Silliman University College of Nursing Dumaguete City

Research Unit on FIRST AID AND WOUND CARE

Submitted by: Corsame, Artlene Maer Zosima, Zenaida Flor de May Y. Submitted to: Mr

Michael B. Obate

June 11, 2011

VISION
A leading Christian institution committed to total human development for the well- being of society and environment.

MISSION
Infuse into the academic learning the Christian faith anchored on the gospel of Jesus Christ; provide an environment where Christian fellowship and relationship can be nurtured and promoted. Provide opportunities for growth and development in every dimension of the university life in order to promote character, competence and faith. Instill in all members of the university community an enlightened social consciousness and a deep sense of justice and compassion.

Promote unity among peoples and contribute to national development.

RESOURCE UNIT ON FIRST AID AND WOUND CARE Time allotment: 1 hour and 30 mins. Topic Description: This topic deals with first aidits aims and guidelines, and the first aid measures used in managing common problems in the care of school-age children. It also includes the guidelines in doing wound care. The nursing process is utilized as a guide in giving first aid. Central Objective: At the end of the ward class, the learners will gain broader knowledge, develop beginning skills and manifest desirable attitudes integrating first aid in the care of school-age children. SPECIFIC OBJECTIVES CONTENTS Prayer Dear heavenly father we praise and thank you for the wonderful blessings that you have showered upon us, for giving us our parents, our classmates, our teachers and all the people that have been part of our lives. May you forgive us and cleanse us from all the sins we have committed. And Lord, may You continue to guide us in our studies and that we may be able to be a good sons and daughters of yours that we may not be tempted to do evil things or even think of evil thoughts. And please help us to do good things Lord and help us to appreciate all the good things in life. This we ask in your Almighty name.
Amen.

T/A

T/L STRATEGIES

EVALUATION The students shall be able to:

After the ward class, the learners will:

I. Introduction 1 min. A. Overview First-aid procedures are constantly being reviewed to ensure that the casualty is getting the best possible care. Most of us feel apprehensive when dealing with "the real thing". By facing up to these feelings, we are better able to cope with the unexpected. It is not an exact science, and is thus open to human error. Even with appropriate treatment, and however hard we try, a casualty may not respond as hoped. Some conditions inevitably lead to death, even with the best medical care. If we do our best, our conscience can be clear. II. First Aid 2.1 Definition 3 mins

Lecture: Social Discussion

Lecture: Social Discussion Question and Answer

Define First Aid in their own terms

 First aid is the immediate assistance or treatment given to someone injured or suddenly taken ill before the arrival of an ambulance, doctor or other appropriately qualified person. The person offering this help to a casualty must act calmly and with confidence, and above all must be willing to offer assistance whenever the need arises. Discuss the three aims of first aid concisely. 2.2 Aims 2.2.1 To preserve life and limb the overriding aim of all medical care, including first aid, is to save lives. Pay strict attention to safety Follow the ABC of resuscitation Control any major bleeding 2.2.2 To prevent the patients condition from worsening sometimes also called prevent further harm or danger of further injury, this covers both external factors, such as moving a patient away from any cause of harm, and applying first aid techniques to prevent worsening of the condition, such as applying pressure to stop a bleed becoming dangerous. Make diagnosis of the injury or illness, if possible, by means of a thorough examination. Give priority to seriously injured casualties. Treat multiple injuries in order of priority, dealing with life-threatening conditions first. Consider the possibility of hidden secondary conditions. 2.2.3 To promote recovery - first aid also involves trying to start the recovery process from the illness or injury, and in some cases might involve completing a treatment, such as in the case of applying a plaster to a small wound

(Quick Review)

