Children’s safety and first aid experience

The core conclusion of children's safety and first aid has never been "How many first aid skills can be learned to keep children safe", but "More than 90% of children's accidents can be avoided in advance. The first rule of first aid operation is not to do the wrong operation first to aggravate the injury."

As a practitioner who has been doing voluntary training in children's safety first aid in the community for three years, this is my most practical experience after encountering dozens of real cases and talking to pediatricians from different departments countless times. Last spring in the community, a 2-year-old Tuantuan got stuck in his throat after eating jelly. The grandmother was so frightened that she held the baby and slapped her on the back hard. After patting her for half a minute, the baby's face turned purple and he couldn't even cry. The social welfare nurse downstairs happened to be passing by after get off work. When she saw this, she immediately used the Heimlich maneuver for more than ten seconds before taking out half of the jelly. Later, I specifically took this case to ask two pediatricians I knew well. Dr. Li, who has a background in emergency medicine, said that in this kind of suffocation situation where you have lost consciousness and cannot make a sound, you must use the Heimlich maneuver as soon as possible. Even a minute late may lead to the risk of brain damage. ； However, Dr. Zhang, who is sitting in the outpatient clinic, specially added that if the child is still coughing and crying at that time, even if the cough makes him bend over and shed tears, do not pat or squeeze the belly blindly. External squeezing may make the foreign body get stuck deeper. The success rate of spontaneous coughing in children is more than three times that of external intervention. Both statements are supported by clinical data. There is no absolute right or wrong. The core is to judge the situation first and then choose a plan. Don't operate blindly with the obsession of "I will use it after I have learned it".

It’s quite interesting to say that 80% of the parents I have interacted with can accurately perform Heimlich’s operating gestures, but more than half of them don’t know that after a child drops his head, even if there is no bleeding, he must be sent to the hospital immediately if he vomits once or wilts for half an hour and does not want to talk. Instead, they focus on the bruised bumps and get nervous. I met a father two years ago. His child swallowed a button battery, and he drank half a cup of vinegar at home. He said that he had read old science that acetic acid can dissolve batteries. As a result, his esophagus was slightly burned when he was sent to the hospital. The doctor said that the latest clinical guidelines no longer recommend feeding children who have swallowed corrosive foreign bodies. Strong acids and alkalis will aggravate corrosion. The old guidelines in the early years did mention the idea of ​​neutralization, but as more cases have been accumulated in recent years, it has been discovered that the harm outweighs the benefits. Knowledge is constantly being updated. If you memorize content you saw a few years ago, you are prone to problems.

When I first became a lecturer two years ago, I always wanted to break down all the first aid steps and hand them over to parents. It wasn't until I met a mother who asked me, "My baby has a fever of 38.4°C, should I give him antipyretics?" I suddenly realized that what many people lack is not knowledge, but a flexible judgment. Take fever as an example. There is indeed a lot of popular science that says "medication must be given when the temperature is above 38.5°C". However, the chief pediatrician I asked said that there is no unified temperature threshold in the academic community. The American Academy of Pediatrics' recommendation is to give priority to the child's condition, as long as it can It is normal to play, eat and sleep. Even if the fever reaches 39℃, you can take a warm bath to cool down physically and observe it first. If the temperature is only 38℃ and you can't open your eyes, and you don't even want to touch your favorite snacks, then don't delay in taking medicine or sending to the doctor. A stuck number will easily delay things.

To be honest, child safety is like installing a leakage protector in your home. Sealing the sockets from the source and not pulling private wires is 10,000 times more effective than learning how to perform cardiopulmonary resuscitation. First aid is just a cover-up measure after a leak. You can't expect the cover-up to be more reliable than the protection itself. I now give classes to parents, and the first page of the PPT never shows the operating steps. I first show three coded photos of the scene: one is a hot water bottle that was dragged over by a child and scattered all over the floor, one is a little foot stuck in the gap of the anti-theft window, and one is a button battery hidden in the crack of the sofa. Every time after putting it down, people in the audience gasped and said that last week their family even put melon seeds on the coffee table for the child to grab.

Now, at the end of every training, I will not say, "I hope everyone can use these skills proficiently." Instead, I will say, "I hope everyone will never use this knowledge in this life." After all, the best first aid for children is never having the opportunity to use first aid. Always take a quick look at the kettle to see if it is within reach of the baby. Cut fruit, don’t cut whole grapes, don’t give jelly to children under 3 years old. Put button batteries, nail clippers and other gadgets in drawers, which is much more useful than memorizing first aid procedures.