Lesson 5.4 – Psychological Impact of Trauma

Children can have both a physical and emotional response to events that threaten the life or physical integrity of themselves or people important to them. This may overwhelm the child’s capacity to cope and they may elicit feelings of terror, powerlessness and out of control physical arousal.

Maslow’s Hierarchy of Needs

To help a child through a first aid trauma;

  • be aware of the child’s responses to the trauma
  • recognise emotional times as an opportunity for intimacy and teaching
  • listen emphatically and validate the child’s feelings
  • help the child to verbally label emotions which will help to soothe the nervous system and recovery rate
  • set limits while helping the child to problem solve

Lesson 5.3 – Stress in Children

Talking to children about their emotions and responses to events can help them understand what’s happened, feel safe and begin to cope. Not talking to children about the event might give them the sense that what happened is too horrible to talk about, which should make the event seem more threatening and frightening.

Minor first aid incidents can see a happy resolution of the incident. However, more serious incidents can leave a child more stressed. Other factors that may add to their distress and anxiety are:

  • the absence of a parent or caregiver
  • presence of strangers

Maintain communication and always explain in simple terms (age appropriate) what has happened and what you intend to do. Providing a distraction such as playing with a bandage, penlight or other equipment can be helpful.

Lesson 4.8 – Croup

Croup, also known as laryngotracheobronchitis, is a type of respiratory infection that is usually caused by a virus. The infection leads to swelling inside the trachea, which interferes with normal breathing and produces the classic symptoms of “barking” cough, stridor, and a hoarse voice.

Signs and Symptoms

  • Distinctive barking cough
  • Difficulty breathing with increased respiratory effort and rate (sternal and rib retraction evident)
  • Poor colour
  • Lethargy and fatigue

First aid treatment includes:

  • Reassurance
  • Call emergency services on triple ‘0’
  • Create a steamy environment in a bathroom as an inhalation for a warm moist atmosphere to assist with respiratory distress

Lesson 2.6 – Anatomical Differences in Children

Children have various anatomical differences to adults which should be taken into consideration when providing a first aid response.

Children have a reduced ability to maintain body temperature due to both physiology and immaturity of the thermoregulation centre in the brain.

Breathing and pulse rates are higher due to the smaller size of respiratory and cardiac physiology and reserves.

They have a reduced ability to maintain fluid and electrolyte balance

Decompensation during injury and illness can be rapid and life threatening. Adults tend to show a more predictable decline in vital signs.

Lesson 1.3 – Australian National Peak Clinical Bodies Guidelines

The approved provider of a centre-based education/care service must ensure that the persons in attendance at any place where children are being educated and cared for by the service, be immediately available in an emergency at all times. This means:

  1. at least one staff member or a supervisor who holds a current approved first aid qualification
  2. at least one staff member or supervisor who has undertaken current approved anaphylaxis management training
  3. at least one staff member or supervisor who has undertaken current approved emergency asthma management training

Lesson 1.4 – Education and Care Services National Law

Education and Care Services National Law and Regulations (2012)

The National Law sets a national standard for children’s education and care across Australia. The National Regulations support the National Law by providing detail on a range of operational requirements for an education and care service.

Under the Education and Care Services National Law, parents must be told within 24hrs of an incident, injury, illness or trauma to their child while under the care of the provider.

An approved provider must notify the regulatory authority of any:

  1. serious incidents
  2. complaints
  3. circumstances at the service which pose a risk to the health, safety or wellbeing of children
  4. any incident or allegation that physical or sexual abuse of a child or children has occurred or is occurring while the child or children are being educated and cared for by the service

Lesson 5.2 – Stress and Debrief

As a first aider, many decisions are made in split seconds and you need to accept that the decisions made at the time were the best decisions.

Self-doubt is common with “what if” and “if only” questions and statements. Be objective and remain positive.


Management of Stress

  • Use the situation to add to your experience, there may be lessons learned/opportunities to improve – reflection guides us 
  • Obtain support from a relevant agency or as provided by your employer
  • Attend debriefings and/or obtain professional help elsewhere

Lesson 5.1 – Documentation, Privacy and Confidentiality

The purpose of a First Aid Record, or Incident Record form is to ensure all treatment provided and the casualty responses are recorded. 

This also serves:

  • as protection for individuals (first aider, patient)
  • as protection for employer/organisation
  • to assists with future investigations and trend analysis

All records should be:

  • accurate and factual
  • legible and written in permanent black/blue ink
  • errors/mistakes must remain legible; strike through/initial

Treatment records are legal documents and must remain confidential.  It is recommended that they are stored securely in a locked cabinet.

Lesson 4.19 – Electric Shock

Even for a mild electric shock, encourage the patient to seek medical aid for assessment of potential effects on the heart.

Signs and symptoms

  • A weak, erratic pulse or no pulse at all
  • Burns, particularly entry and exit burns
  • No pulse and no breathing = Cardiac arrest
  • Loss of consciousness

Downed power lines

  • Remain at least 8 meters from any live exposed electrical cable
  • DO NOT attempt to remove the cable
  • If a vehicle is being touched by a high voltage cable, DO NOT go near the vehicle or try to remove the casualty from the vehicle.  Ensure casualty stays in the vehicle

Management of electric shock

  • Check for danger to yourself, bystanders and the patient
  • Switch off power, if possible, before trying to help the patient
  • If the patient is in contact with high voltage lines, do not approach, but wait until power is disconnected by authorized electrical personnel
  • If domestic power cannot be switched off quickly, remove the patient from the electrical supply without directly touching them. Use a non-conductive, dry material (e.g. a dry wooden broom handle)
  • Follow DRSABCD
  • Call triple zero (000) for an ambulance
  • If conscious, hold any burnt area under cool running water for 20 minutes
  • Remove jewellery and clothing from burnt areas, unless stuck to the burn
  • Cover the burnt area with a loose and light non-stick dressing, preferably clean, dry, non-fluffy material such as plastic cling film
  • Seek medical aid

Lesson 4.18 – Poisoning

A poison is any substance that can cause harm or threaten life.