 Relieve any discomfort, pain or anxiety. Arrange for appropriate medical attention. 2.3 Priorities 2.3.1 Assess the situation Your priorities are to identify any risks to yourself, to the casualty, and to any bystanders, then to assess the resources available to you and the kind of help you may need help. Your approach should be brisk, but calm and controlled, so that you can quickly take in as much information as possible. State that you have first-aid skills when offering your help. If there are no doctors, nurses, or more experienced people present, calmly take charge. 2.3.2 Make the area safe The conditions that caused the accident may still be presenting further danger. Remember that you must put your own safety first. You cannot help others if you become a casualty yourself. Often, very simple measures, such as turning off a switch, are enough to make the area safe. Sometimes more complicated procedures are required. Never put yourself and the casualty at further risk by attempting to do too much; be aware of your limitations. 2.3.3 Assess all the casualties and give emergency first aid Quickly assess all casualties moving them only if they are in danger or you need to do so to apply lifesaving treatment. Deal with life threatening conditions first. Search the area thoroughly, so that you do not overlook a casualty who may have been thrown near in the accident or have wandered away while confused. Give emergency first aid. Once it is safe, quickly make an initial assessment of each casualty following the ABC of resuscitation, so that any

55 mins

casualty needing emergency first aid is treated immediately. 2.3.4 Get help You may be faced with a number of tasks: to maintain safety, to telephone for help, and to start first aid. Often people can be asked to: o Make the area safe o Telephone for assistance o Fetch first-aid equipment o Control traffic and onlookers o Control bleeding or support a limb o Maintain the casualtys privacy. o Transport the casualty to a safe place. 2.4 Resuscitation 2.4.1 Definition Cardio-pulmonary resuscitation is the first aid procedure intended to revive a heart and lung arrest within 3 to 4 minutes, from the time the heartbeat and breathing stops prevent death or irreversible brain damage. 2.4.2 The ABC of Resuscitation CPR has its ABCs and these are as follows: A-irway check for airway clearance by opening the clients mouth. Look for an object that obstructs it like food or small toys. Get any obstructions using your index and middle fingers. B-reathing while tilting the clients head, place your ear over his mouth, facing his chest and listen for breathing and watch for the rise and fall of the chest. If the client is not breathing, provide ventilation by giving rescue breathing. C-irculation check for the circulation by palpating the carotid pulse. Provide artificial circulation the use of external chest compression

Outline the steps in resuscitation correctly.

Lecture: Social Discussion Question and Answer (Quick Review)

2.4.3 The Resuscitation Sequence When dealing with a collapsed casualty, following the sequence below will enable you to check the casualty's response, breathing, and circulation, and slow you how to resuscitate if necessary. Check the casualtys response: Try to get a response by asking questions, carefully shaking him or gently pinching him. Open the airway and check breathing: Tilt the head back to open the airway. Check for breathing. If the casualty is breathing, place him in the recovery position. Breathe for the casualty: look into the mouth and remove any obvious obstruction. If the casualty is not breathing, keep the head tilted back, pinch the nostrils, closed, and give two breaths or mouth-tomouth ventilation. Assess for circulation: Check the pulse for up to ten seconds. If you can feel a pulse, continue artificial ventilation. If there is no pulse or no other sign of recovery, begin CPR. Commence CPR: Alternate 15 chest compressions to 2 breaths of artificial ventilation (repeat this sequence as necessary). III. Common Problems of School-Age Children and their Management Explain briefly the nature of 3.1 Wounds and Wound Care each problem. 3.1.1 Types A. According to degree of contamination a. Clean An uninfected wounds in which no inflammation is encountered and the respiratory, alimentary, genital, and urinary tract are not entered. Are primarily closed wounds; or if necessary

Given actual situations, the learners will:

