Emergencies and children

First, two apologies: One, I published my site yesterday without proofreading it. My husband kindly pointed it out to me by saying, “What the? The blog today was a disaster! I mean, seriously, it was really bad. There were spelling errors, grammar mistakes and the format was all messed up. I could barely get through it.” I am really sorry if this offended anyone and after too much wine and vodka last night, I fixed some of it. My only excuse is that I was busy making Christmas nice for my family, buying my husband his Christmas gift and then trying to look nice for him at the holiday party we attended last night. Completely inexcusable! Did you happen to read yesterday’s entry about the importance of keeping your knives sharp?

Two, today is about children and if you don’t have any, it might be kind of useless. You probably have no interest in saving any of them as they seem to be everywhere these days — like bed bugs.

1. Choking — the most important thing to do when a child starts to cough while they are eating is to immediately scream and hold their arms over their heads while pounding on their back. No, not really but this scenario has provided repeated entertainment for me as a bystander. I don’t know why, but I tend to try to treat my children like people. Imagine how you would feel if the next time something goes down the wrong pipe (as it often will) someone did this to you. Think about it. The image of adults doing this to each other makes me chuckle.
What you should really do …
— NOTHING! Leave them alone and let them work it out. Knocking them around or sticking your fingers down their throat has a better chance of lodging the food or item into their trachea. Do NOT hold them upside down. How does this even make sense as a tactic? Common sense people!
— If “nothing” does not work, you WILL know it. They will stop making noise or the only noise they make will be a whistle or a wheeze, and they will start to turn blue. This will be difficult to miss. Now is the time to act. If there another person with you, call 911. Then do the Heimlich maneuver. It is difficult to explain in writing but easy to do. Remember, the whole idea is to create enough force to eject the item from their throat, so this is no time for timidity. Believe me, if you need to, you will be able to do it. The technique is different in babies. If you want to see it done, check these videos out. For a child over one for a child less than one.
— Do not reach in to pull out the item unless you can see it. Again, the risk is that you will push it further down.

2. Poisoning — If you think your child swallowed something that may be dangerous and they are behaving differently or seem sick, call 911 immediately. If they seem fine, call poison control. This is really a good number to have memorized or to keep in a place near the phone. (800) 222-1222. Poison control will want to know exactly what they took, the age and approximate weight of your child and how much they took to your best of your knowledge. This last one is often difficult to assess depending on the substance but I think it wise to round up.
Do NOT try to get them to throw up. Not only has it been proven to be ineffective in most cases, it puts the child at risk for aspiration (inhaling some of the stuff into their lungs) which can be very serious. You also run the risk that whatever they took not only damaged their esophagus on the way down, it will damage it again on the way up.

3. Head injury — I want to do a whole week on concussion because there is so much to say and so much new research to explore. In this limited space, I will try to touch upon what is most important. Neuro-anatomy 101: the brain is in the head and the brain is very important. The skull is very hard but certainly not impenetrable. If your child hits his head, it is not necessarily the size of the egg or the depth of the cut that matters. Focus on his behavior. If he loses consciousness or starts vomiting, he bought himself a trip to the ER. If he seems at all confused or is behaving differently, it is a concussion. “Getting your bell rung” is a term that gets tossed around. It has such a nice festive sound to it, but don’t be fooled, it is nothing to take lightly. If you are concerned at all, see your doctor. The most important thing you can do is to protect them against a second blow to the head within a short period of time after the first.

4. Allergic reactions — Here is another one that needs a week to explore. Where did all these food allergies come from? It is an interesting topic but the bottom line is that they are real and parents and caretakers need to be aware and prepared. Not all reactions are allergic reactions and not all allergic reactions are life-threatening. If your child has had a previous allergic reaction, you probably have an epipen. It does you no good at home. Get a few, keep one everywhere. If your child is having her first allergic reaction to something, watch her carefully. You can give her benadryl which should help but you should also follow up with your doctor. Allergies can develop at any time and it is crucial to know when to call for help. Look for the following and err on the side of caution.
– sudden, severe or rapidly worsening symptoms
– swelling of the lips, tongue or throat
– wheezing, chest tightness, difficulty breathing
– confusion, sweating, nausea, vomiting
– severe, widespread hives
– lightheadedness or loss of consciousness (duh)
If your child has any of these severe symptoms and someone nearby has an epipen, don’t be afraid to use it.

5. Seizures — there are many different types of seizures but the one that will grab your attention is a tonic-clonic seizure which is the typical one you think of when you think of a seizure. Febrile seizures (seizures that are caused by fevers) are common in children although the vast majority of fevers do not cause seizures. Seizures, especially in children, are very frightening to witness. As in all emergencies, the key is to stay calm. If you can, check the clock. It will be helpful to know how long the seizure lasts. If it is her first seizure, call 911. Move anything out of the way that she can get hurt on and loosen any tight clothing around her neck. You can put her head on a soft pillow and turn her to one side. Do not put anything in her mouth or try to give her mouth to mouth resuscitation. If it is not the first seizure for your child, you can watch and wait but if the seizure lasts for more than five minutes or causes them injury, call for help.

There are so many other emergencies where children are involved including burns, cuts, bruises, they can’t find their shoes, they are thirsty and they have to go to the bathroom. In all these instances, do not panic. They will follow your lead. I am fond of the, “You’ll be fine” school of medicine in most cases. Of course, the best way to treat an emergency or accident is to prevent it from happening in the first place. This will help you as well since, admit it. When your child comes to you crying that they fell or hurt themselves, be honest. Your first impulse is to roll your eyes and take another swig. It’s kind of annoying. They are so damn needy and uncoordinated. No need to make them crazy but use caution and teach them safety. In other words, let them run but not with scissors. Let them experiment but not with fire. Let them climb but not on the roof. You get the idea. Kids are kids and you cannot, nor should you, protect them from everything.
Apology number 3: sorry for the length and lack of levity in this blog. Truthfully, there isn’t much humor to be found in hurt kids. They make me absolutely nuts but I love the little Fockers!

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