How to Handle Medical Emergencies
In any emergency, if medical professionals are overwhelmed with calls, you might have no choice but to administer basic first aid to kids who need it. Initially, for any unconscious kids, remember the ABCs of Basic Life Support: Airway, Breathing, and Circulation. First, help a victim breathe by carefully lifting her chin and tilting her head back, unless you suspect a neck injury. Second, put your ear by her nose to listen for breathing. Third, put your ear to her chest or hold her wrist to check for a heartbeat or pulse, indicating normal blood circulation.
Don't move an injured or unconscious student's head if you suspect she has suffered neck trauma. If your suspicions are correct and you move her head anyway, you might be responsible for greater injury than she has already suffered, including paralysis. Unless you believe there's no choice, let trained medical professionals treat her.
Take the following steps for anyone over the age of one year old:
Assess that it is safe to approach the fallen person.
Attempt to wake the person by rubbing your knuckles firmly against the sternum (breastbone) and shouting, “Are you okay?”
If the person fails to rouse, immediately call 911 or shout for help, depending on your situation. If there is an AED available, also shout for someone to bring it.
If the person becomes conscious, is moaning, or moves, do not start CPR.
Call 911 if the person is not able to speak or appears confused. If the person does not wake, begin CPR and use an AED, if available.
If a student isn't breathing, you may have to administer emergency CPR or cardio-pulmonary resuscitation. The steps for performing CPR are:
Open the airway using the head-tilt, chin-lift method — one hand on the forehead, fingers of the other hand under the bony part of the lower jaw, near the chin. Tilt the head back, gently lift the jaw, making sure not to close the mouth or push on soft parts beneath the chin. Avoid lifting the neck in the case of spinal injury.
Check for normal breathing by putting your ear to the person's mouth and turning your head to look for chest movement while listening for air flowing through the mouth or nose and trying to detect breath on your cheek. A person with periodic gasping is most likely in cardiac arrest and needs CPR.
If there are no signs of breathing, pinch the nose; make a seal over the mouth with your mouth and give the person a breath strong enough for you to see the chest rise. When the chest falls, repeat the rescue breath once more for a total of two breaths. If available, use a CPR mask as a barrier between your mouth and the person's mouth that you are rescuing. The above three steps are called rescue breathing.
Begin chest compressions by placing the heel of your hand in the middle of the chest, over the lower half of the breastbone at the nipple line. Place your other hand on top and lace your fingers together (heel of one hand on chest; heel of the other hand on top of that hand) and compress the chest about 1″–2″. Allow the chest to recoil completely and then perform thirty compressions, a rate of 100 compressions per minute.
After thirty chest compressions, immediately repeat the two rescue breaths. Open the airway with head-tilt, chin-lift again. This time, go directly to rescue breaths without checking for breathing again. Give one breath, making sure the chest rises and falls, then give another.
Perform the cycle of thirty compressions followed by two breaths for about two minutes. Then stop and recheck for breathing. If the person is not breathing, continue chest compressions and rescue breaths.
Continue this cycle until he's revived or medical professionals arrive.
If a kid is bleeding profusely, wear rubber gloves, then get a wad of gauze from your medical kit and press it firmly to the wound until the bleeding stops. If the pad becomes blood soaked, press another pad on top of it and continue stanching the bleeding. When the bleeding stops, wrap a bandage around the wound, but not so tightly that it impedes circulation. Finally, await the assistance of medical professionals. For more in-depth information on first-aid procedures, read The Everything® First Aid Book.
AED is a small electronic device used to deliver an electric shock in an attempt to disrupt or stop abnormal electrical activity in the heart. The AED will automatically diagnose any cardiac arrhythmia when attached to an unconscious person. When you see one of these lethal rhythms, you can then treat the person with the AED electrical therapy or a shock (defibrillation) to re-establish a normal and effective rhythm. You can learn how to use an AED in many first-aid and CPR classes.
When monitoring special events or lunch periods you may also encounter a choking emergency. Choking occurs when an object gets stuck in the throat and partly or completely blocks the airway. Signs of choking include:
Pointing to throat, hands crossed on throat (universal sign of choking)
Gasping or coughing
Signs of panic
Red face that steadily turns blue
Loss of consciousness
When you suspect a student is choking, ask her, “Are you choking?” If the student is able to answer you, don't do anything because it's likely she will free the food or object on her own. In the case of actual choking, the person will not be able to talk and you need to help them. Call 911 if the person can't talk, make noise, or breathe well or is unconscious, then perform the Heimlich maneuver as outlined below. If the person is unconscious, lay her on her back, check her mouth for any visible obstruction, and try to dislodge it using a finger sweep. If you are unable to do so, begin mouth-to-mouth resuscitation and CPR. Continue to check inside her mouth for any signs of the foreign body as the chest compressions of CPR may dislodge it.
Never slap any person on the back you think might be choking. A baby who is crying, has a strong cough, and appears to be breathing well should be placed in a sitting position and allowed to finish coughing. Never stick your fingers down a baby's or anyone else's throat in an attempt to remove an object while they are coughing, as you run the risk of pushing the object further into the airway.
The Heimlich maneuver (pronounced “Hi-mlick”) is a technique whereby you administer abdominal thrusts to yourself or another person who is choking. The Heimlich maneuver is recommended for use in clearing a blocked airway in conscious adults and children over the age of one. The act of abdominal thrust lifts the diaphragm and forces air from the lungs, similar to a coughing action, so that the foreign body in an airway may be moved and expelled.
The steps to perform the Heimlich maneuver on a choking person are:
Stand behind the person, wrap your arms around the waist, and tip the person slightly forward.
Make a fist with one hand and place it slightly above the navel.
Grasp your fist with your other hand and press forcefully into the abdomen with quick, upward thrusts, using force as if you were attempting to lift the person up.
Continue the thrusts until the foreign body is dislodged.