Lecture through a game: Mechanics Identify the type of wound of the picture given to you. Then give a short description. Slideshow presentation

they are drained with no drainage. Wound containing no pathogenic organisms There is low risk of infection

b. Clean-contaminated Are surgical wounds in which the respiratory, alimentary, genital or urinary tract has been entered? Such wounds show no evidence of infection. Wound made under aseptic conditions but involving body cavity that normally harbors microorganisms. There is greater risk of infection than with clean wound c. Contaminated Include open, fresh, accidental wounds and surgical wounds involving a major break in sterile technique or a large amount of spillage from the gastrointestinal tract. Contaminated wounds show evidence of inflammation. Wound existing under conditions in which presence of microorganisms is likely There is high risk of infection d. Dirty or infected Wound presents signs of infection (inflammation, purulent, drainage, skin separation) Include old, accidental wounds containing dead tissue and wounds with evidence of a clinical infection, such as purulent drainage. (e.g., ruptured bowel) Bacterial organisms present in wound site usually 105 organisms per gram of tissue

Identify at least 2 signs/symptoms for each common problem. Cite at least 75% of the first aid measures for each problem. Perform the appropriate first aid measures satisfactorily. Give at least 2 tips to prevent the problem. B. According to how they are acquired (extent of tissue layers involved) a. Incision clean cut from a sharp edge such as a broken glass (e.g. knife or scalpel) Open wound; deep or shallow; painful

b. Contusion closed wound caused by a blow to body by blunt object; contusion or bruise characterized by swelling, discoloration, and pain wound is more severe if internal organ is contused; wound may cause temporary loss of function of body part; localized bleeding into tissues may cause hematoma (collection of blood) c. Abrasion a superficial wound in which the top layers of the skin are scraped off, leaving raw tender area open wound involving the skin d. Puncture a wound with small entry site, but a deep track of internal damage penetration of the skin and the underlying tissues by a sharp instrument, either intentional or unintentional e. Laceration a crushing or ripping forces which results in rough tears or lacerations tissues torn apart, often from accident (e.g.,

with machinery) f. Penetrating Wound penetration of the skin and the underlying tissues, usually unintentional (e.g., from a bullet or metal fragments) 3.1.2 Kinds of Wound Drainage/Exudates A. Serous A serous exudate consists chiefly of serum (the clear portion of the blood) derived from blood and the serous membranes of the body, such as the peritoneum. It looks watery and has few cells. An example is the fluid in a blister from a burn. B. Purulent It is thicker than serous exudate because of the presence of pus, which consist of leukocytes, liquefied, dead tissue debris, and dead living bacteria. C. Sanguineous It is consist of large amounts of red blood cells, indicating damage to capillaries that is severe enough to allow the escape of red blood cells from plasma. This type of exudates is frequently seen in open wounds. D. Mixed Types a. serosanguineous- consisting of clear and blood-tinged drainage; exudate is commonly seen in surgical incision b. purosanguineous- discharge consisting pus and blood which is often seen in a new wound that is infected 3.1.3 Factors Affecting Wound Healing A. Developmental Considerations Healthy children and adults often heal more quickly than older people, who are more likely to have chronic diseases that hinder healing. For example, reduced liver function can impair the synthesis of blood clotting factors.

Lecture with slideshow presentation

B. Nutrition Wound healing places additional demands on the body. Clients require a diet rich in protein, carbohydrates, lipids, vitamins A and C, and minerals, such as iron, zinc, copper. Malnourished clients may require time to improve their nutritional status before surgery, if this is possible. Obese clients are at increased risk of wound infection and slower healing because adipose tissue usually has a minimal blood supply. C. Lifestyle People who exercise regularly tend to have good circulation and because blood brings oxygen and nourishment to the wound, they are more likely to heal quickly. Smoking reduces the amount of functional hemoglobin in the blood, thus limiting the oxygen-carrying capacity of the blood, and constricts arterioles. D. Medications Anti-inflammatory drugs (e.g., steroids and aspirin) and anti-neoplastic agents interfere with healing. Prolonged use of antibiotics may make a person susceptible to wound infection by resistant organisms. 3.1.4 Wound Care A. Guidelines in cleaning wounds Use solutions such as isotonic saline or tap water to clean or irrigate wounds. If antimicrobial solutions are used, make sure they are well diluted. When possible, warm the solution to body temperature before use. (This prevents lowering the wound temperature, which slows the healing process). If a wound is grossly contaminated by foreign material, bacteria, slough, or necrotic tissue, clean

