Staying calm in a crisis - tips on applying first aid to children

Why do we panic?

Let's think about the main reasons a person panics during a medical crisis:

• being unaware (uneducated) about the situation
• we know that if we don't do something, this situation can be disastrous
• thinking that we may do more harm by acting
• the situation is emotionally distressing.

Now, let's look at the same points, but this time from the point of view of our ER doctors and paramedics at a distressing medical emergency. They are not panicking. Why?

• they know what to do
• they know that doing something is always better than doing nothing
• they know they won't do more harm than what's already done
• they are emotionally removed.

How to stay calm in a crisis

So, how do we stay calm during a crisis? Let's try to take a leaf out of the educated professional's book with each point:

• Get trained! Basic first aid skills are something everyone should know. Once you know what to do, you can act. This alone will help you stay calm in a crisis.
• It's important to remember that although the child is sick or hurt, you're already helping just by being there! There's always something you can do.
• Even something as small as giving the child calm reassurance such as, "I'm here and I'm getting help. I won't leave you" can have a huge positive impact on the child.
• STOP! Stop and think. It often helps to close your eyes for a moment and say, "this isn't my child, it's a child who is sick and hurt, and what do I need to do to assist this child?" This can actually help you remove the emotion, if only temporarily, and act. People panic less when they're productive.

Here's an example:

Your child is having an asthma attack and using a nebuliser machine to help them to breathe. If you come in the room screaming doom, your child's breathing will not improve as you've just transferred your panic to them.

Now let's turn this around. You walk in the room and calmly say, "you're already looking better, that's it, and you're doing well. We have an ambulance on the way, I won't leave you, okay."

The machine is helping your child breathe, but your reaction is stopping the situation from getting worse. What's more, you know you have to look calm for your child, and in doing so you're automatically less panicked. It's a positive cycle as you're actually helping yourself to calm down as you're talking to the child, keeping them calm.

This is also true for an unconscious child. Unconsciousness is best defined as no response. This child cannot talk, cannot move, and cannot even blink, moan or most importantly, take care of their own airway. If you take care of their airway by placing them in the recovery position (laying on their side for child/adult, in your arms face down supporting the head for a baby) then you are helping this child live.
The last sense to leave a human being is hearing, so continue to calmly talk to a child, even if they are unable to respond using their other senses. And remember, that this will in turn help you to remain calm yourself and think more clearly.

Listen to your instincts!

Humans are the only living creatures who ignore their instincts.

Nobody knows your child (or grandchild) like you do, not even doctors. Doctors are wonderful when it comes to advanced skills and medicine.

Remember, if something's not right to you, it's probably not right. If you're questioning whether or not to take a child to a doctor, the answer is always yes. Your questioning it means the thought is there. Think of the worst-case scenarios:

You don't take your child to a doctor...worst-case scenario, they ended up really needing it.
You take the child to a doctor... worst-case scenario, they ended up not needing it.
Always go with the second out of these options. If you're not sure, get sure!

First aid basics

The most stressful situations are the ones we know the least about.

It's important to stress that learning first aid is best done by doing a course conducted by a qualified first aid trainer as there's a lot of information for each topic. There are a lot of topics and it's good to be able to ask questions at the time of a course.

The following section is a reminder of how many ‘what ifs' can happen and how much you really need to know in order to keep calm and in control as a parent attending to a child:

• ensure your own safety first, that of bystanders, then your child
• apply pressure if the child is bleeding
• run affected area under cool tap water if the child is burnt
• remove outer clothing and get your child seen to if the child has a high fever
• call 13 11 26 if you suspect poisoning
• keep them still and call an ambulance if the child has been bitten
• know what to do if the child is choking (This requires a first aid course)
• commence CPR if the child isn't breathing (This requires training and practice)
• place them in the recovery position and ensure they're breathing if the child is unconscious
• keep them in the position they were found, unless their airway is compromised if you suspect a spinal injury
• keep them still and call an ambulance if you suspect a fracture
• give them sugar (if conscious) if you suspect a diabetic ‘turn'
• reassure them and call an ambulance if you suspect a stroke (adults)
• keep child upright, give their medication and call an ambulance if you suspect asthma
• give the Epipen* in cases of severe allergic reaction (anaphylaxis) (this requires training) and call an ambulance.

Of course, first aid is not as simple as the examples just given, this is only the tip of the iceberg. Always know what to do by means of a first aid course. Each of these scenarios will be covered in greater detail at a first aid course, giving you more confidence to deal with a child (or adult) calmly.

But to be sure you don't get confused, let's look at each of these from a different angle:

First aid don'ts

• With every situation don't put yourself, or anyone else in any danger.
• Bleeding: don't remove pressure, look closely, or remove penetrating objects.
• Burns: don't pop blisters, use lotions, or let chemicals run to unburnt skin.
• Fevers: don't cuddle the child or place in cold bath. Don't panic if there's a seizure.
• Poisoning: don't induce vomiting or give anything to eat/drink.
• Bites/stings: don't leave yourself not knowing what to do.
• Choking: don't pat the back if they're coughing. Don't panic.
• Not breathing: don't panic! Don't leave yourself not knowing what to do.
• Unconscious: don't leave them if their airway is not clear - ever!
• Spinal injury: don't move them unless their airway is compromised.
• Fracture: don't force the child to move unnecessarily.
• Diabetes: don't give food/drink if they're unconscious or having a seizure.
• Stroke: don't do nothing!
• Asthma: don't panic! Don't restrict medication if available. Don't lay child down or crowd round them.
• Severe allergic reaction (anaphylaxis): don't hesitate using an Epipen!* Don't leave yourself not knowing what to do.

From here I'm sure you're already thinking of the ‘what ifs' and have questions regarding each scenario. That's great!

This means you're more confident (believe it or not) when it comes to dealing with a first aid situation. The more you question, the more you learn, and the more comfortable you'll become in a crisis.

Knowledge is power! Stay safe.

*autoinjector of epinephrine (adrenaline)

Article written by Michelle Fiddian. Michelle is a former trainer at 000 Ambulance, and a qualified first-aid teacher. www.littleaid.com.au

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