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How To Use a Car Seat Harness Correctly

It’s Child Passenger Safety Awareness Week and I have decided to talk a little about the car seat harness. The car seat harness holds a child down in the car seat so they cannot slide up, forward and out the car seat in the event of a crash.

There are two different types of harnesses; the 5-point and 3-point harness. What this really means is that the harness comes into contact with your child in 5 or 3 points. The 5-point harness has straps over both shouldres, both hips and one between the legs whereas the 3-point harness only has straps over the shoulders and one between the legs. Not only is a 5-point harness more secure but it also allows the forces from an accident to be distributed more evenly across the body.

Using the harness incorrectly is one of the most common mistakes parents make. In this short post I have outlined 3 really simple steps to take to correctly position your child in a car seat. Please remember to always check the manufacturer’s instructions first before using your car seat.

  1. Place your child all the way back in the car seat

Your child must sit snugly in the car seat with the bum and back firmly against the backrest.

  1. Correctly position the shoulder straps

Rear-facing car seats: the shoulder straps should be at or just below shoulder level (+- 2.5 cm)

Forward-facing car seats: the shoulder straps should be at or just above the shoulder level (+- 2.5 cm)

Image: Diono.com

  1. Tighten harness straps snugly

The straps should be tight enough so there is no excess webbing (check this using the pinch test).

Image: Diono.com

The harness should also not be too tight that it pinches your child’s skin or forces them into an unnatural position.

HARNESS RETAINER CLIPS

Image: safekids.org

Car seats made in Europe, Australia and South Africa do not come with harness retainer clips. You will most likely only see these clips if you are in the United States or Canada. These clips are not for added safety and are not designed to keep your child in their car seat in the event of a crash. In fact they are more likely to open up from the impact and slide down the straps. These clips are positioning devices and used to keep the shoulder straps in position pre-crash.

South Africa adheres to European car seat safety standards so you will not find car seats in this country with retainer clips. European regulation requires all car seat harnesses to be released in one motion and therefore a chest clip is simply not allowed. European car seats use other methods to keep the harness in place.

There are many other gadgets and devices available to use together with your harness to provide added comfort or extra protection. These are generally not safe since most of them are not crash tested and therefore can cause serious harm in the event of a motor vehicle accident.

RESOURCES

https://cpsboard.org/cps/wp-content/uploads/2014/01/Technician-Guide_March2014_Module-8.pdf

https://csftl.org/chest-clip-myths-busted/

 

 

Common First Aid Myths

 

I am often surprised by how some of my patients manage their injuries before they come to the emergency room. I think my own mother is also guilty of practising some really strange methods whilst I was growing up. Over the years, medical advice and management has evolved. What may have made sense years ago is now out of date and has been replaced with more sound research and often logic. Here are just a few of the first aid practices and myths that I have seen over the years.

1. BUTTER ON A BURN

The idea behind this myth is not entirely wrong. Butter can help alleviate the initial pain caused by a burn because of its direct cooling effect. This however does not last long because butter, or any greasy substance for that matter, will actually slow down the release of heat from the skin. This means that the trapped heat can continue to burn the skin. Rather run the affected area under cool running tap water for up to 20 minutes immediately after the burn.

2. LEAN YOUR HEAD BACK DURING A NOSEBLEED

This one I see all the time and it is very wrong. If you lean your head back during a nosebleed you will inevitably swallow blood. This blood can irritate the stomach and cause nausea and vomiting. It can also even cause you to choke. Rather pinch the nose closed and lean your head forward.

3. PUT SOMETHING IN SOMEONE’S MOUTH WHEN THEY ARE HAVING A SEIZURE

This is often done to try and prevent someone from biting his or her tongue during a seizure. Tongue biting does happen often, but it very rarely causes any airway obstruction. You are more likely to cause an airway obstruction from whatever you have put in the mouth.

Seizures can look really scary but it’s better to move that person to a flat surface and clear the area around them so that they cannot injure themselves, while waiting for the seizure to end.

4. RUBBING ALCOHOL FOR A FEVER

 Many parents try reduce their little one’s fevers by rubbing alcohol directly on the skin or adding it to a sponge bath. As alcohol evaporates it can significantly cool the skin and potentially help reduce a fever. The problem with this is that rubbing alcohol (isopropyl alcohol) is also quickly absorbed into the skin and the fumes inhaled, which can lead to alcohol poisoning.

5. STAY AWAKE AFTER A BUMP TO THE HEAD

Parents often ask me if their little one is allowed to sleep after taking a knock to the head. It is no longer recommended to keep someone awake after a head injury. The concern was always that if someone with a concussion went to sleep they would not wake up.

If there are no red flags then it is perfectly acceptable to allow your child to sleep. Sleep is actually really important for the brain to heal. You can read more about head injuries here https://www.oneaid.co.za/a-bump-to-the-head-when-should-you-worry/

6. LIFT YOUR ARMS ABOVE YOUR HEAD WHEN YOU ARE COUGHING OR CHOKING

Someone who has a partial airway obstruction will still be able to cough. You should do nothing else but encourage coughing. When I was a child, my mother used to make me lift my arms up above my head. This can actually be dangerous because when you lift your arms, this movement causes the neck to move as well. The object causing the irritation may then slip further down into the airway and cause a complete obstruction.

7. MAKE SOMEONE VOMIT IF THEY HAVE SWALLOWED A POTENTIAL POISON

Do not make your child or anyone vomit by giving Ipecac syrup or even sticking your finger in their throats. This can be very harmful, especially if the poison swallowed is burning or corrosive.