the wound at every dressing change.(Foreign bodies and devitalized tissue act as a focus for infection and can delay healing). If a wound is clean, has little exudates, and reveals healthy granulation tissue, avoid repeated cleaning. (Unnecessary cleaning can delay wound healing by traumatizing newly produced, delicate tissues, reducing the surface temperature of the wound, and removing exudates which itself may have bactericidal properties). Use gauze squares. Avoid using cotton balls and other products that shed fibers into the wound surface. (The fibers become embedded in granulation tissue and can act as foci for infection. They may also stimulate foreign body reactions, prolonging the inflammatory phase of healing and delaying the healing process). Clean superficial noninfected wounds by irrigating them with normal saline. (The hydraulic pressure of an irrigating stream of fluid dislodges contaminating debris and reduces bacterial colonization). To retain wound moisture, avoid drying a wound after cleaning it. Hold cleaning sponges with forceps or with a sterile gloved hand. Clean from the wound in an outward direction to avoid transferring organisms from the surrounding skin into the wound. Consider not cleaning the wound at all if it appears to be clean.

3.2 Burns and Scalds 3.2.1 Definition Burns results to excessive exposure to thermal, chemical, electric, or radioactive agents A scald is a burn from a hot liquid or vapour, such as steam. 3.2.2 Types and Assessment Findings First-degree burn- damage is limited to the top skin layer called epidermis; the burn cases pain and redness Second-degree burn- the top skin layer and the part of the layer under it called the dermis, are damaged; the person has blisters, pain, and swelling Third-degree burn- damages both the epidermis and the dermis; no blisters appear, but white, red, brown, gray, or black leathery tissue is visible. 3.2.3 First Aid Measures Remove the child from the cause of burning without endangering yourself. Hold the burn under cold water at least 10 minutes. If the burn is minor remove clothing from the affected area. If the burn is more serious, remove clothing only if it is stuck to the burn and you can do so easily and without doing more harm. Do this after cooling with water. Loosen tight clothing and removed any jewellery, because the burnt area may swell. Cover the burn with clingfilm or a clean, non-fluffy cloth (handkerchief, pillow case or linen/cotton tea towel). Or put a clean plastic bag over a foot, hand, arm or leg. Do not apply any lotions, creams or fats. Do not burst blisters or use adhesive dressings.

 Take the child to the neatest Accident and Emergency. Watch for signs of shock. 3.2.4 Tips on Prevention Never leave children alone around open flames, stoves or candles. Keep matches, gasoline, lighters and other flammable materials out of childrens reach. Teach children a plan for escaping your home in a fire and practice it! Install smoke alarms in your home on every level and in every sleeping area, testing them once a month and replacing the batteries at least twice a year. Before bathing children in heated water, always run your open hand through the water to check its temperature or use a tub thermometer. Keep hot foods and liquids away from table and counter edges. Never carry children and hot foods or liquids at the same time. Make sure that pot handles are turned towards the stove when cooking so that a child cannot accidentally grab the handle and spill the contents. Keep things that easily catch fire (such as papers) away from heat sources like stoves, heaters and fireplaces. 3.3 Bruises and Sprains 3.3.1 Definition Bruise are accompanied by bleeding into the damaged area, which can lead to pain, swelling, and bruising Sprain is an injury to a ligament at or near a joint. 3.3.2 First Aid Measures Bruises Raise the injured part. Lift up the affected part

of the body to a comfortable position so that it can rest. This reduces the circulation and minimizes swelling. Apply firm pressure with your hand on a cold compress for as long as 30 minutes to minimize the swelling. You can use a cold pad dampened with cold water or an ice pack.

