramping, or vomiting, emergency medical services should be contacted.
When an infant is choking, hold the baby tummy down on your legs, with their head lower than the buttocks; hit them firmly on the back, between the shoulder blades up to 5 times, or until the object dislodges. If the object does not come loose, turn the baby over, face up. Place two fingers in the middle of the chest, just below the nipple line. Begin chest compressions by pushing down sharply, up to 5 times. If the object still does not dislodge, call your local emergency hotline.
20 Allergic Reaction
The most common severe allergic reactions occur after receiving an injection, from pollens, stings or bites, and from foods like nuts, eggs, or shellfish. Signs of an allergy may be rash, itchiness, or swelling of the hands, feet, or face. Labored breathing may accompany these symptoms. If you observe any of these symptoms you should contact emergency services immediately.
19 Heat Exhaustion
This emergency can come on suddenly, usually after playing in the heat, sweating heavily and becoming dehydrated. Warning signs can include dizziness, nausea or vomiting, heavy sweating with cold clammy skin, a weak but rapid pulse, cramps, headache, and fatigue. Immediately move the child out of the heat and to a shady or air conditioned location. Lay him or her down and elevate their feet. Remove tight or heavy clothing. Provide a cool drink of water, or anything without caffeine. Help to fan the child or to sponge with cool water. Monitor and call emergency medical services if the condition worsens.
The signs and symptoms of hypothermia usually develop after exposure to cold weather or with immersion into a cool body of water. Contact emergency medical services immediately, and then do the following. Move the child out of the cold, protect them from the wind, and insulate them from the cold ground. Remove any wet clothing and replace with warm, dry coats or blankets. Additional warming should be introduced gradually. Start with a warm compress at the center of the body. Encourage him/her to drink warm, sweet drinks. Do not attempt to warm the child with a hot bath or heat lamp, and do not attempt to warm the limbs with heat or massage, this can cause additional stress to the heart and lungs.
17 Asthma Attack
A child that is wheezing or having difficulty breathing may be experiencing an asthma attack. Help the child to sit up in a comfortable position, and administer medication if they have it. If no medication has been previously prescribed or is not available: encourage the child to take long, deep breaths to prevent hyperventilation. Instruct him/her to breathe in through the nose and out through the mouth, encourage the child to remain calm. Attempt to identify the trigger, if possible remove the child from the exposure and relocate him/her to an area with clean, cool air. If available, provide a hot, caffeinated drink, to encourage the airways to open temporarily. If the symptoms do not diminish soon after a period of rest, seek emergency medical attention. For babies- if your child has not been diagnosed with asthma but shows the symptoms of an attack, call your pediatrician and take your baby to the emergency room immediately. Signs of an asthma attack in babies are: nighttime coughing and waking, wheezing that may be silent, rapid breathing, trouble feeding, agitation and crying, retractions, nasal flaring, grunting on expiration, and bluish skin around the mouth, nose, and fingertips.
16 Diabetic Shock
It is rare for babies to be diagnosed with diabetes, but the number of children with diabetes is increasing every year. As the frequency of the disease increases, it is important to understand the warning signs for a child in diabetic distress. If possible, try to determine if the child is suffering from hyperglycemia (high blood sugar) or hypoglycemia (low blood sugar). Signs of high blood sugar are warm, dry skin, fruity or sweet smelling breath, extreme thirst, and drowsiness that could evolve to unresponsiveness. Symptoms of low blood sugar are weakness, fainting, or hunger, confusion and irrational behavior, sweating and cold, clammy skin, increased pulse, and decreasing responsiveness.
If you suspect that a child is hyperglycemic, call emergency medical services immediately. If you suspect hypoglycemia, have the child sit down. Administer the child’s glucose prescriptions, if possible. If not available, give them a sugary drink like juice or soda, candy, or 2 tsp of sugar. If they do not improve quickly, try to identify any underlying causes and seek medical advice immediately. If you are unable to determine if the blood sugar level is too high or too level, opt to give the child something sugary. This will relieve low blood sugar but is not likely to cause harm with already elevated blood sugar. If the child doesn’t improve shortly after receiving the sugar, call for medical help right away. If at some point, the child loses responsiveness, treat them for the recommendations under Unresponsive, listed below.