The substance may get breathed into the lungs when vomited up and cause serious damage. The substance may also cause more damage to the lining of the oesophagus when vomited. The best thing to do is to call an ambulance or head straight to your nearest emergency room.

8. IF SOMEONE FEELS FAINT, MAKE THEM SIT WITH THEIR HEAD BETWEEN THEIR KNEES

If you do this and the person bent over does faint, they can fall out of the chair and get injured. Fainting is usually caused by decreased blood to the brain. If you are seated and put your head between your legs you will only slightly increase blood flow to the brain. It is far better to make that person lie down flat on their back and raise their legs. If the person has already fainted you should also lay them on their back and raise their legs.

9. APPLY HEAT TO A SPRAIN, STRAIN OR FRACTURE

Cold is commonly used for acute injuries and heat for more chronic conditions. Heat causes blood vessels to dilate, which increases blood flow, swelling and ultimately pain and cold has the opposite effect. After a sprain, strain or fracture it is better to apply ice to help with the swelling and pain.

Heat is very good for muscle spasms and other inflammatory conditions such as arthritis. Heat reduces muscle tension and causes muscles to relax. The increase in blood flow caused by the heat also helps remove pain-causing inflammatory cells and bring in healing cells.

10. PUT RAW STEAK ON A BLACK EYE

We can probably thank the Looney Tunes for this one! The only benefit you will get from this myth is the effects of the cold. Meat is often full of bacteria so whilst a big piece of raw steak will help with the swelling, it may cause an eye infection in the process. It is much better to apply an ice pack or even a frozen bag of peas.

There are many other myths. Do you have any others you would like to share with me? Can you remember any first aid tips or tricks that your Mother and even your Grandmother used to practice?

Essential Fire Safety Equipment You Need In Your Home

How many of you have smoke detectors installed in your homes? Do you also own a fire extinguisher and if so is it the correct one? In this blog post I want to go into a little more detail on these products and why they are so important to have in your home.

SMOKE AND CARBON MONOXIDE DETECTORS

A smoke detector alarm detects the presence of smoke and possible fire in your home whereas a carbon monoxide (CO) detector alarm alerts you when the levels of CO in your home are dangerously high. Smoke detectors are a must for all homes. You only need a carbon monoxide detector if you use fuel-burning appliances such as gas stovetops, heaters and geysers. CO detectors are also important if your home has a fireplace.

These detectors need to be installed where you can hear them, especially while you are sleeping. It would be pretty pointless to put one in the garage if your bedroom is on the top floor. It is recommended that you have a smoke and carbon monoxide detector either inside or just outside of every bedroom. You also need to make sure there is one on each floor of your house.

Carbon monoxide detectors should also be installed near fuel-burning appliances, just outside the garage and in rooms with wood burning fireplaces. Carbon monoxide is a silent killer. You cannot see or smell the gas and in the early stages CO poisoning will feel more like the flu. You can read more about carbon monoxide and how it affects the body in my previous blog post: https://www.oneaid.co.za/gas-or-wood-how-to-safely-keep-warm-this-winter/

Most of these alarms run on batteries so they need to be tested regularly, at least every month. The batteries should also be replaced once a year.

FIRE EXTINGUISHERS

There are at least four different types of fires that can happen in your home and water is definitely not the safest way to extinguish all of them.

Common causes of house fires:

1.     Class A

These fires involve combustible materials such as wood, textiles, straw, paper etc. These are materials that can combust, i.e. burn in air.

2.     Class B

These fires are caused by the burning of liquids or materials that liquify, such as petrol, paint, alcohol and paraffin.

3. Class F

These fires involve cooking oils and fats in the kitchen.

4.   Electrical appliances (formerly type E)

These are fires caused by electrical appliances

What fire extinguisher do you need?

There are five main types of fire extinguishers; water, foam, dry powder, CO2  and wet chemical. The different types of extinguishers are used to put out different classes of fires. There is not one extinguisher type that works on all classes of fire.

  1. Water fire extinguisher

These extinguishers are used to put out class A fires. The water has a cooling effect, which causes the fire to burn more slowly until all the flames have been extinguished. These extinguishers should not be used on or near electrical appliances.

These are not recommended for class F fires. If you had to use this extinguisher on such a fire in your kitchen, there would be an explosion of steam much larger than the one you see when rinsing a hot pan under water. This explosion would throw hot oils all over your kitchen, which could cause a new fire and most definitely result in thermal burns to your skin and eyes.

2.Foam fire extinguisher

Foam extinguishers are useful against both class A and B fires. Similar to water extinguishers, foam extinguishers have a cooling effect. These should also not be used on or near electrical appliances.

3. Dry powder fire extinguisher

These extinguishers can be used on class A, B, C and electrical fires. They work by forming a barrier on top of the fire so that the burning fuel has no more access to the oxygen it needs to burn.

These extinguishers should not be used in enclosed spaces as the powder that is dispersed can be inhaled. Therefore they are not recommended for home use.

4. CO2 fire extinguisher

CO2 extinguishers are used on class B and electrical fires because CO2 does not conduct electricity. These extinguishers work similar to the dry powder ones whereby they suffocate the fire by removing the oxygen from its surface.

5. Wet chemical extinguisher

These are the extinguishers you would use on a class F fire. They can also be used on class A fires. They work by creating a layer of cooling foam on top of the burning oil or fat and therefore also cut off the oxygen supply.