Sprain Follow the RICE procedure. Rest, steady and support the injured part in the m the most comfortable position for the casualty. Ice pack or cold compress should be applied to cool the area, if the injury has just happened. This will reduce swelling, bruising, and pain. Compress the injury. Apply gentle even pressure to the injured part. Elevate and support the injured limb, to reduce blood flow to the injury and to minimize the bruising. Dipped Take or send the casualty to the hospital or if injury seems very minor, advise the casualty to rest the injured part. 3.4 Nosebleed 3.4.1 Definition and Cause Tiny blood vessels in the membranes that line the nostrils may rupture when treated roughly. This can happen during a sneeze, a bang on the nose, or if the child blows their nose too vigorously. A nosebleed is only dangerous if the child loses a lot of blood or if the blood is thin and watery following a head injury. 3.4.2 First Aid measures Let the child sit down. Ask her to lean forward over a basin to allow the blood to flow freely from her nose. Do not let her lean back, as the blood may tickle down her

throat and cause her to vomit. Pinch the nostrils. Encourage her to breathe through her mouth. Ask her to spit any blood into the basin.. Reassure and encourage her not to sniff, swallow, cough, or even speak. This will allow time for clots to form. Her nostrils needs to be pinched for about 10 minutes. Release the nostrils to see if the nosebleed has stopped. If it has not, her nostrils will have to be pinched for two more periods of about 10 minutes. If the nosebleed lasts for longer than 30 minutes, take her to an emergency department or see a doctor. If the nosebleed has stopped, ask her to remain leaning forward. Clean the blood from around her nose with cotton wool dipped in tepid water. The child now needs to rest for a while. Most importantly, she must avoid doing anything that will disrupt the clotting process.

3.5 Fainting 3.5.1 Definition and Cause Fainting is caused by a brief restriction in blood flow to the brain, which usually corrects itself quickly. Children may faint out of hunger, fear or pain, or if they have to stand without moving for a long time. 3.5.2 First Aid Measures If your child feels faint, lay her down with her legs propped up on cushions and carry out the following: Watch for signs of dizziness, sickness or weakness, very pale face, briefly losing consciousness, and slow pulse. Lie the child down, raise his/her legs and support them. Loosen any clothing that is tight-fitting and provide fresh air. Give calm reassurance. Offer a sugary drink or small snack to raise the sugar

level in her blood. Do not offer food or drink if she is not fully conscious. If she loses consciousness, monitor her condition (ABC). If she is breathing, place her in the recovery position. Call an ambulance if she doesnt regain consciousness within three minutes. 3.6 Hyperventilation 3.6.1 Definition and Cause Hyperventilation is rapid or deep breathing, usually caused by anxiety or panic. This overbreathing, as it is sometimes called, may actually leave you feeling breathless. When you breathe, you inhale oxygen and exhale carbon dioxide. Excessive breathing may lead to low levels of carbon dioxide in your blood, which causes many of the symptoms that you may feel if you hyperventilate. 3.6.2Signs and Symptoms Your heart pounds. It feels like you can't get enough air. You feel tingling and numbness in the arms, legs, and around the mouth. You feel a sense of doom. You may pass out. 3.6.3First aid measures Have the hyperventilating person breathe slowly into a paper bag that's held closely around his or her mouth and nose. The person should breathe like this for five to seven minutes. Talk to the individual the entire time. Try to distract him or her and make the person feel comfortable and safe. If symptoms fail to improve or the person loses consciousness, take him or her to the emergency room. 3.7 Animal Bites

