First Aid Fundementals

If this world were perfect, every accident (from bumps and scrapes to life-threatening injuries) would happen in the presence of skilled healthcare professionals. However, most of us tend to have homes outside of the emergency room, leaving us to fend for ourselves when these injuries occur. Most of the minor injuries that occur at home or in the outdoor setting can be adequately managed with a well-stocked first-aid kit. This guide is designed to educate parents on the typical items contained in a first-aid kit and special items included when the kit is being taken to camp or sporting events. Keep in mind that each person’s healthcare is slightly different than the next person, so some items that your child might need are not listed here. 

Equipment

Dressings/Bandages

• Sterile eye pads

• Sterile gauze pads (various sizes)

• Adhesive bandages (Band-Aid®, various sizes)

• Butterfly bandages

• Bandage tape

Medications/Sterilizers

• Alcohol swabs
• Tylenol or Ibuprofen*
• Hydrocortisone cream
• Triple antibiotic ointment
• Benadryl*
• Hydrogen Peroxide

*IMPORTANT—Make sure you know the dose needed for your child. Overdoses typically happen when parents act quickly to their child’s need and don’t correctly calculate the dose. If you need help with dosing, call your local pharmacist. Also, it is important to pick the correct formulation of the medications. For example, if your child normally takes the liquid form of Benadryl®, make sure that is what you include in the first-aid kit.

First-aid kits for outdoor adventures and summer camp:

Include all of the items mentioned above, but add the following things:

·         Extra Benadryl

·         Water purifying tablets

·         An epinephrine pen (Epi-Pen®) if your child has severe reactions to stings or allergens

·         Foil emergency blanket for warmth

The most common injury in the wilderness is an allergic reaction (other than scrapes). Having extra allergy medication on hand will help you to rest at ease while your child is camping. Also, if your child will be in the wilderness and should need to rinse a wound where there is no running water, you want to make sure you sterilize the water prior to pouring it on an open wound. 

First-aid kits for sporting events:

Include all of the items mentioned in the “home” kit, but add the following things:

·         ACE bandage wrap

·         Analgesic muscle cream (such as Bengay®)

Important Points to Remember:

1.       Anti-diarrhea medications are typically not to be used in children. Some causes of diarrhea (such as bacteria and viruses) need to be cleared from the stomach, and these medications stop that from happening. If you child starts experiencing episodes of diarrhea, see a physician as soon as possible.

2.       If your child is diabetic, a glucagon kit should ALWAYS be included in his or her first-aid kit.

3.       If your child’s wound is not healing (even a minor scrape), see a physician as soon as possible.

How to treat a minor wound:

·         Make a general assessment of how severe the wound is. If the wound is severe (or if it is an injury to the head), apply pressure to the bleeding area and immediately take your child to the emergency room.

·         If the wound is minor (i.e. little bleeding and only surface level scrapes or cuts), proceed with treating the wound with your first-aid kit.

1.       Stop the bleeding. If the wound has any blood at all, the first goal is to stop the bleeding. Place a clean cloth on the wound and hold pressure against it. Occasionally remove the cloth to see if the wound is still bleeding. If the bleeding has stopped, move on to the next step.

2.       Clean the wound. Use running water, if possible. If camping, DO NOT use water from streams or ponds unless it has been purified (the bacteria and other organisms in the water will get in the wound). Dab the wound dry with a clean cloth and apply hydrogen peroxide. Repeat the hydrogen peroxide application several times. Dry the wound with a clean cloth and move on to the next step.

3.       Prevent infection. Sparingly apply the triple antibiotic ointment.   The ointment should cover the entire wound and approximately ½ inch around it to prevent bacteria from getting into the wound. You do not have to use a lot of ointment. Too much ointment can just lead to increased cost and soggy bandages. Once the ointment is applied, move on to the next step.

4.       Secure the wound. Choose an appropriate bandage based on the size and severity of the wound. For small wounds (smaller than a dime in size), a typical BandAid® will be fine. Larger wounds will need a larger bandage, and wounds that are oozing or bleeding might need gauze bandages to soak up the fluid. DO NOT APPLY THE STICKY PART OF A BANDAGE DIRECTLY TO A WOUND. Secure the bandage to the skin around the wound by using bandage tape or a cloth is the tape is not available. 