Before going out to buy a fire extinguisher you need to identify the different fire risks you have in your home, because this will determine which type of extinguishers you need and where you need to keep them. It is probably best to have an expert come and inspect your home and assess your individual needs. They can also guide you on where to install smoke and carbon monoxide detectors.

If you do have a fire extinguisher in your home make sure you know how it works. Read the manual or have someone show you, because in an emergency you really don’t want to be figuring out how the safety pins work.

RESOURCES

https://www.cityfire.co.uk/wp-content/uploads/2018/11/fire-extinguisher-types.pdf

https://www.cpsc.gov/s3fs-public/SmokeAlarmWhyWhereandWhichCPSCPub559RevisedJuly2016PostReview.pdf

https://surreyfire.co.uk/types-of-fire-extinguisher/

Gas or Wood? How To Safely Keep Warm This Winter.

We are now well into winter and definitely feeling the chill! South African homes are not well equipped to withstand the cold and we have to resort to various heating appliances to stay warm during winter. This is why structural fires and carbon monoxide poisoning are so common during the winter months. Below, I outline some safety tips on keeping warm in the home.

WHEN USING A GAS HEATER

  1. Always make sure the gas heater and especially the cylinder is completely turned off before going to bed or leaving the house.

  2. Always keep the room well ventilated to avoid carbon monoxide (CO) build up.

  3. Do not use outdoor gas heaters indoors, as they may produce more CO.

  4. Make sure all components of the heater are well maintained. Ensure the gas bottle is safely secured with no leaks.

  5. Natural gas is odourless. In order to identify leaks more easily manufacturers add chemicals to give it that distinctive rotten eggs smell.  If you smell gas in your home turn off the gas cylinder and do not use an electric fan to try and remove the gas.

  6. When switching your gas heater on always start by first turning on a match or lighter and then opening the gas supply. When switching the heater off always turn the gas cylinder off first.

  7. Never move a gas heater whilst in use.

  8. Do not place anything on or over the heater, such as damp laundry items. This can result in a fire. Do not ever sit on a gas heater either as it could fall over.

  9. Do not use flammable liquids and/or aerosols near a gas heater. Do not use a gas heater in a room that has recently been painted.

  10. Make sure to keep all flammable items a safe one-metre away.

  11. Have smoke and CO detectors installed and test them regularly.

  12. Always keep a fire extinguisher in your home.

 

WHEN USING A FIREPLACE 

  1. Keep a window slightly open.  This will help prevent the room filling up with smelly smoke. It also prevents the build up of carbon monoxide (CO).

  2. Make sure the damper of your chimney is open so that the smoke can leave the house. Only close the damper once the fire is completely extinguished.

  3. Use dry wood and not wet or green wood. Wet and green wood cause more smoke.

  4. Clean out any ash from the previous fire. Thick layers of ash restrict the air supply to the fire and cause more smoke. 

  5. Use smaller pieces of wood because these create less smoke.

  6. Remember to have your chimney cleaned once a year before the winter season. Animal nests and excess soot can block the escape of smoke.

  7. Never leave a fire in the fireplace unattended. Always make sure it is completely extinguished before going to bed and/or leaving the house.

  8. Make sure the area around the fireplace is clear of potentially flammable items such as books, curtains and furniture. Keep a safe one-metre distance.

  9. Keep fireplace tools and accessories such as firelighters, matches and lighters out of a child’s reach.

  10. Use safety screens so your children can’t get burnt by hot flying embers or by touching the hot glass of a closed fireplace.

  11. Have smoke and CO detectors installed in your house and test them regularly.

  12. Always keep a fire extinguisher in your home!

CARBON MONOXIDE POISONING

It may seem counter-productive to keep a window open when you are trying to keep your home warm, but this is extremely important if you are burning a fuel, such as gas, paraffin, coal or wood to generate heat.

Carbon monoxide (CO) is a colourless and odourless gas produced by the incomplete combustion of these carbon-containing fuels. When there is too much CO in the air your body replaces the oxygen attached to red blood cells in the blood, with carbon monoxide. This is because the affinity between haemaglobin (Hb) (in the red blood cells) and carbon monoxide is much stronger than the affinity between Hb and oxygen. This can be extremely dangerous and lead to hypoxia, irreversible brain damage and eventually death.

Symptoms of carbon monoxide poisoning include:

  • Tiredness
  • Shortness of breath
  • Headache
  • Dizziness
  • Nausea or vomiting
  • Weakness
  • Confusion
  • Loss of consciousness

If carbon monoxide poisoning is suspected you need to move the victim into fresh air, either by opening all the doors and windows or getting the person outside. This will allow some oxygen to start displacing the carbon monoxide. Definitive management is however in hospital with high flow 100% oxygen so you need to call an ambulance right away.

ELECTRIC HEATERS

Some of you may have electric heaters in your homes. These are safer than using gas and fire but still not 100% safe. Electric heaters use a lot of electricity so they can easily overload circuits and cause power failures or fires.

You should never plug in more than one electrical device into the same outlet as the heater to prevent overheating and overloading. To prevent electric shocks electric heaters should not be used in rooms where moisture builds up such as bathrooms and kitchens. There is also a fire risk if flammable items such as fabric come into contact with electric heaters that have hot elements and the electric bar heaters pose an additional burn risk.

