Injuries from objects/person: 3 - 4 years
How big a problem is it?
Small children are naturally inquisitive and slips and falls are a normal part of their development. You can’t stop your child from climbing, but you can ensure that the things they climb are stable. Injuries from falling TVs and furniture tip-overs are a lot more common than you may think. While most may not be serious, some can result in broken bones, cuts or head injuries.
Who does it affect?
Between 2013 - 2017, around 4 children per week aged 3 - 4 years were hospitalised. These children really require constant supervision in the risky environments as they have no judgement about risk themselves. This makes it all the more important to get those risks sorted out.
Firmly mount TVs to a wall or a piece of furniture, or place the older models onto low stable furniture that is able to hold the weight. You can secure the base with screws for extra stability.
Use brackets, braces or wall straps to secure unstable or top-heavy furniture to the wall. Dressers, bookcases, and mirrors are what we mean here. It’s also good to put stops on dresser drawers to prevent them from being fully pulled out.
It’s common to place items such as iPads, DVDs and remotes up on furniture where you think they can’t be reached. However, children are creative and will find a way to get to them that often involves climbing on furniture. It’s best to place them out of reach where they can’t be seen such as in a locked cupboard.
Rearrange drawers and shelves so that heavy items are lower down.
Generally, bleeding is of a minor nature and includes small cuts, grazes, etc.
However, bleeding may be severe and life threatening if a large vein or artery has been injured – e.g. the jugular vein in the neck.
Some wounds are associated with other injuries beneath the skin – e.g. an organ injured by a stabbing; broken bones which have pierced the skin.
Symptoms and signs – Not all may be present
a wound with, or without, an embedded foreign object
pain from skin surface wounds
bruising or discolouration of the skin
loss of normal function in the injured area
pale, cold, sweaty skin
How you can help
Apply direct pressure to the bleeding wound
Apply firm pressure over the wound. Use a sterile or clean bulky pad and apply it firmly with hand pressure. Apply a bandage to keep the dressing in place.
If bleeding is severe, DO NOT waste time looking for suitable padding, but be prepared to use the patient’s hand or your hand to hold the wound together if the patient is unable to do this unaided.
Raise the injured area
If the wound is on a limb, raise it in a supported position to reduce blood flow to the injured area.
If an arm is injured, you could apply an arm sling or elevation sling.
Try to avoid any direct contact with the patient’s blood or other body fluids. Use disposable gloves if possible. If gloves are not available, place your hands inside a plastic bag.
If there has been any contact with blood or any other body fluids, wash your hands or any blood splashed on the skin thoroughly with soap and water as soon as possible after the incident.
If you are concerned about a possible risk of infection, obtain advice from your doctor as soon as possible.
If a foreign body is embedded in the wound
DO NOT remove it but apply padding on either side of the object and build it up to avoid pressure on the foreign body.
Hold the padding firmly in place with a roller bandage or folded triangular bandage applied in a criss-cross method to avoid pressure on the object. Keep the patient at total rest
Even if the injury involves the arm or upper part of the body, the patient should rest in a position of greatest comfort for at least 10 minutes to help control the bleeding. Seek medical assistance
If the wound appears to be minor and the patient is able to travel by car, arrange an urgent appointment with a local doctor to assess and treat the injury.
If the injury is severe or the patient is very unwell – call 111 for an ambulance as soon as possible.
While waiting for an ambulance to arrive, observe the patient closely for any change in condition.
If blood leaks through the pressure pad and bandage
Apply a second pad over the first. Use a tea towel or similar bulky fabric and apply maximum pressure to the area.
For major uncontrolled bleeding quickly remove the blood-soaked pad and bandage and replace with a fresh bulky pad and bandage. The continuing bleeding may be due to the pad slipping out of position when the first bandage was applied.
A crush injury occurs from compression of large muscle groups and soft tissues by a heavy weight. The most serious sites for a crush injury to occur are the head, neck, chest, abdomen and thigh.
Call 111 for an ambulance.
