CPR and Choking Emergencies

Choking

First ask the child, “Are you choking”? If the child is not coughing, speaking, or breathing give abdominal thrust. Make a fist with the thumb, place your fist above the naval and place the palm of the hand over the fist. You will begin to do abdominal thrust until the object is out or the child loses consciousness then you will begin CPR. Would need to look into the child’s mount before performing rescue breaths to make sure the object doesn’t loosen. If you can see the object, try to scoop it out with the finger trying not to push it further into the throat.

CPR
First Check for alertness. Shake or tap the child gently. See if the child moves or makes a noise. Shout, "Are you OK?" If there is no response, shout for help. Tell someone to call 911 and get an AED (if available). Do not leave the child alone until you have done CPR for about 2 minutes.  Second, carefully place the child on his or her back. If there is a chance the child has a spinal injury, two people should move the child to prevent the head and neck from twisting.  Next, perform chest compressions: Place the heel of one hand on the breastbone -- just below the nipples. Make sure your heel is not at the very end of the breastbone. Keep your other hand on the child's forehead, keeping the head tilted back. Press down on the child's chest so that it compresses about 1/3 to 1/2 the depth of the chest. Give 30 chest compressions. Each time, let the chest rise completely. These compressions should be FAST and hard with no pausing. Count the 30 compressions quickly.   Third, open the airway. Lift up the chin with one hand. At the same time, tilt the head by pushing down on the forehead with the other hand.  Fourth, look, listen, and feel for breathing. Place your ear close to the child's mouth and nose. Watch for chest movement. Feel for breath on your cheek. If the child is not breathing: Cover the child's mouth tightly with your mouth. Pinch the nose closed. Keep the chin lifted and head tilted. Give 2 rescue breaths. Each breath should take about a second and make the chest rise. Continue CPR (30 chest compressions, followed by 2 breaths, then repeat) for about 2 minutes. There, after about 2 minutes of CPR, if the child still does not have normal breathing, coughing, or any movement, leave the child if you are alone and call 911. If an AED for children is available, use it now. Finally, repeat rescue breathing and chest compressions until the child recovers or help arrives.
According to the American Heart Association (2012), there are several programs and trainings offered to respond to or prevent an emergency situation.  Heart saver CPR, teaches childcare professionals how recognize and treat life-threatening emergencies, including cardiac arrest and choking for adult, child, and infant victims. They can also learn to recognize the warning signs of heart attack and stroke in adults and breathing difficulties in children. CPR for Family and Friends, pediatric demonstrates the American Heart Association pediatric infant and child how to recognize signs of choking in infants and children, how to reduce risk of Sudden Infant Death Syndrome (SIDS), also how to prevent common fatal injuries in infants and children.
Heart saver First Aid & CPR can be taken without CPR. It teaches rescuers to effectively recognize and treat emergencies in the critical first minutes until emergency medical service personnel arrive. For those who need First Aid training there is a complete training on health and safety training which covers principles of first aid, medical emergencies, injury emergencies, environmental emergencies including: bites, stings, heat and cold emergencies, and poison emergencies.
Heart saver Automated External Defibrillator (AED) is a basic technique device use for adult CPR. There is a course given by the National Safety Council Courses teaching how to use an AED which is ideal for those seeking certification, coaches, or fitness instructors. How to use an AED includes: a working knowledge of CPR, Safety for both victims and rescuers, proper placement of electrodes, when to deliver the first shock, and hands on practice.
Pediatric First Aid, CPR, & AED, programs address important issues when caring for children with medical conditions such as asthma, diabetes, HIV, and dealing with signs of abuse and neglect. No matter how careful parents are, children still get hurt, as well as having more serious injuries and sudden illnesses. The National Safety Council’s Pediatric First Aid, CPR, and AED programs cover the latest techniques for emergency care and offer practical safety tips for preventing injuries. It also addresses breathing and cardiac emergencies in infants and children, identifying and caring for common age-related injuries, and preventing childhood injuries. They are also recommended for child care providers, early childhood education professors or students, youth organizations, and parents, and are approved by the Office for Child Care Services.  
There are several other steps adults must take to ensure they are prepared to handle CPR and choking emergencies. Handling these crisis include: having a first aid kit at home, and in the car for outdoor activities emergencies. Adult should also include, medications, AED, contact information for the fire department, police department, family doctor, hospital, mother’s work phone number, father’s work phone number, or other guardian or person for emergency contact, and poison control.