Whatever heating methods you use this winter none of them are guaranteed safe, so remember to take the necessary precautions. It is important that you teach your children about fire safety from a young age. If your little ones do get thermal burns from poking fires and other heating elements follow the principles of first aid.

To find out more about management of thermal burns you can read my previous post: https://www.oneaid.co.za/baking-with-your-little-ones-safety-and-tips-to-taking-care-of-thermal-burns/. It is also recommended that you develop a fire escape plan and make sure your children know how to safely get out of the house in the event of a fire.

RESOURCES

https://www.betterhealth.vic.gov.au/health/healthyliving/gas-heating-health-and-safety-issues

https://www.healthychildren.org/English/safety-prevention/all-around/Pages/Fire-Safety.aspx

https://www.nhs.uk/conditions/carbon-monoxide-poisoning/ https://riseandshine.childrensnational.org/how-to-protect-children-around-fireplaces/

Keeping Your Children Safe During Bath time

I’m sure many of you will agree that bath time is loads of fun for our kids. Whilst the bathroom is a fun place, it can also be a scary place with a number of dangerous hazards such as the drowning, burns and poisoning.

It’s important that you are always in the bathroom with your children before, during and after bath time. Drowning is a major cause of death in children under five years. According to the Consumer Products Safety Commision in the United States, 80% of the 87 children, under five years who drown at home each year, have drowned in the bathtub. Young children are top heavy and can slip suddenly and drown in very little water. Infants and toddlers also don’t have the upper body and core strength to lift themselves up if that slip under the water.

HOW TO RUN A BATH

  • Keep your child away from the bath until the water is the right temperature.
  • The safe temperature of bath water should be between 37oC and 38oC (36OC for a newborn). Children have thinner skin than adults so they can burn much more quickly. Even if the bath feels warm to you it may be hot to your little one. Your plumber can also set the thermostat of your geyser to a maximum of 50oC.
  • Always fill your bath with cold water first. Your child could put his hand or foot in the water before the bath is ready and get burnt. If you have a mixer tap, run hot and cold together but start with the cold and slowly increase the amount of hot.
  • Run cold water through the tap before your child gets into the bath to cool the tap and prevent them from getting burnt if they touch it.
  • If you have a mixer tap, point the lever on the cold setting when you are finished running the bath to ensure the hot water does not get accidentally turned on in the bath.
  • Do not overfill the bath. Fill the bath water to just over your little one’s knees.

HOW TO HAVE A S-A-F-E BATH

S: Supervision is key! Always supervise babies, toddlers and children less than six years in the bath and when you run the water. Never leave an older child to supervise.
A: Arrange everything you will need for bath time in advance for e.g. towel, soap, shampoo, nappy, clean clothes and any medications.
F: Feel the water with your elbow first. It should feel warm but not hot. You can also use a water thermometer. Remember to swirl the water around to ensure an even temperature with no hot pockets.
E: Empty the bath as soon as bath time is over.

SLIPS, TRIPS & FALLS

Slips, trips and falls in the bathtub and shower are a common cause of injury in young children and according to statistics more common than tub drownings.

Use a non-slip mat in the bath. If you are using a bath seat or ring, your child will still need to be supervised. A bath seat is not a safety device. These seats are actually associated with an increasing number of reported drownings. This is because the device gives parents a false sense of security and they are therefore more likely to leave their baby alone in the bath.

Infants should be bathed in the bathroom basin or a smaller infant bathtub. This way they can’t roll over or ever be completely covered by the water.

Wipe up any splashes before your kids get out the bath so that nobody, including you, can slip and hit their head. As your kids get older you should also teach them to remain seated in the bath and not to stand up and jump.

Be sure to keep a MiniKit in your bathroom for peace of mind. Each kit contains a range of thoughtfully selected first aid items geared towards common childhood injuries. You can purchase one here: https://www.oneaid.co.za/product/minikit/

WHEN CAN YOU STOP SUPERVISING YOUR CHILD IN THE BATH?

This is a difficult question to answer as children mature at different ages. Since most children who drown in bathtubs are under the age of five, the general consensus is children under the age of six should never be allowed to bath alone and even those over six should be closely monitored. Even if your child knows how to swim you should never be too far away.

OTHER BATHROOM HAZARDS

Toilet: luckily my daughter has never been interested in exploring the toilet bowl but I have had moms tell me how their child likes to play with the water in the toilet. Keep the toilet lids closed at all times and if your little one is particularly curious install a toilet-lid lock.

Appliances: make sure any electrical appliances in the bathroom are unplugged and out of reach when your child is having a bath. Regular plug sockets may actually not be fitted in bathrooms for safety reasons so rather keep extension cords out.

Medicines: many of us keep medication in the bathroom. Make sure they are all locked away, out of sight and out of reach.

Dangerous items: make sure you keep cosmetics, razor blades, nail scissors, cleaning products and other dangerous items away.

Don’t get distracted during bath time. Keep your phone on silent or rather keep it out of the bathroom and join in on the fun. You could also try having a shower with your child instead for some extra fun. My daughter loves this and the best part is that I manage to get cleaned up as well freeing up some time later in the evening for something else. Just make sure you get a slip-proof mat for the shower first.

