As a child becomes unwell he may become less active, sleep more and become more drowsy. More serious abnormalities are floppiness, a weak cry, irritability or poor response to things around him – see a doctor urgently if these occur.
If a child is breathing rapidly, noisily or seems to be having difficulty breathing you should see a doctor urgently. If the problem is very severe you may see a dusky colour around your child’s lips or there may be pauses when he stops breathing. You should call an ambulance if this occurs.
Skin colour and appearance
Small red or purple spots on the skin that don’t change color when you press on them can indicate a medical emergency such as meningitis or sepsis, particularly when accompanied by a fever.
Another widespread rash which can be a medical emergency are hives which appear with lip swelling. Hives should be immediately treated with an antihistamine. If there is lip or facial swelling, or laboured breathing, the child must see a doctor to a serious, life-threatening allergic reaction.
Fluids in and out
If a child has severe diarrhoea or vomiting, he or she runs the serious risk of dehydration.
Be sure every child is passing some urine every 6 hours and encourage drinking sips of clear fluids.
Signs of serious problems are vomiting with blood or green fluid (bile), or bowel motions with blood. You should see a doctor urgently if these occur.
Fever is the body’s way of fighting off illness and is not in itself harmful. Usually, rest and fluids are the best medicine, but occasionally a child will have a bacterial infection and need treatment with antibiotics.
A baby under 3 months with a fever over 38° should be taken to see a doctor as the cause of the baby’s illness is often harder to determine.
For older children, you should take them to see a doctor if they have severe shivering and chills or a fever over 40°for an extended period of time.
A headache with neurological symptoms (such as confusion, blurred vision and trouble walking) should be evaluated by an emergency room doctor.
Headaches combined with fever, vomiting, confusion or stiff neck should also be evaluated quickly as the child could have a serious infection or illness, such as meningitis, which is a medical emergency.
If a child gets headaches often, that should be evaluated. Regular headaches could be caused by something serious or by a need for vision correction with glasses.
A seizure, or fit, is a sign of a neurological imbalance in the brain. Regular seizures are usually caused by a condition called epilepsy, but it is also possible for a child to experience just one episode, especially if the child is unwell.
Seizures typically include uncontrollable shaking, muscle spasms, stiffening of the limbs, loss of bladder control, loud noises, laboured breathing, and confusion.
If a child has a seizure, loosen their clothing and move objects that might cause injury.
Do not try to hold the person down or restrain them. This can result in injury- it is best to let the person move freely until the seizure stops.
Reassure concerned bystanders who may be upset and ask them to give the person room.
After the seizure, lay the person on their side to maintain an open airway and stay with them until medical help arrives.
The human body can go into shock as a result of severe illness or injury. When a person is in shock, it means the body is essentially shutting down and blood flow to the body is reduced.
Shock can happen as a result of cardiac failure, traumatic injury, bacterial infection, blood loss or anaphylactic (allergy) reaction. Shock needs immediate medical attention.
Rapid, shallow breathing
Cold, clammy skin
Rapid, weak pulse
Confusion or lack of responding
Loss of consciousness
Blue tint to lips and fingernails
Who can I call for help?
In a life or limb-threatening emergency, don’t put off calling your local emergency services immediately. That is truly the only number you need to know in a crisis.
For less urgent matters, a nurse on call is a free government-sponsored service that gives immediate health advice from a registered nurse 24 hours a day, 7 days a week.
Be familiar with DRSABCD
If at any stage the child you are treating for a serious illness or injury loses consciousness, you should have the skills to manage this situation until medical help arrives. Taking a training course with a reputable first aid training organization is a great way to gain full certification in First Aid or CPR (Cardio-Pulmonary Resuscitation). You might even be in a position to save a life!
In the meantime, here’s a great video on how to manage an unconscious, unresponsive patient…
While Sitter Train does not offer a certification in CPR, it is useful to review the following diagrams on life-saving techniques. Please review below, noting that CPR method is different for infants to older children.
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