Pinch the soft the nose with your thumb and index finger. Help the child to lean forward, and hold the pinch for 10 minutes. If the bleeding continues beyond 20 minutes, or if the nosebleed is following an accident, a fall, or an injury to the face; seek medical attention.
Offer the child ice chips or sips of cool water, encourage small, frequent sips to prevent dehydration. Then progress to flat ginger ale or lemon lime sodas, clear broth, popsicles and diluted juice. When tolerable, serve bland foods like rice, applesauce, toast, cereal, or crackers. For a baby under 6 months of age, offer 1 TBSP of electrolyte solution (like Pedialyte ,) and offer shorter but more frequent feeding sessions. Gradually increase the amount of fluid once there is no vomiting. Encourage rest. Resume regular diet after 24 hours of not vomiting.
Continue your child’s regular diet, but increase liquid in children and offer additional breast milk or formula to infants. Use an oral rehydration solution (like Pedialyte). Avoid juice and sweet drinks as they can make the diarrhea worse. Do not offer plain water to babies younger than 6 months of age. If your baby is under 6 months of age, seek medical advice. If your baby is younger than 12 months of age and has a high fever of 102 degrees or more, seek medical advice. If your child is also vomiting, refusing liquids, experiencing decreased urination, complains of severe belly pain, or has diarrhea that contains blood or mucus, contact your doctor right away.
12 Object in the Eye
First, wash your hands with soap and water and put the child in a well lit area. Look into to eye to try to identify the object. Pull the lower lid down while you ask the child to look up. Hold the upper lid up while you ask the person to look down. If the object is floating on the surface, tilt the head back and try to flush the area with an eye dropper or with a gentle stream of clean, warm water. Do not rub the eye, try to remove an object that is embedded in the eye, and do not attempt to remove a large object that appears to be embedded or that is protruding between the lids. If the object isn’t removed through flushing, if the object is embedded, if abnormal vision is being experienced, if pain and redness or sensation of something in the eye continues, seek immediate medical evaluation.
11 Object in the Nose
If a foreign object is found in the nose of a child, encourage the child to gently blow out from the nose. If only one nostril is affected, close the opposite side by gentling applying pressure before instructing the child to gently blow through the affected nostril. Be sure to instruct the child not to attempt to inhale the item. If the object is visible, attempt to remove it with a pair of tweezers. Don’t use cotton balls or anything else to poke at or to try to move the object. If these methods are unsuccessful, seek emergency medical assistance.
10 Object in the Ear
Small children may not be aware of a foreign object in the ear, but it can be the cause of pain and hearing loss. If you find an object lodged in a child’s ear, never try to probe it with a cotton swab or any other tool, doing so make risk pushing the object further in. First, simply tilt the head sideways to see if the object will fall out. If this doesn’t work but the object is clearly visible, pliable, and can be easily reached with tweezers, gently attempt to remove it. If the object is an insect, try to float it out by filling the ear with warm (not hot) baby oil, the bug should suffocate and float to the surface. You can also try to flush the object out with a bulb syringe and water. Do not attempt either of these methods for anything other than an insect, if your child has ear tubes in place, or if there is pain, bleeding, or discharge coming from the ear. If the object still isn’t removed, or if the child continues to complain of pain, discomfort, difficulty hearing, or the sensation of an object still present, call your physician for medical advice.
9 Severe Bleeding
Scrapped knees and elbows are one thing that require little attention, nothing a band-aid can't fix. But when a baby or child experiences an injury that involves a lot of bleeding it's important to apply pressure to the wound with a towel or anything available that will help to absorb, slow down, or stop the bleeding. Immediately contact emergency medical services, and keep pressure on the wound until help arrives.
Immediately put the burn under cool running water and keep it there for at least 10 minutes. After the burn is cool, apply clean plastic wrap or a clean plastic bag to the affected area. Call for emergency help if necessary. The best way to avoid burns is to ensure that babies and children cannot access flammable objects or the stove top area. Toddlers who are learning to stand, cruise and climb can sometimes grab a hold of the wrongs things, the handle on a pot of boiling water can be one of them.