RESOURCES

https://www.aappublications.org/news/2015/11/11/PPBath111115

https://medlineplus.gov/ency/patientinstructions/000154.htm

http://www.ncbi.nlm.nih.gov/pubmed/19596735

https://pediatrics.aappublications.org/content/124/2/541.long

https://pediatrics.aappublications.org/content/100/4/e1.long?utm_source=TrendMD&utm_medium=TrendMD&utm_campaign=Pediatrics_TrendMD_0

How To Clean A Wound: The Controversy Of Antiseptics

What do you do when your little one scrapes their leg? Do you rush off to your medicine cupboard to grab your bottle of Dettol of Savlon? This may actually not be necessary. Whilst it’s important you clean a wound as soon as possible in order to reduce the risk of infection, what you clean it with has been an area of debate in the medical world for years. Research has shown that running tap water over a wounds is just as effictive in cleaning a wound. Antiseptics may actually damage the skin and slow down the healing process.

WHAT IS THE DIFFERENCE BETWEEN AN ANTISEPTIC AND A DISINFECTANT?

A Biocide is the general term for a chemical agent that inactivates microorganisms and depending on their activity they can either inhibit the growth of, or kill microorganisms completely.

Both antiseptics and disinfectants inactivate microorganisms. These terms are often used interchangeably but there is a very big difference. Antiseptics are biocides that are used on living tissues and disinfectants are biocides used on inanimate objects or surfaces. So for example in your kitchen, you would use an antiseptic to wash your hands and a disinfectant to wash the countertops.

HOW SHOULD I CLEAN A WOUND?

Before you clean a wound you have to stop any bleeding. This is done by applying direct pressure. Of course the wound may still continue to bleed a little for a while and/or when you clean the wound it may start to bleed again. As long as the wound is not bleeding excessively you can proceed to clean it.

For most simple wounds I would simply recommend rinsing them under cool running water. In the ER and in theatre we always clean wounds with lots and lots of water. If you are out and about and don’t have running water, you can always use bottled water. If this weren’t available then I would rinse the wound with a diluted antiseptic such as cetrimide or povidine-iodine (if of course there are no known allergies). If you are going to use an antiseptic, use it only once to initially clean and never chronically. When you clean the wound again after a day or so use water. Don’t ever use rubbing alcohol or peroxide to clean an open wound.

You can gently rub off any foreign material using a piece of gauze soaked in water. Use tweezers to remove any debris that may still remain. Remember to disinfect the tweezers before use.

Once the wound is clean you can then apply a moist dressing. You can use petroleum jelly or what I love to use is a lanolin ointment such as a nipple cream. To find out more about moist healing you can read my previous blog: https://www.oneaid.co.za/picking-scabs-popping-blisters/

WHAT ABOUT ANTIBIOTIC CREAMS?

These include creams such as Supiroban, Fucidin and Neosporin. I do not recommend using an antibiotic cream for a simple wound. Most wounds heal very well on their own.

The problem with using these creams is the possibility of developing bacterial resistence. If the wound were to get infected later on and you have been applying an antibiotic cream since day one, this cream would not be very effective against the infection.

Technically you can develop resistence towards antiseptics but this is very unlikely since antiseptics have a broader spectrum of microorganisms they inactivate than antibiotic creams. If the wound was very contaminated and has a high chance of infection then I would rather apply a very thin layer of an antiseptic cream.

Newer research has found that the body’s surface actually supports wound healing on its own. We all have bacteria that live on our skins that cause us no harm. These bacteria help protect us from pathogens in the environment. Using creams and solutions that have antimicrobial activity will upset the balance of organisms on our skins and interfere with this defense system.

WHAT ARE THE SIGNS OF AN INFECTED WOUND?

After you have cleaned the wound and applied a dressing it’s important to monitor the wound for any signs of infection over the next few days:

  • Swelling;
  • Redness;
  • Increasing pain;
  • Bad smell from the wound;
  • Warm skin around wound;
  • Wound is leaking pus; and/or
  • Body temperature > 38 degrees Celsius.

If you notice any of these above changes, go straight to the emergency room.

If you are anything like my mother you probably have very old big bottles of antiseptics lying around. One of my microbiology Professors at University once told us that microorganisms can grow on the surface of these antiseptic liquids after a while. Also the antiseptic components of these solutions deteriorate after some time so always check the expiry dates. Rather buy smaller bottles and don’t keep them too long after they have been opened.

RESOURCES

https://emj.bmj.com/content/19/6/556.1

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC88911/

https://www.sciencedirect.com/science/article/pii/S1743919117305368

https://www.woundsresearch.com/article/1585

https://www.woundsresearch.com/article/1586

https://www.woundsresearch.com/article/sams-dodd

https://mospace.umsystem.edu/xmlui/bitstream/handle/10355/3613/DoTopicalAntibioticsImproveWound.pdf?sequence=1&isAllowed=y

https://www.researchgate.net/publication/45149036_Benefit_and_harm_of_iodine_in_wound_care_A_systematic_review

Tips For Choosing The Right High Chair

Before going out and buying a high chair it’s important to know the safety requirements. A US study found that more than 9 400 children, aging three years and younger, were treated each year for high chair related injuries in emergency rooms from 2003 to 2010. That’s one child every hour!

Nearly all of these injuries were as a result of a fall where the child either climbed in or out of the chair or stood in it. Majority of the injuries seen were head injuries (37%) then bumps and bruises (33%) followed by lacerations (19%). Most of us use our high chairs in the dining room or kitchen where the flooring is usually hard, so you can imagine the impact this has on a small brain.

This has prompted the US to update their safety standards (unfortunately there are no available statistics for South Africa). From mid-2019 all high chairs in the US will have to have a passive crotch restraint and a three-point restraint system, which means there has to be a fixed post that sits between a child’s legs and restraints that are fixed to the high chair in three different places. They found that children were able to slip out the bottom of a high chair and hope a fixed post will prevent this.