3.7.1 Insect Bites Bee, wasp, and hornet stings usually are painful rather rather than dangerous. An initial sharp pain is followed by a mild swelling and soreness, which first aid can relieve. Some people are allergic to stings and can rapidly develop the serious condition of anaphylaptic shock. Stings in the mouth or throat are serious, as the swelling can cause airway obstruction. Foreign protein in insects saliva introduced when skin is penetrated for a blood-sucking meal. Fleas, mosquitoes, ants, bees, and other insects are found everywhere. Manifested by firm papules capped by vesicles or excoriated and popular urticaria for hypersensitivity reaction. There is little or no reaction in nonsensitize people. A. First Aid Measure First aid measure: Use antipruritic agents and baths; Administer antihistamines and prevent secondary infection Rinse the area under cool running water or put a cold compress on it for a few minutes to reduce pain and swelling. If the sting is inside the mouth give an ice-cold drink to sip or ice cubes to suck. If the swelling gets worse or the child's breathing is affected, call an ambulance and monitor the child's airway, breathing, and circulation (the ABC of resuscitation) until the ambulance arrives. 3.7.2 Dogs and Rodents A. First Aid Measure Superficial Bites- Bites that puncture only the skin can be safely treated at home. Wash the wound thoroughly with warm, soapy water.

Wash away any dirt by rinsing the wound under running water for several minutes. Gently pat the wound dry with a clean tissue then cover it with plaster or sterile dressing until it has healed. Deep Bites- Bites that penetrate deep into the tissues beneath the skin needs medical expert. Put a clean pad over the wound and press down on it to control the bleeding. Raise the injured part of the body above the level of the heart to reduce blood flow to the wound. Cover the bite. Use either a clean pad or a sterile dressing. Bandage it firmly. Take the child to the accident and emergency department or to the doctor. 3.8 Seizures (Convulsions) 3.8.1 Definition and Cause A convulsion, or fit, consists of involuntary contractions of many of the muscles in the body, cause by a disturbance in the function of the brain. Convulsions usually result in loss of, or impaired, consciousness. 3.8.2 Types Minor Epilepsy short of major epilepsy which cause only a brief blurring of consciousness like daydreaming. On recovery, the casualty may simply have lost the thread of what he or she was doing. Major Epilepsy this condition is characterized by recurrent, major disturbance, of brain activity, resulting in violent seizures and severe impairment of consciousness. Epileptic fits can be sudden and dramatic, but the casualty may have a brief warning period for example a strange feeling or a special smell or taste.

3.8.3.Signs and Symptoms Minor Epilepsy sudden switching off; like the casualty may be staring blankly ahead. slight or localised twitching or jerking of the lips, eyelids, head or limbs. Odd automatic movements, such as lipsmacking, chewing or making noises. Major Epilepsy the casualty suddenly falls unconscious, often letting out a cry. Breathing may cease. The lips may show greyblue tinge (cyanosis) and the face and neck may become congested. Convulsive movement begin. The jaw may be clenched and breathing may be noisy. Saliva may appear at the mouth, blood stained if lips or tongue have been bitten. There may be loss of bladder or bowel control. 3.8.4First Aid Measures Minor Epilepsy Help the casualty to sit down in a quiet place. Remove any possible sources of harm, for example hot drinks or sharp objects, from the immediate vicinity. Talk to her calmly and reassuringly. Do not pester her with questions. Stay with her until you are sure she is herself again. If the casualty does not recognize and know about her condition, advise her to consult her own doctor as soon as possible. Major Epilepsy If you see the casualty falling, try to support him or ease his fall. Make space around him and ask bystanders to move away.

 Loosen clothing around his neck and, if possible, protect his head. When the convulsions cease, place him in the recovery position. Check breathing and pulse, be prepared to resuscitate if necessary. Stay with him until he is fully recovered. 3.9 Poisoning 3.9.1 Definition Poisoning is often accidental, but can also deliberate (for example in cases of attempted suicide). It can occur as a result of accidents, or be caused by eating contaminated food or poisonous plants. Drugs and alcohol can also poison the body. 3.9.2 First Aid Measures Open an unconscious casualtys airway and monitor airway, breathing and circulation. Swallowed Poison do not attempt to induce vomiting, as this may harm the casualty further. Inhaled Poison remove the casualty from danger and placed into fresh air. Do not endanger yourself. Absorbed Poison flush away any residual chemical on the skin. Obtain appropriate medical assistance. 3.9.3 Tips on Prevention Keep toxic chemicals out of childrens reach and sight (not under the sink). Keep medicines in a locked cupboard. Leave poisonous household substances in their original containers. Never store them in old soft drinks bottles; children are commonly misled by such container and try to drink the contents. Buy medicines and household substances in childresistant containers. Dispose appropriately of unwanted medicines.

