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Treatment of an Acute Asthma Attack

By on May 1, 2015 in First Aid, Paediatric First Aid

Asthma Inhaler Asthma is a common, long-term condition which affects the airways, causing coughing, wheezing, breathlessness and chest tightness.

Asthma attacks may be triggered by a variety of different irritants, such as pollens, animal fur, house dust mites, exercise or infection. The muscles around the walls of the airways tighten, so that the airways become narrower. The lining of the airways become inflamed and swell, and there may be increased production of mucus or phlegm which can plug the airways, narrowing them further.

Diagram showing the normal airway and the airway of an asthma suffer for comparison

Treatment of asthma is aimed at two goals: relieving symptoms and preventing future symptoms and attacks. Often a daily (preventer) inhaler is used to control inflammation. In the event of an attack a ‘reliever’ inhaler helps to manage the symptoms. The most common reliever inhaler is salbutamol (Ventolin ™) and is blue. People with asthma should have a personal action plan, agreed with their GP or asthma nurse that includes information about the medicines they need to take, how to recognise when symptoms are getting worse, and what steps to take when they do so.

SIGNS AND SYMPTOMS

Coughing at rest
Wheezing sound from the chest at rest
Difficulty breathing, possibly with use of muscles in shoulders and upper body to help.
Chest tightness

More serious symptoms include:

Unable to talk, or to complete a full sentence
Exhaustion
Blue/white tinge around lips
Collapse

If these symptoms are present, call 999.

TREATMENT OF AN ACUTE ASTHMA ATTACK

Remain calm and reassuring
Encourage the patient to stand or sit upright, or leaning slightly forward, relax their shoulders and concentrate on breathing out
Help the patient to take their inhaler correctly. Children, particularly younger children, should use a spacer. Two puffs of inhaler through the spacer may be given every two minutes up to a maximum of ten puffs if required. If the child does not feel better at this stage, or if you are worried earlier, call 999.
If an ambulance has not arrived 10 minutes after the initial 10 puffs have been completed, and the child is still unwell, repeat the process.
If treatment is successful, and the patient feels better, they may resume normal activities.

Download

Asthma Attack Information Sheet

 

Head Injury Guidance

By on March 13, 2015 in First Aid, Paediatric First Aid

Child Injury

Minor head injuries, or bumps to the head, are common in children. If there has been no loss of consciousness, and there is no deep cut or severe damage to the head it is unusual for there to be any damage to the brain. Rarely, though, there may be bleeding within the skull which causes pressure on the brain, symptoms of which may take hours, or even days, to occur. Carers should be alert to these signs as they may indicate a serious condition needing urgent treatment.

 

WHEN TO CALL 999 OR SEEK IMMEDIATE HELP

If there has been any loss of consciousness
Fall from a height (> 3 metres) or high speed injury (road traffic accident, hit by projectile)
Blood or clear fluid leaking from ears or nose
Abnormal drowsiness or behaviour, confusion or problems understanding or speaking, or in nonverbal children inconsolable or inconsistently consolable crying
Seizure
Weakness in part of body, dizziness, loss of balance or uncoordinated movement
Problems with vision, such as blurred or double vision
More than one episode of vomiting
Headache which is not resolved with paracetamol, or which gets steadily worse
Inability to remember events leading up to or after the injury

WHEN TO SEEK LESS URGENT ADVICE (e.g. GP, minor injury or walk in centre)

If none of the above signs are present but

Fallen from a height greater than the child’s own height or greater than one metre
Fallen downstairs
Suspicion of deliberate harm (abuse)
Under one year old
Vomiting (but see above re more than one episode)
Known blood clotting disorder
Has consumed alcohol

WHEN IT IS APPROPRIATE TO KEEP WATCH AT HOME

If none of the above signs are present and

If there was no loss of consciousness
Minor bruising or grazing only
Cried immediately, but can be consoled and otherwise interacts normally

Child with head injury It is not unusual for a child (particularly younger children), to cry immediately after an injury, be distressed, and then want to sleep for a short time. This is normal and you should allow them to sleep – the sleep should appear peaceful and breathing should sound normal, and they should wake up fully after a nap. If the injury occurs shortly before bedtime, this can be followed as normal. If you are concerned, wake the child after an hour or so, if they can be woken as normal (even if grumpy), then they can be allowed to return to sleep. You may want to do this several times during the night if you are concerned.

Observe the child for 2-3 days, or until symptoms have settled, if you become concerned about their behaviour or responses seek further advice. Encourage them to get plenty of rest and avoid strenuous activity. Pass on information about the event to other care-givers so that they can also observe the child.

 

WOUND CARE

Minor wounds can be cleaned with tap water. Bumps and swellings can be treated by applying a cold facecloth.

Larger cuts may need further treatment, but in the first instance stop the bleeding by applying pressure over the wound, using a sterile wound dressing or clean cloth.

Download

Information Sheet

Guidance on Fever in Children

By on January 30, 2015 in First Aid, Paediatric First Aid

Child with Fever A fever is an increase in body temperature. Normal body temperature can vary within a small range, depending on age, time of day and method of measurement. The simplest method of measurement uses a thermometer which is placed briefly in the ear. In this case, a normal range of temperatures is from 36⁰C to 38⁰C.

An increase in temperature in itself is not dangerous, and can often be treated at home. Fevers in children are not uncommon, and sometimes even after full examination there may be no reason found for a fever.

LOOKING AFTER A FEVERISH CHILD

Give the child plenty of drinks, such as water or squash. Give babies smaller but more frequent feeds. If you are breastfeeding then continue to do so.
Do not worry about food if the child does not feel like eating, but encourage them to drink more.
Signs of dehydration include dry mouth, lack of tears, sunken eyes or producing less urine. In babies, the soft spot on the head (fontanelle) may be sunken. If you notice any of these signs, seek further advice from your doctor or via 111.
Do not over- or under-dress a child with fever. Physical methods of cooling a child, such as fanning, sponging with tepid water etc are not advised.
It is not necessary to use medication to treat fever, but if the child is distressed paracetamol or ibuprofen can help them to feel better. Always follow the instructions on the bottle.
Check on your child regularly, including during the night, especially infants.

WHEN AND WHERE TO SEEK HELP

If the child

Becomes unresponsive
Struggles to breathe or becomes blue
Has a fit
Develops a rash that does not disappear if a glass is pressed firmly against it

CALL 999 OR GO STRAIGHT TO YOUR NEAREST ACCIDENT OR EMERGENCY DEPARTMENT.

Contact your GP or NHS111 if

The child’s health gets worse or you are worried
If the child develops signs of dehydration (dry mouth, no tears, sunken eyes, sunken fontanelle, reduced output of urine), is drowsy and seems generally unwell
A high temperature lasts more than 5 days and the child has not yet seen a health professional
If the child is less than 6 months old

Download

Information Sheet