High chairs are not recommended for children younger than 6 months of age. A child is only ready for a chair once they have good head and neck control and are able to sit up on their own. If one is used too early a child could experience positional asphyxia. You may however, be able to start a little sooner with a reclining high chair (see my previous blog, ‘How safe is your car seat?’). https://www.oneaid.co.za/how-safe-is-your-car-seat/

CHOOSING THE RIGHT HIGH CHAIR

Framework: choose a high chair that is sturdy. Put some weight on it and see if it squeaks, deforms or moves or collapses.

Gaps: make sure there are no gaps your child can slip out of. Also check for gaps that little fingers can get caught in.

Harness: choose a high chair with either a three-point or five-point harness that includes a crotch strap or a post. The restraint should go over the shoulders, around the waist and if a five-point harness then between the legs.  

Wide base: a high chair becomes top heavy when your child is in. Choosing a chair with a wide base will make it more stable so that it does not tip easily.

Wheels: if you choose a high chair with wheels, make sure they can be locked when the chair is in use.

Folding locks: if the high chair folds check that the locks work well enough so that the chair cannot fall or collapse when in use.

Joints: choose a high chair with metal joints. These are stronger than plastic, which can crack after time.

Safety standards: make sure the high chair meets current safety standards and has been approved by an international safety authority.

BOOSTER SEATS AND HOOK-ON SEATS

Please be careful when you use these chairs. If not used correctly these seats can be dangerous.

Hook-on seat: These chairs are mounted directly onto a table and should only be used once your baby has good head and neck control and can sit upright. The mounts must be slip resistant and because this seat carries the entire weight of your baby the table has to be strong so that it does not tip over.

Booster seat: These seats are attached to normals chair by straps to raise a child’s height. They are usually used when a child has outgrown the high chair but is not quite tall enough to sit at the table unaided. They should also have straps to keep your child in the seat.

KEEPING YOUR CHILD SAFE IN A HIGH CHAIR

  • Never leave your child unsupervised when they are in a high chair.
  • Always use the safety straps when your child sits in the chair, even if only for a few minutes. The tray is not a restraint.
  • If the chair folds, make sure it is locked each time you set the chair up.
  • If the chair has wheels, make sure they are locked each time you set the chair up.
  • Never allow your child to stand in the high chair.
  • Do not place the high chair near a counter or table. Your child may be able to push against the surface and cause the chair to tip over.
  • Don’t allow older children to climb or play on the high chair while another child is seated in it because it could tip over.
  • Position the high chair at its lowest possible height if this is adjustable.
  • Make sure potential hazards such as hot food, drink and sharp cutlery are out of reach.

When choosing a high chair opt for an age-appropriate one with plenty of safety features. It’s also important to check often for recalls once you have purchased your chair. High chairs are commonly recalled because of their safety issues. Recent recalls include the Skip Hop Tuo convertible high chair and the Graco Table2Table 6-in-1. You can check http://www.recalls.gov to see if your high chair has been recalled.

RESOURCES

https://journals.sagepub.com/doi/abs/10.1177/0009922813510599

http:// https://www.nationwidechildrens.org/newsroom/news-releases/2013/12/new-study-finds-24-children-a-day-are-treated-in-us-emergency-departments-for-high-chair-related

A Simple Guide To Bandages

With so many different types of bandages available its easy to get confused with what bandage to use when. Bandages are generally used to cover wounds, to apply pressure to bleeding wounds and to support and immobilise sprains, strains and broken bones.

I have put together a list of the most common types of bandages and when to use them. As you will see most of them have interchangeable uses so its really a matter of preference and of course, cost.

There are three major types of bandages – roller bandages, triangular bandages and tubular bandages.

ROLLER BANDAGE

These are long single strips of breathable material. Depending on the thickness and elasticity, these bandages are the most versatile.

The different roller bandages are described below:

1. Conforming bandage
This bandage has a high degree of stretch so that it can conform to any shape. This bandage comes in a light, medium and heavy weight

Use:

  • Can be used to hold a dressing in place
  • Can be used with a dressing to apply pressure to control bleeding wounds
  • A thicker weight can be used to compress and support a sprain or strain

2. Crepe bandage
This is a thicker weight than conforming bandage.

Use:

  • Can be used to hold a dressing in place
  • Can be used with a dressing to apply pressure to control bleeding wounds
  • Can be used to compress and support a sprain or strain
  • Can be used to compress a limb in the event of a poisonous snake bite

Both conforming and crepe bandages are never applied directly onto open wounds. A dressing must be in place first.

3. First aid dressing
This is a roller bandage that has a dressing pad sewn into it. The bandage is usually lightweight with some elasticity.

Use:

  • The pad is applied directly onto an open wound and then the bandage is rolled to keep it in place. There is no need to apply a separate dressing first.

4. Elastic adhesive bandage
This roller bandage has a very sticky adhesive, which can be taped directly onto the skin. This bandage is thick weight. However, this is not my favourite bandage as it can be very painful to remove if there is a lot of hair on the skin and some people may have an allergy to the adhesive.

Use:

  • Can be applied onto a joint to compress and support a sprain or strain
  • Can be applied over a conforming or crepe bandage for additional pressure to control bleeding wounds. Great for amputations and arterial bleeding.
  • Can be applied onto a conforming or crepe bandage to secure it in place
  • Can also be used to hold ice packs in place on the injured area

5. Cohesive bandage
This is a thin lightweight breathable bandage that sticks to itself, without actually being sticky. There is no risk of pulling out any hairs when removing this bandage.