Poisons can enter the body by:

  • ingestion, through the mouth
  • inhalation breathed in via nose/mouth
  • absorption, through the skin
  • injection, under the skin, includes bites and stings

DO NOT induce vomiting, unless advised to do so by the Poisons Information Centre

DO NOT give the patient anything to eat or drink

Wash substances off the face and around the mouth with water


Lesson 4.17 – Substance Abuse

Substance misuse can be accidental or deliberate. Patients under the influence of drugs and/or alcohol may be at risk of harming themselves or others.

Signs and symptoms

  • Nausea, vomiting and/or diarrhoea
  • Failing respirations
  • Irregular pulse
  • Altered conscious state or unconsciousness

Management

  • DO NOT approach the patient if you don’t feel safe
  • DO NOT be judgmental (could provoke hostility)
  • BE AWARE of your environment at the scene (including sharps)

Information required for the medical team

  • What drug or drugs were used
  • How much
  • Time taken (when)

Lesson 4.16 – Eye Injury

Eye injuries may be serious, even if minor, as the eye is very sensitive and easily damaged. Eye injuries may involve either or both the bones and soft tissues surrounding the eye, as well as the eyeball itself.

DO NOT apply direct pressure on the eyeball!  DO NOT try to remove any embedded object!

Treatment

  • DRSABCD
  • Reassure the casualty
  • Place in a position of comfort
  • Support the head and advise the casualty to avoid movement
  • Bandage to hold pad in place
  • Instruct to close affected eye and try not to move unaffected eye
  • Monitor casualty

Lesson 4.15 – Ear Injury

Bleeding and fluids in or draining from the ear may be from an injury to the ear itself or as a result of a serious head or spinal injury.

Types of ear injuries

  • A blood clot that forms on the outer ear, under the skin
  • Eardrum Punctures – Result of an object in the ear
  • Eardrum Rupture – Increased water or air pressure causes these types of ear injuries
  • Inner Ear Injury – This is also the result of air or water pressure being increased
  • Middle Ear Injury – The result of an object in the ear
  • Other – Abrasions, contusions and lacerations

Signs and Symptoms

  • Pain
  • Impaired hearing or deafness in affected ear
  • Bleeding from the ear

If related to an injury within the skull

  • Watery fluid mixed with blood coming from the ear
  • Headache and/or altered conscious state

Treatment of the Conscious Casualty

  • DRSABCD
  • Reassure the casualty
  • Place the casualty in a position of comfort, sitting with the head inclined to the injured side
  • DO NOT plug the ear. Allow the fluid to drain
  • Loosely cover the ear with a sterile dressing
  • Monitor casualty and treat for shock

For Foreign Bodies in the Ear (such as dirt, sand, insect etc.):

  • If object can be easily seen and grasped: remove it but DO NOT use toothpick, cotton bud etc.
  • Pull down on the earlobe and tilt the head to the affected side
  • Place a cap full of room temperature oil in the ear to float the object/insect out
  • If either/both methods are unsuccessful seek medical attention

Lesson 4.14 – Drowning

A drowning person has the potential of respiratory and/or cardiac arrest. If possible use an item that floats to aid in the removal of the person from the water.

Treatment:

  • DRSABCD
  • Place casualty in the recovery position open the airway and let any water/vomit drain out
  • Reassure casualty
  • Continue to monitor ABC (Airway Breathing Circulation) and consciousness/responses
  • If no signs of life are present immediately start CPR and defibrillate
  • Continue with CPR until emergency personnel arrive

DO NOT ENDANGER YOURSELF!

Lesson 4.13 – Environmental Impact

Normal human body temperature is around 37 degrees Celsius. Usually, the body can regulate itself to deal with changes in external temperatures; however, extreme cold or hot weather conditions can wreak havoc on the body and cause fluctuations in body temperature that if left untreated can cause illness.

Please complete the 2 lessons below BEFORE marking this unit as complete.

Lesson 4.12 – Crush Injuries

A crush injury is an injury by an object that causes compression of the body.  This form of injury is common following a natural disaster or work accident that may involve heavy machinery.

Management

  • Follow DRSABCD
  • If possible, remove the crushing force as soon as possible if safe, within the first hour
  • Control any obvious bleeding and treat the casualty for shock by keeping them flat and if possible, elevate their legs
  • Immobilise the limb(s)
  • Call triple 000 urgent

Lesson 4.11 – Burns

Burns can be caused by various sources like heat, chemicals, electricity, extreme cold or solar radiation and damages the soft tissue of the body. Burns comes in various degrees from minor to severe.

DO NOT use ointments, lotions, creams or powders on a burn, it will seal in heat and may contaminate the burn. Avoid touching the area and do not burst any blisters.  Do not remove anything sticking to the burn.

Signs and symptoms:

Superficial Burns (First degree Burn)

  • blistered
  • red
  • very painful

Deep Burns (Second-degree burn)

  • blistered, with a moist surface if the blister has broken
  • dark red or pale yellow
  • mottled red and white
  • painful

Full-thickness Burns (Third-degree burn)

  • feels dry and leathery.  Because the nerves are destroyed, the pain will not be as great as in a superficial burn
  • is white or charred
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