Summary of experiences on children’s safety and first aid

Prevention always takes precedence over rescue. First aid must be dared but cannot be performed blindly. There is no universal standard that is universally applicable. All treatments must be adjusted based on actual scenarios.

Last month, a throat-stuck incident occurred in a small class. At that time, the teacher was giving fruits to children after meals. A little boy secretly stuffed a whole sapphire grape into his mouth while the teacher turned his head. After chewing it twice, his face turned red and he couldn't speak. The first reaction of the life teacher next to him was to reach out and prick it. The other head teacher who had just participated in the district's first aid training responded faster. He picked up the child and put it upside down on his knees. He tapped the middle of the shoulder blade with the heel of his palm. In less than 30 seconds, the whole grape was spit out. The child cried twice and everything was fine.

When I later talked about this case at a parent-teacher meeting, some parents asked me if it would be enough to use the Heimlich maneuver for all chokes? In fact, no, there are now different views in the academic circles: if the child has completely lost consciousness and is not breathing, Heimlich is not the first choice, and cardiopulmonary resuscitation must be performed immediately ； If it is a baby under 1 year old, the strength and posture of tapping are different from those of older children. Many people have memorized the formula, but when they actually get started, the force is either too light and ineffective, or too hard, breaking the child's ribs. There are many cases. Oh, by the way, some parents asked me before if they could use the kind of first-aid suction wand sold online for a child with a stuck throat? I specifically checked and found that there are currently no relevant medical devices approved in China, and there are not many clinical data from abroad. I personally do not recommend using it. If the foreign body is pushed deeper when inhaling, it will be troublesome.

To be honest, I have seen many near misses like this. Every time I review the case, I feel that if I had cut the grapes in half and removed the seeds in advance, this kind of thing would never have happened. All the round fruits distributed to children in our garden, whether they are grapes, cherry tomatoes or longans, are required to be cut in half and seeded. High-risk snacks such as jelly are simply not allowed to be brought into the garden. To put it bluntly, to eliminate the danger before it occurs, no matter how advanced your first aid skills are, it will work. I have encountered the most outrageous parent before. They put antihypertensive medicine on the coffee table. The 3-year-old child thought it was jelly beans and ate half of the bottle, so he was sent to the hospital for gastric lavage and suffered a serious crime. This kind of accident could have been completely avoided. If we wait until something goes wrong before talking about first aid, it is actually half a step too late.

Parents have asked me about the treatment of burns before. There was a lot of quarrel on the Internet. Some people said that 15 minutes is enough, some said that it must be 30 minutes, and some elderly people said that they should apply toothpaste and badger oil. In fact, there are differences between different guidelines: the American Heart Association recommends that running cold water for 10-15 minutes is enough. The clinical guidelines of domestic burn departments recommend 20-30 minutes for moderate to mild burns and no ulceration. If the room temperature is high in southern summer, it can be extended appropriately. However, no matter which school you choose, you are absolutely not allowed to apply toothpaste, soy sauce, or iodine. First, it will contaminate the wound surface. Second, it will affect the doctor's judgment of the depth of the burn. In the past, some parents applied half a tube of toothpaste to their children. When they went to the hospital for debridement, the children cried heartbrokenly, and the adults also regretted it.

There are also cases of falling off the bed or hitting the head. I just received a consultation from a parent last month. The child fell from a height bed of more than 1 meter and had a big bump on the back of his head. Grandma’s first reaction was to rub it and apply safflower oil. As a result, the bump got bigger and bigger. She was sent to the hospital for a CT scan and luckily there was no intracranial bleeding. There are no absolute standards here. If the baby cries immediately after the fall, is conscious, and does not vomit or walk unsteadily, then there is a high probability that it is fine. Just apply cold compress within 24 hours. Do not rub or apply blood-activating and blood-stasis-removing medicine. ； But if you can't cry for a long time after the fall, are confused, and vomit frequently, don't do anything. Call 120 and send him to the hospital immediately. Don't waste time by observing him at home.

I have to conduct first aid training for all the teachers and parents in the kindergarten at least 4 times a year. I used to like to do PPT, explaining the knowledge points and listing them clearly. But later I found that it was useless and everyone forgot about it. Now when I train, I explain the core precautions in the first 10 minutes, and then use the simulator to practice Heimlich and CPR for the rest of the time. Each person practices it at least 10 times, until you don’t need to think about the formula, and you can pick up the child’s hand and know where to put it and how hard to use it. As we in the health care community often say: Memorizing first aid formulas 100 times is not as good as practicing muscle memory once.

The longer I work in this field, the more I realize that there is really no perfect standard answer to child safety and first aid. Every baby has different tolerance levels, and accident scenarios are also very different. You should be more careful to eliminate possible dangers in advance, practice first aid actions twice more at ordinary times, and don’t panic when you encounter an accident. It will be more useful than watching 100 fragmented short first aid videos. After all, we are doing this just so that our children can grow up safely.