Use:

  • Most commonly used to compress and support sprains and strains

TRIANGULAR BANDAGE

This is the most versatile bandage. It is usually a single sheet of thick cotton or calico in the shape of a large triangle. It can be applied to areas of the body where it may be more difficult to apply a roller bandage such as the scalp.

Use:

  • These bandages are most commonly used to construct slings for soft tissue injuries, broken bones or dislocations. Some triangular bandages come with safety pins to help you construct the sling but most of the time you will not need them;
  • Can be used to secure splints;
  • Can be used as a pad on top of a dressing to apply extra pressure for a bleeding wound;
  • Can be folded down to form a strip of bandage and wrapped around a wound to hold a dressing in place and/or apply extra pressure to control bleeding;
  • Can be used to elevate a limb to reduce blood flow to the area if bleeding a lot from an open wound;
  • Can be used to elevate a limb to reduce blood flow and limit swelling; and/or
  • Can be used as a tourniquet in an emergency when the use of a tourniquet may be warranted.

TUBULAR BANDAGE

These bandages are not normally found in first aid kits. They can be medium to heavy weight.

Use:

  • The thicker weight bandages are used for compression, support and to reduce swelling for joint sprains and strains;
  • Can be used to protect the skin under a cast for a broken bone;
  • Can technically be used to keep a dressing in place and apply pressure to bleeding wounds but care needs to be taken when applying it so that the dressing does not shift when the tube is pulled over the injured area.

WHAT IS A DRESSING?

A dressing is something that is applied directly onto a wound to cover it. A bandage can then be applied over a dressing to keep it in place if the dressing is not adhesive.

WHAT IS A PLASTER?

Depending which way you look at it, a plaster can either be an adhesive dressing or an adhesive bandage with an attached dressing. Plasters are more commonly known as adhesive dressings and Band-Aid is a brand of plasters.

Bandages are only helpful if used properly. It’s important to recognise the bandages you have in your first aid kit and to know which bandage you should use when and how to properly apply them.

First Aid Tips Every Mom Should Know

10 First Aid Tips Every Mom Should Know

I was recently asked by All4Women to put together my top 10 first aid tips for moms. I wanted to share these with all of you in this blog post. You can find more tips in my MiniKit Pocket Guide (https://www.oneaid.co.za/product/minikit/).

  1. Keep emergency numbers on speed dial: Every parent should know who to call in an emergency. You should also teach this to your children. Write the numbers down and stick them on your fridge or somewhere near the phone.
  2. Cuts and scrapes: Stop any bleeding by pressing firmly on the wound with a gauze or cloth. Then rinse the wound under cool running water before applying a dressing such as a plaster. Tap water is perfectly fine, you don’t need fancy antiseptic solutions.
  3. Burns: Rinse burns under cool running water for up to 20 minutes. This will prevent any further damage and reduce pain. Do not use freezing cold water or ice
  4. Bee stings: Remove the stinger if still attached and apply an ice pack to reduce swelling. Don’t use tweezers as this may squeeze out more poison. Rather scrape the stinger off with a flat-edged object such as a bankcard.
  5. Nosebleed: Lean your child forward so they don’t swallow any blood and pinch the nose closed just below the bony part. Blood can irritate the stomach and cause nausea and vomiting.
  6. Broken bones: If you suspect a broken bone don’t move the limb or apply any weight. Splint the injured limb to prevent any movement before going to the emergency room.
  7. Seizures: Never put anything into the mouth of a child who is having a seizure. This includes medicines for fever if your child is having a febrile convulsion. Roll your child onto his or her side and wait for the seizure to stop.
  8. Heat exhaustion: Get your child out of the heat and elevate his or her legs. Prevention is key so make sure your child drinks plenty of fluids before and during any activity in hot weather.
  9. Poisoning: If you suspect your child has swallowed a potentially harmful substance do not make them vomit or give them anything to eat or drink unless told to do so by emergency services. Here are 10 essential tips to prevent poisoning in your home (https://www.oneaid.co.za/10-essential-tips-to-prevent-poisoning-inyour-home/).
  10. Be prepared: Always have a well stocked first aid kit on hand so you can manage minor injuries without delay and reduce the risk of infection or severity of injury.

Be sure to follow me on Instagram @oneaidsa

Sea Creatures To Avoid At The Beach

I am really looking forward to taking my little one to the beach for the first time this year. Whilst the beach is great fun for any child there are a few sea creatures that can ruin a holiday.

If your child gets stung by one of these little guys try not to panic. Most stings cause nothing more than a localised skin reaction and a whole lot of pain. If your child is prone to allergic reactions there is a possibility they could however develop a severe allergic reaction and you will have to be on the lookout for this.

There are many dangerous marine animals but fortunately South Africa doesn’t have too many that your little ones will come across on the beaches and in rockpools. Below, I will describe how to manage the stings and bites of the most common sea creatures on South Africa’s shores.

  1. JELLYFISH

There are over 2000 different species of jellyfish and the toxins vary among them.

The nematocysts (cells inside the tentacles that release the toxin) from different species of jellyfish are either inhibited or stimulated to release more toxin depending on what first aid is applied which can make initial management challenging.

The jellyfish we encounter in South African waters are most commonly a relatively harmless type of box jellyfish. They most often only cause immediate pain, redness, tingling and itchiness.

