Fifteen children in a room, what could possibly go wrong?! Dr Alan Wong offers advice on how to be medically prepared for your child’s party.
Hosting a party for kids can be a rewarding experience, but when you get a lot of kids in one room, there’s bound to be something that doesn’t go according to plan. Being prepared for unexpected events will reduce the stress. So to help you with your preparations, here is a list of some of the more common medical emergencies and how to deal with them.
Choking is probably one of the first medical emergencies that come to mind when dealing with kids at a party. Some of the common foods that children can choke on are hard candy, nuts, and popcorn. To recognise choking, look for signs such as inability to talk, inability to cough forcefully, difficulty breathing, skin or lips turning blue, or loss of consciousness. The universal sign for choking is hands clutched to the throat, but not every child will give that signal.
If a child is coughing loudly, there’s no need to do anything. Just encourage them to continue coughing. If the child’s cough is not effective, stand or kneel behind the child, place your arms under the child’s arms and around their upper abdomen. Clench your fist and place it between the navel and ribs. Grasp this hand with your other hand and pull sharply inwards and upwards. Repeat this until the object is expelled from the airway or the child becomes unconscious. If the child becomes unconscious, call 999. Perform CPR if you know how.
Severe allergic reaction
Another frightening medical emergency is a severe allergic reaction (anaphylaxis). If you suspect a severe allergic reaction, first call 999. The signs and symptoms of anaphylaxis include skin reaction such as hives, swelling of the face, eyes, and lips, wheezing, vomiting, diarrhea, or fainting. If the child previously had a severe allergic reaction, he/she will often have an epinephrine auto injector (epipen). The child should know how to inject the medication by themselves. But if they need help, first pull off the safety cap from the pen. Make a fist around the syringe so the orange tip is pointing down. CAUTION: DO NOT PUT YOUR THUMB ON THE ORANGE TIP. If the pen is upside down, you will inject yourself in the thumb! With the child sitting or lying (not standing), press the orange tip firmly against the outer thigh until you hear it click. Hold it in place for 5 to 10 seconds; then remove it. You can give the injection through clothing if needed. If no epipen is available, give supportive care such as rescue breathing or CPR. The best thing you can do for a severe allergic reaction is call 999 as early as possible.
For children with burns, first cool the burn. Hold the burned area under cool (not cold) water for 10 minutes. Remove tight items, such as rings, before the area swells. Don’t break blisters but if blisters break, gently clean the area with mild soap and water and cover it with a non-stick gauze. For burns covering a large area of the body, do not immerse the burn in cold water. Doing so could cause a serious loss of body heat or a drop in blood pressure and decrease blood flow.
If a child has a bleeding wound, first remove any obvious dirt or debris from the wound. Don’t remove large or deeply embedded objects. Wear gloves if available. Place a sterile bandage or clean cloth on the wound. Press the bandage firmly with your palm to control the bleeding (Don’t put direct pressure on an eye injury or embedded object). Maintain pressure by binding the wound tightly with a bandage or a piece of clean cloth. Secure with adhesive tape. Raise the injured part above the level of the heart if possible. Don’t remove the gauze or bandage. If bleeding seeps through the gauze, add another bandage on top of it.
If a child feels faint, it may be related to dehydration, overheating, low blood sugar, exhaustion, or an underlying condition. Someone about to faint may have symptoms of lightheadedness, unsteady balance, sweating, nausea, vomiting, or look pale. If a child is about to faint or has already fainted, loosen any tight clothing, make sure the area is well ventilated. Lie the child down with their feet slightly elevated. You need to take the child to the hospital if they fell and may be hurt, is having trouble speaking/ seeing/moving, or he/she had a seizure.
Falls, especially if there is head injury, are very scary for parents. But actually most childhood head injuries are minor. Potentially serious head injury are those with unconsciousness, blood or clear fluid from the nose or ear, changes in behaviour, dizziness and stumbling, vomiting more than 2-3 times, severe or worsening headache. If any of those occur, it is best to take the child to the emergency department right away.
A high temperature can be alarming, but in an otherwise healthy child it usually isn’t something serious. A fever often means that the body is fighting off infection. You should bring the child to a doctor or hospital if:
▪ the child is younger than 3 months old
▪ the child is younger than 1 year old and has had fever for more than one day
▪ the soft spot on the child’s skull is bulging
▪ the fever triggers a seizure
▪ the child has a fever and a rash
Vomiting and diarrhea may be caused by many things but is most commonly due to gastroenteritis. A child who repeatedly vomits or goes to the toilet more frequently than usual is at risk of becoming dehydrated very quickly. You should bring the child to a doctor or hospital if:
- there are signs of dehydration, such as dry mouth, sunken eyes, decrease in urination
- inability to keep clear fluids down
- vomit that’s greenish-yellow, looks like coffee grounds, or contains blood
- a hard, bloated, or painful abdomen (belly)
- swelling, redness, or pain in a boy’s scrotum
- projectile or forceful vomiting in a newborn