4.0 Fractures 4.1 Definition Fracture is a break in the rigid structure and continuity of a bone; and is known as the most common type of bone lesion 4.2 Common Types 4.2.1 Closed a closed fracture has intact skin over the site of injury There will often be bruising and swelling around the fracture site. 4.2.2 Open When the underlying skin is broken. The bone is therefore exposed through the tissues to contamination bacteria from the skin surface and the air. 4.3 Signs and Symptoms Indications of a fracture are deformity, tenderness, swelling, pain, inability to move the injured part, protruding bone, bleeding, or discoloured skin at the injury site. A sharp pain when the individual attempts to move the part is also a sign of a fracture. 4.4 First Aid Measures Closed Fracture Tell the casualty to keep still and steady and support the injured part with your hands until it is immobilised For firmer support, secure the injured part to a sound part of the body. For upper limb fractures: always support the arm against the trunk with a sling. For lower limb fractures: if removal to hospital will be delayed, bandage the sound leg to the injured one. Call for an ambulance. Treat the casualty for shock, if necessary. If possible, raise the injured limb.

 Check the circulation beyond any bandages every 10 minutes and loosen if necessary. Open Fracture Cover the wound with a clean pad or sterile dressing and apply pressure to control the bleeding. Without touching an open wound with your fingers, carefully place some clean padding over and around the dressing. If bone is protruding, build up pads of soft, non-fluffy material around the bone until you can bandage over the pads. Secure the dressing and padding: bandage firmly, but not so tightly that the circulation is impeded. Immobilize the injured part as for a closed fracture. Treat the casualty for shock. Check the circulation beyond the bandage every 10 minutes. 4.1 Drowning 4.1.1 Definition Drowning is the process of experiencing respiratory impairment from submersion/immersion in liquid. When a person is drowning, the air passages close to prevent water from entering the lungs, thus depriving the victim of oxygen and eventually leading to unconsciousness and death. Usually, only if the victim has been unconscious in the water for some time do the lungs fill up with water. More commonly, the water goes into the stomach. 4.1.2 First aid measures 30 Drowning causes asphyxia by water getting into mins the lungs. To help a drowning child you must be safe. Drowning can also cause hypothermia.

Carry the child out of the water with the head lower than the chest. Get another adult to call an ambulance.

Evaluate the progress of the health problem.

Don't bother trying to get water out of the lungs . the child will cough it out as she starts to breathe. If the child is conscious:

Wrap her in dry clothes coats or towels and get her into clothes. Take her to the hospital. She might have inhaled some water, which may damage her lungs. If the child is unconscious: Call an ambulance. Assess her airway, breathing and circulation. Evaluation Open Forum

IV.

References: Bale, S. & Jones, V. (1197). Wound Care Nursing. London: Balliere Tindall. First Aid and CPR. 3rd ed. Sudbury Massachusetts: Jones and Barlett Pub. First aid manual. (1997). London: Dorling Kinderseley Limited. Hockenberry, M. & D. Wilson. (2007). Wong's nursing care of infant's and children. (8th ed.). Singapore: Elsiever Pte. Limited. Kozier, B. (2004). Fundamentals of nursing: Concepts, process and practice. Phil.: Pearson. Middlemiss, P. (1998). The Hamlyn encyclopedia of child health. London: Reedd Consumers Books. Thott, A.T. (1997) Wounds and lacerations. 2nd ed. St. Louis: Mosby Co. West, R. (2003). Family guide to children's ailments. London: Quantum Publishing Limited. Wound care. Lippincott Williams and Wilkins: Wolters Kluwer Co. First aid: aims. (June 8, 2011). http://en.wikipedia.org/wiki/First_aid