How to treat jellyfish stings:

There is some debate as to how to treat jellyfish stings. Some suggest rinsing the wound in seawater others suggest vinegar or hot water and then there also seems to be some confusion about the order of steps. Based on a systematic review, which provides the best evidence, I have outlined the management of a jellyfish sting:

  1. Always provide Basic Life Support first. Don’t try remove any tentacles unless your child is responsive and stable.
  2. Flush the area with seawater to remove the tentacles that are stuck to the skin. You can use tweezers to gently remove tentacles whilst flushing. You can also use your hands provided you wear gloves. Don’t scrape away tentacles or rub with sand as the pressure will only release more toxin. Do not use fresh water as this causes more toxin to be released.
  3. Apply a paste of bicarb (50% bicarb of soda and 50% seawater) for several minutes and rinse off with seawater.
  4. Immerse the area in hot water (as hot as possible without burning the skin). Heat will help to reduce the pain. Apply for 30-90 minutes either in a hot shower, bath or by using heat packs.
  5. If heat has not helped the pain apply ice packs.
  6. Oral analgesics, anti-inflammatories and antihistamines are all effective.
  7. Monitor for a severe allergic reaction.

Jellyfish sting don’t’s:

Vinegar: I don’t recommend rinsing with vinegar. Vinegar is only effective for certain species of jellyfish and since it is very difficult to identify the species responsible for a sting I would avoid it. Vinegar can cause nematocysts to release more toxin causing significantly more pain.

Tweezers: Trying to remove stingers with tweezers or by scraping can also cause them to discharge more toxin. It is now recommended to avoid this.

  1. BLUEBOTTLE

The blue bottle, also known as the Pacific or Portuguese  man-o’-war, is very common along the coast of South Africa. Management of these stings is similar to that of the jellyfish sting described above.

  1. SEA URCHIN

These spikey creatures are like the hedgehogs of the sea and are commonly found in rock pools. If your little ones accidentally step on one or touch one, the urchin will shoot out some of their spines.

As with most sea creatures some are more poisonous than others, but most sea urchins cause nothing more than a painful puncture wound similar to that of a splinter. On the odd occasion there may be also be burning, swelling and numbess of the area that lasts a few hours.

What to do if your child comes into contact with a sea urchin:

  1. Remove all the spines with tweezers or your hands if large enough. Do this very carefully as the spines are fragile and can break easily.
  2. Stop any bleeding with firm pressure.
  3. Rinse the wound with salt water.
  4. Soak the wound in vinegar throughout the day or apply a cloth soaked in vinegar over the wound to dissolve any spines you were unable to remove.
  5. Follow with warm compresses to help with the pain and swelling.
  6. Analgesics and anti-inflammatories such as Ibuprofen.

If you don’t manage to remove the spines and they don’t fully disolve with vinegar they may need to be removed by a medical practitioner.

The spines would also have caused puncture wounds into the skin so its important to keep the area clean and watch out for any signs of infection.

  1. SEA ANEMONE

These beautiful creatures, which live in rock pools, can be very tempting for our kids and thankfully most of their stings are harmless.

What to do if your child has been stung by an anemone:

  1. Flush the area with seawater to remove as many stingers as you can.
  2. Immerse area in hot water for up to 90 minutes.
  3. Apply ice packs if heat does not help.
  4. Oral analgesics, anti-inflammatories and antihistamines.
  5. Monitor for a severe allergic reaction.

WHEN YOU NEED TO SEEK MEDICAL HELP:

  • Difficulty breathing
  • Confusion and/or loss of consciousness
  • Chest pain
  • Nausea and vomiting
  • Muscles cramps severe bleeding
  • Severe pain that won’t go away
  • Stings on a large surface area, the face, throat or genitalia
  • Signs of infection over the next few days: increased pain, redness, swelling, pus and/or fever

SIMPLE SAFETY TIPS

  • Look for any warning signs at the beach about jellyfish and other dangerous marine life in the area and AVOID.
  • If you find any jellyfish or blue bottles on the beach it’s likely there will be more floating around in the breakers. Rather avoid the water.
  • Never touch a jellyfish or blue bottle, even if it looks dead. The tentacles can still sting even if they aren’t attached to the body.
  • Invest in some good quality swim shoes. They can be worn in and out of the water. These have a rubber sole and will protect little feet from nasties they may step on, as well as the hot beach sand, which can burn.
  • Don’t forget that tetanus prophylaxis is important for any break in the skin. Refer to my previous blog for more information.

It’s important your kids respect the little animals they may come across at the beach. Teach your children to look but NOT touch. There are so many fun things to do at the beach so don’t let bluebottles and sea urchins scare you. Just keep an eye out and initiate immediate first aid to prevent a small injury from turning into something much bigger.

Keep on hand my on-the-go first aid MikiKit. It is compact and will fit perfectly into your beach bag https://www.oneaid.co.za/shop/

RESOURCES:

http://www.ambulance.nsw.gov.au/Media/docs/090730bluebottle-eee3bc83-ce7c-4281-a095-b427eb01e6d0-0.pdf

https://www.mdpi.com/1660-3397/14/7/127

https://www.merckmanuals.com/professional/injuries-poisoning/bites-and-stings/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3640396/

https://www.nsri.org.za/2012/02/how-jellyfish-sting/

https://www.racgp.org.au/afp/2015/januaryfebruary/marine-envenomations/

 

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