5.       Maintain bandages. The bandages will periodically need to be changed due to blood and other fluids coming from the wound. The cleaner and dryer you can keep the bandages, the better. Each time you change the bandage, repeat the cleaning steps (hydrogen peroxide) and re-apply triple antibiotic ointment. If the wound starts to look red around the edges and any puss or greenish fluid appears, take your child to a physician as soon as possible.

What about Sprains?

Many parents are confused about how to treat a sprain. The proper treatment for a sprain has three steps: stabilize, treat, protect.

1.       Stabilize. Take all pressure off of the wound and get your child somewhere that they can rest the sprained area (usually an ankle). 

2.       Treat. Two things are going to happen with a minor sprain—swelling and pain. Treat the swelling by applying a COLD pack for 10 minutes every hour for the first 72 hours after the injury. If you use a compression wrap (such as an ACE® wrap) to hold the ice to the wound, you will also help treat the swelling by applying pressure to the sprain. Treat the pain by giving your child an appropriate dose of ibuprofen. The ibuprofen is an anti-inflammatory medication, so it will also help with the swelling.

3.       Protect. Your child’s ankle will be slightly weak for a while after the sprain. During this time it is important to stabilize the sprain with a brace or athletic tape (not compression wrap) when weight is going to be applied to the sprained area. 

When should I seek immediate medical attention?

1.       If your child has an injury to the head or that is bleeding severely, go immediately to the emergency room.

2.       If your child has a cut that may need stitches, go to the emergency room. Cuts that need stitches are typically ones that cut through the skin into the fat tissue or muscle. If you are unsure, secure the wound and go to an urgent care center.

3.       If you suspect that your child has a broken bone, go to the emergency room immediately. You can suspect that they have a broken bone if there is extreme pain at the injury site and there will usually be immediate bruising. Compound fractures (when the bone comes out of the skin) are obviously a medical emergency and should be addressed in an emergency room.

4.       If your child has a rare medical problem that would cause them to bleed easily, seek medical attention immediately.

Explanation of Use for Each Item:

·         Latex gloves—Gloves protect the injured person from the care-taker’s germs on their hands. Gloves also protect the caretaker when handling blood and other body fluids.

·         Scissors—Scissors are very useful in cutting bandages to fit wounds and cutting clothing off of an injured area of the body.

·         Small flashlight—Not all injuries happen in the daylight. It is important that you can see what you are treating.

·         CPR mask—In extreme circumstances, CPR may need to be administered. The mask protects both the rescuer and the injured person from spreading disease.

·         Sterile eye pads—Useful for minor eye injuries or cuts to areas around the eye. All eye injuries should be immediately evaluated by your child’s eye doctor.

·         Sterile gauze pads (various sizes)—These are very useful in protecting open wounds such as scrapes, minor burns, and small cuts. 

·         Adhesive bandages (Band-Aid®, various sizes)—Adhesive bandages are great for small wounds that are not bleeding or oozing much. 

·         Butterfly bandages—These are useful on the knuckles and other “irregular” surfaces when they get scraped because butterfly bandages are flexible.

·         Alcohol swabs—Alcohol is typically used to sterilize and area before something gets injected, such as a glucagon pen or epinephrine pen. Try not to use alcohol on open wounds because it stings and your body will absorb some of it through the open skin.

·         Tylenol or Ibuprofen—Use these medications for minor pain. Again, be sure you know the appropriate dose for your child according to their age and weight.

·         Hydrocortisone cream—This cream can be used for minor itching caused by bug bites or allergic reactions. If at any point the itchy spot turns to an open wound (either from scratching or infection), call your pharmacist or physician before continuing the treatment.

·         Triple antibiotic ointment—This ointment can be applied to a wound before bandaging is placed on it. This will help keep bacteria from attacking the wound while it is trying to heal.

·         Benadryl®—Benadryl® is used for allergies. If your child experiences a minor allergic reaction (i.e. rash, minor swelling, runny nose/watery eyes), you can give Benadryl®. If the reaction is severe, however, get the child to an emergency department as soon as possible.

·         Hydrogen Peroxide—Hydrogen peroxide is useful in cleaning wounds before they are bandaged. This will help to prevent infection and help the wound heal quicker by getting all of the “junk” out of there.