References:

CPR and FIRST Aid: American Heart Association Courses (2012) Retrieved, March 22, 2012 from http://www.centuryhealth.org/content160.htm

CPR Procedures. (2012). Retrieved, March 22, 2012 from http://www.wavelandfiredepartment.com/TrainEquip/cpr_procedures.htm

How to Give First Aid to Choking Victims (2011). Retrieved, March 22, 2012 from www.ehow.com/how_2089861_give-first-aid-choking-victims.html

Emergency Preparedness: Natural and Human-Generated Disasters

The disaster scenario is a recenly upgraded “Tropical Strom Anna moving toward landfall and is expected to make landfall, and possibly strengthen, in 24 hours. The Governor has declared a state of emergency in response to the potential flooding due to heavy rainfall that is expected with this system” (Department of Children & Family Services, 2011). There are many dangers of a tropical storm-downed power lines, medicine, flooding, generator problems, fallen trees, unclean water and a lack of food. The destruction from the storm depends on its intensity, its size, and its location. After the tropical storm has passed, standing water can cause the spread of disease, transportation or communications infrastructure may have been destroyed and hampering clean up and rescue efforts. People, pets, homes and business are at risk.
Teachers and staff should be prepared to protect the children and structures from risk of a natural disaster (Disaster Training International [DTI], 2001). Preparation should occur in early childhood education environment because risk is everywhere and children may be more vulnerable to injury. If not prepared this disaster could cause the need to replace equipment or repair buildings. It could also cause a program to close for a certain amount of time, or it could cause injury or loss of a teacher, staff member or child’s life. There appropriate steps to develop an advance disaster plan and how to deal with it if it occurs. First, identify the hazards that are typical in your area (ARC, 2001; NCCCHSRC, 2005 b). Also make sure staff member have basic first aid and CPR training, and keep their certificates current.
The following steps to prepare for a flooding and tropical storm: stay up to date with the status of the storm possible flooding in the area, be sure to review and update evacuation and safety plans as needed, be ready if a declaration of disaster is made for your daycare center, inform parents how you will communicate if you are unable to reopen and finally be safe. If the childcare center is declared a disaster, the center will be required to complete a center Re-Opening Form. The form will not be posted until a declaration of disaster is made (Department of Children & Family Services, 2011).
To assess the potential risks after a tropical storm it is necessary to inspect the premises of the childcare facility, to identify potential hazards for the children, prepare any equipment that is damaged and could cause injury, store chemicals and other potentially harmful objects out of the reach of children and make sure all cribs and child equipment meet safety requirements, check all products for recalls.

The assess of risks of a tornado are to designate a safe location inside the facility by avoiding any large rooms that do not have extended length, choose a room on the lowest floor without exterior walls and far from glass as possible. If there are no safe places in the building, consider an alternate location such as the building next door (Tornado Safety in Child Care Centers, 2012).

Potential complications created by the danger itself is, people were not able to reach their children because the main roads were closed, water was contaminated due to broken water lines, gas and water pipes broken causing a fire or flood hazard.

There are several materials or documentation that would be helpful; keep contact information for each child’s parent, legal guardian in a safe place that you have easy access to that you can grab in a hurry and keep a list of all children’s names in the safe location. Teachers should have a portable radio with new batteries that can be taken to the safe location; other items include bottle water, flashlights, extra batteries, thick blankets to shield children from broken glass, and a first aid kit. It is important to check all items periodically to make sure they are in working conditions.

It is imperative to conduct random disaster drills for families and children in your care. Parents should be informed about alternate shelters so they are aware of the whereabouts of their children. An evacuation plan should be posted in each classroom with an alternate exit in case of an emergency. Conducting drills each month to practice the evacuation plans help to insure all routes are covered. If there are multiple routes use one route one month and another for the next. Conduct drills at different times of the day, including nap time, for maximum preparedness. Before going to the safe location, conduct a head count of all staff and children to ensure everyone is accounted for. Bring along an attendance sheet to do a check. Remind the children to stay calm during the drills or any emergency, teach them to get down on their knees, crouch forward and cover their heads during the storm. This will protect them from flying objects.

References:

Department of Children & Family Services: Prepare for Tropical Storm. (2011). Retrieved March 18, 2012 from http://www.dss.state.la.us/index.cfm?md=emaillist&tmp=viewcampaign&nowrap=1&msgid=680&uid=hHhwn=hQ

Frost, S. (2012). Safety Tips for Childcare Facilities: Assess Potential Risks. Retrieved March 18, 2012 from http://www.ehow.com/way_5154588_safety-tips-childcare-facilities.html

Robertson, C. (2010). Safety, Nutrition, and Health in Early Education (4^th Ed) Belmont: Wadsworth/CENGAGE Learning.

Rumble, A. (2012). Tornado Safety in Child Care Centers: Practicing and Counting. Retrieved, March 18, 2012 from http://www.ehow.com/info_7921167_tornado-safety-child-care-centers.html

Wikipedia: Effect of Tropical Storms. Retrieved, March 18, 2012 from http://en.wikipedia.org/wiki/Effects_of_tropical_cyclones