7 Broken Bone
If possible, remove clothing from the injured area. Apply an ice pack wrapped in cloth. Stabilize and support the injury with a simple splint made of a small board, cardboard, folded newspaper or pillows. Wrap it up with clean cloth, bandages, or tape. Prevent further movement and keep the limb in the position that it was found in. Immediately contact emergency services. Don’t allow your child to eat or drink anything, just in case surgery is required. Do not attempt to wash the wound or any part that is projecting. Keep the child lying down until help arrives.
6 Head Injury
When a toddler finds herself/himself subject to a bump on the head, be sure to examine for other injuries, and watch for changes in their behavior. Encourage the baby or child to rest, and apply a cold compress to the injury. After a fall or a blow to the head, your child may experience pain or a headache, a bump, or paleness. Crying is normal and expected, as long the child remains alert. If they become drowsy, begin vomiting, or they seem to be deteriorating contact medical services. You should be concerned if the child loses consciousness, if the fall was from greater than 3 feet, or if a divot appears in the skin of the skull (this could be a sign of skull fracture). Any of these warrant a trip to the hospital for emergency care.
Harmful substances may include alcohol, drugs, medications, chemicals, and some plants, berries, or seeds. If you suspect that your child has ingested any of these items, establish what they have swallowed, and how much of it. A label or a sample of the plant may be useful to medical professionals. Immediately contact poison control and/or emergency medical services.
4 Electrical Shock
Never touch an injured child or person that is still in contact with electrical current. Don’t move a child or person with electrical injury unless he or she is in immediate danger. If you are able to, turn off the source of electricity. If not possible, move the electrical source away from you and the child by using a dry object of cardboard, wood, or plastic. If a burn is present, cover it with any clean cloth or sterile bandages that are available. Never use a blanket or a towel, as the fibers can stick to a burn. Anyone who has been injured by an electrical shock should be seen by a doctor. If the contact was a high voltage wire or lighting, call emergency medical services immediately. If the child is not breathing or moving, ask someone else to contact emergency services and begin CPR immediately, prevent the child from becoming chilled, and continue resuscitation methods until the child begins breathing or until help arrives.
3 Near Drowning
When a child is discovered partially or fully submerged in water, immediately ask any bystanders to call emergency medical services. Remove the child from the water if will not put you danger to do so. Always use caution when moving a person who is drowning, assume that they may have a neck or spine injury and avoid bending or turning their neck. Place your ear next to their mouth and nose, and watch the chest for movements, to check for signs of breathing. If the child is not breathing, check the pulse for 10 seconds. If there is no pulse, start CPR and follow the guidelines in this article for an Unresponsive baby. Do not use the Heimlich maneuver on a victim of near drowning, unless you believe the airway may be blocked by something other than water. If the child is breathing, try to calm him or her and remove any cold, wet clothing. Cover them with something warm and support the head and neck with pillows if possible. Even if the child seems to be ok, all near drowning patients should be seen by a doctor. Lung complications, fluid or body chemical imbalances may develop, or other traumatic injuries may be present.
When you notice that a child has collapsed and is making sudden jerking movements, it may be a seizure. For a baby or child, they may arch their back, stiffen their body and clench their fists. They may also feel hot to the touch, and appear flushed and sweaty. Use pillows, blankets, or clothing to protect the head from injury. Do not try to restrain them. Remove their clothing if necessary and possible. Once the seizure has ended, move the baby or child onto their side and tip the head backwards. Some seizures may be caused by epilepsy or high fevers. Call emergency medical services if necessary.
1 Unresponsive Baby
First, check to see if the infant is breathing. Tip the head back and monitor for breaths by looking for movements or feeling for air. If the baby is not breathing, ask someone to call emergency medical services. Prepare to administer CPR, tilt the head back, seal your mouth over the baby’s mouth and rose, and blow 5 breaths into the baby. Then, give 30 chest compressions by pushing firmly with two fingers at the middle of the chest. Watch for the chest to move inward, and then release. Provide 2 additional breaths followed by another 30 chest compressions. Continue with repetitions until the baby resumes breathing, or until help arrives.
Remember, that when a child becomes ill, injured, or distressed while in your care, the most important thing is for you to remain calm. Do you best to make rational, well thought-out and informed decisions. Anytime that you feel unsure about what to do or how to help the child, contact medical advice immediately. Print this article, as a reminder of how to proceed in the event of an emergency. Never use this advice as a substitute for medical care, and always have local emergency phone numbers, readily available.