CPR and Choking Emergencies

     My first scenario describes a choking emergency. Two teachers and children are sitting at a table having snack time when one of the three year olds girl begins to choke on a piece of food. The individuals involved in the emergency consist of the child choking, the teachers and other children at the table. This emergency is occurring during snack time at a head start program for children aged three and four. The first step in the situation is to remain calm, one teacher rushes to attend to the choking child while the other teacher goes to call 9-11. The teacher attending to the three year old girl who is choking first asses her airway and ability to breathe, since the child is coughing the airway is not fully blocked and oxygen is able to being exchanged so the teacher encourages the girl to continue to try and cough. The teacher evaluates the child for any more signs of distress and then administer the Heimlich Maneuver, which consists of five back blows followed by five abdominal thrust, alternating until the airway is cleared. While one teacher is attending to the choking child, the other teacher is providing support and making sure to keep the other children calm during the emergency. The parent/guardian is to be notified of the emergency, if the child's airway is not able to be cleared and must be taken to emergency room for shock then call and direct parents to meet child at hospital. Do not leave the child and make sure you have the child's permission slip to be able to accompany them in an emergency situation. An incident report should always be completed along with the ABC of safety following any emergency to evaluate the cause of the incident and prevent it from occurring again.

            My second scenario is a six month old infant is found unconscious in his crib after nap time and is not responding to attempts to wake him up. This situation is occurring in a private at home care facility. The first proper step for dealing with this emergency is to call 9-11. Next would be to assess the babies condition by a gentle flick on the babies foot or tap on his shoulder while saying his name to see if any signs of consciousness are provoked. Next the baby must be evaluated for any signs of bleeding. If any signs of bleeding are present CPR cannot be preformed until the bleeding is controlled.

            If no signs of bleeding are present the next step is to check for signs of breathing. Signs of breathing can be evaluated by placing your head down by his mouth looking towards his feet to see if there are any signs that the babies chest is moving, or breathing sounds are occurring. If no signs of breathing are present then two gentle rescue breaths are to be administered to try and open the airway and start the babies breathing again. The proper way to give rescue breathes is by covering the baby's nose and mouth with your mouth and gently exhale into his lungs for just a second until you see his chest rise, pause between breaths to allow for exhale. If you did not observe the babies chest rise then his airway is blocked and must be cleared through choking techniques.

            If the airway is not blocked and the baby is still unconscious after the two rescue breaths then chest compressions must be administered. While the baby remains on his back on a hard surface, use two/three fingers in center of chest, and push straight down about one and half inches. Repeat this for a smooth thirty compressions at rate of one hundred per minute. Once you have complete thirty compressions, give two rescue breathes and repeat compressions . Continue to repeat the pattern of chest compressions and rescue breaths until emergency responders arrive, or the baby becomes conscious.

            Emergencies can quickly arise, making it vital that childcare professionals are adequately educated and prepared on the proper ways to respond if an emergency situation arises. Situations where breathing, bleeding and poisoning are involved always constitutes a serious emergency. “To lessen risk as an emergency occurs, teachers should be prepared with proper planning, organizing, and responses based on knowledge and training” (Robertson, 2013). In the instance that an emergency does arise it is important that childcare providers are trained and first aid kits are prepared. Childcare professionals should regularly check inventory of medical/emergency supplies as well as batteries on fire detectors and AED. All staff members must be trained as well as regularly tested regarding CPR and First Aid. Childcare facilities should regularly make sure that all emergency contact information is up to date and easily accessible if needed. When caregivers are prepared for emergency situations they are more likely to be prevented or  resulting in life threatening injury. Having regularly scheduled drills helps ensure that everyone is prepared to handle an emergency situation if it does arise.

            I think creating a child safety team leader is a way adults can help ensure they are prepared to handle emergency situations. Childcare facilities should assign specific duties that each professional so they know exactly what area they are in charge of incase of an emergency. For instance one caregiver could be in charge of all the emergency contact information of the children, she is responsible for making sure it is kept up to date, and accessible during an emergency. While another professional maybe in charge of supplies, making sure nothing is expired and all items are stocked.

References:

Robertson, C. (2013). Safety, nutrition, and health in early education (5th ed.). Belmont, CA:

            Wadsworth/Cengage Learning