Remove the crushing force
Remove the crushing force if possible because permanent tissue damage may occur with severe crushing force.
If the crushing force has been in place for some time, be prepared to give prompt first aid, because removal of the crushing force may cause a sudden collapse or deterioration in the patient’s condition.
Treat the patient’s injuries
Assess and treat any injuries in order of their importance.
Control any bleeding with a sterile pad applied firmly to the injured area. Assist the patient into the position of greatest comfort and use soft padding to provide support for the injured part.
If a limb is involved, support and immobilise the injured area.While waiting for the ambulance to arrive, observe the patient closely for any change in condition.
An abrasion (graze)
How you can help
Gently clean with soapy water or saline. If there are pieces of gravel embedded in the wound, ask the patient to try to remove them while the area is soaking in soapy water.
Dry the area well by blotting with gauze swabs or a pad of tissues.
If a protective dressing is necessary, apply a non-adherent sterile dressing and fix it in place with a light roller bandage or tape.
A puncture wound
How you can help
Clean the wound with warm soapy water and allow it to penetrate the puncture track because tetanus spores may be trapped deep in the wound.
Allow the wound to dry thoroughly in the air before covering it.
If a protective dressing is needed, use a porous adhesive dressing and change it daily to keep the wound healthy and dry.
Contact a local doctor for advice about tetanus immunisation.
Keep the injured arm or leg still. Someone who knows how to might use a splint to keep it still. You can support the injured arm or leg with a pillow or sling. Raise the arm or leg higher than the heart to help reduce swelling. Your child will need pain relief. If your child does not need an ambulance take them to the nearest hospital Emergency Department
If your baby is unconscious, follow the steps below.
Loss of consciousness First Aid
Follow DRS ABCD to start CPR
D Dangers? Check for any dangers to yourself such as electricity or traffic.
R Responsive? Check responsiveness by calling loudly and shaking the child's arm.
S Send for help. Dial 111 and confirm an ambulance is on its way. Use the appropriate emergency number in other countries.
A Airway. Open the airway by moving the head into a neutral position and lifting the chin. Do not tilt the head back too far.
B Breathing. Look and feel for movement of the lower chest and stomach area. Listen and feel for air coming from the nose or mouth.
C CPR. If the child is not breathing, start CPR - 30 compressions to 2 breaths. Put the child on a firm surface. Place 2 fingers of one hand (for a baby) or the heel of one hand (for a child) in the centre of the chest just below the nipples. Push down hard and fast 30 times in about 15 seconds (push down one-third of chest depth). Once you have completed 30 compressions (pushes) on the chest, breathe into the baby's mouth 2 times. Seal your lips around the baby's mouth and nose. For a child over 1, you may need to breathe into their mouth and pinch their nose closed. Gently puff into the child until you see their chest rise. Continue with the cycle of 30 chest compressions and 2 breaths until the ambulance arrives.
D Defibrillator. Attach defibrillator as soon as it is available and follow prompts.
The CPR advice is from the KidsHealth website and a page containing the Basic Life Support Flow Chart. The Basic Life Support Flow Chart is developed by the New Zealand Resuscitation Council and Australian Resuscitation Council. For more information see www.nrc.org.nz
The first aid advice is from the St John’s comprehensive online First Aid Library.
Tetanus bacteria may be found anywhere, but it is especially in soil and animal waste – dog poo for example. If a child has a cut that comes into contact with the earth, they could be exposed to tetanus. If a child has an injury from a sharp object in the earth such as a nail, they could also be exposed.
People can catch tetanus from wounds as small as a prick from a rose thorn. One of the earliest signs of tetanus is stiffening of the jaw muscles, which is why tetanus is often referred to as lockjaw. Recovery from tetanus may take months and about 11 per cent of people who get tetanus die from the disease. Tetanus vaccine is given at age six weeks, three months and five months. Boosters are given at four years and 11 years of age.
Adult boosters are given at 45 and 65 years of age. For more information contact the Immunisation Advisory Centre 0800 IMMUNE (466863) or https://www.immune.org.nz/diseases/tetanus