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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/

 

Baking With Your Little Ones; Safety and Tips to Taking Care of Thermal Burns

This weekend I plan on doing a little baking with my daughter. We are going to make cookies for her friends at playschool. My daughter loves getting involved in the kitchen which usually means I have to be super vigilent about keeping an eye on her.

I think the kitchen is the most dangerous room in the house. It’s the room with the most appliances, utensils and where most of us keep the cleaning materials. For our cookie making masterclass this weekend we will be using the oven for baking and this is why I am going to be talking a little more about thermal burns in children. Of course children can also sustain chemical and electrical burns in the kitchen but for this blog I will only be looking at thermal injuries.

Thermal burns can occur from hot liquids, hot solids or flames. According to the WHO, burns are the “fifth most common cause of non-fatal childhood injuries” worldwide. However in South Africa things are a little more frightening. In children 1 to 4 years of age, thermal injury is the second most common cause of mortality, with toddlers and boys being at highest risk.

CLASSIFICATION  OF BURNS

Burns are no longer classified as first, second or third degree and are currently being described according to the depth of the burn.

  1. Superficial thickness – This burn involves only the epidermis (the outermost layer of the skin). Here you will only notice a reddening of the skin.
  2. Partial thickness – This is further classified into superficial or deep partial thickness. This burn involves the entire epidermis and parts of the dermis.
    1. Superficial partial thickness: appears red with blisters and is very painful.
    2. Deep partial thickness: looks waxy white with some areas of red, wet and blistered. This depth of burn may be less painful.
  3. Full thickness – This burn involves the entire epidermis and the entire dermis. The skin looks white and leathery. There is no pain as the nerve endings in the skin have all been damaged. However, surrounding areas of partial thickness burns will be painful.
  4. Fourth degree – This is the deepest type of burn where there is damage to the structures underlying the skin such as the muscles and bones.

Full thickness and fourth degree burns almost always require surgical intervention and skin grafting. Some deep partial thickness burns may also require surgical management.

HOW TO TREAT A COOKING BURN

Act FAST: A child’s skin will burn much faster than adult skin.

The longer a burn remains open, the more likely it will get infected so get it covered as quickly as possible.

  1. Remove your child from the source of the burn.
  2. Remove any clothing near the affected area to expose the wound. Don’t try to remove anything that is stuck to the burn.
  3. Place affected area under cool running water for up to 20 minutes. Do this as soon as possible to prevent any further thermal injury.
  4. Pat dry gently with a clean cloth or gauze.
  5. You can now apply a burn gel if you have one (if you don’t have this proceed to the next step). This will help cool the wound but should only be used short-term. Remove after a few hours and wash away any excess gel left on the wound with cool running water, then gently pat area dry.
  6. Cover the wound loosely with a dry, sterile non-adherent dressing.

WHAT ABOUT BLISTERS?

It’s important to leave blisters alone. You can apply a burn gel over a blister. Just be careful when you rinse the wound of the gel once you remove it that you don’t rub too hard, as the skin on top is very thin. Cover the blistered wound with a dry dressing.

If the blister has popped the underlying skin is raw and exposed and at increased risk of infection. It is now even more important to keep the wound clean.  There is new evidence to suggest that you can now cover the wound with a wet dressing until it heals provided you regularly wash the area and keep the dressings clean.

You can read more in one of my previous blogs https://www.oneaid.co.za/picking-scabs-popping-blisters/

BUTTER, TOOTHPASTE AND TURMERIC

I have seen patients put all kinds of things on their burns. Superficial burns require nothing more than initial cooling, a dry dressing and some painkillers. If there are blisters you can manage the wound as described above. Applying home remedies can do more harm than good.

Antibiotic ointments for prophylaxis (prevention of infection) are an issue of debate. Many specialists don’t advocate their use as they can cause antibiotic resistance if the wound were to get infected. 

GO TO THE ER!

  • Any burn, regardless of depth, bigger than the palm of your child’s hand;
  • Any burn, regardless of size, deeper than a superficial partial thickness burn;
  • Any burn, regardless of size, involving the head and neck, hands, feet, groin and joints;
  • Circumferential burns of any size around the chest, abdomen or a limb; and/or
  • When there was a risk of inhalation burns

SAFEGUARD YOUR KITCHEN AGAINST BURNS

Burns are preventable!

  • Make sure appliances that contain hot liquids such as kettles and slow cookers as well as hotplates are kept out of reach.
  • Make sure that electrical cords of these appliances are also out of reach. Exploring children can pull on the cords as well as trip over them if they are lying on the floor. I read about an incident where a young child tripped over a cord pulling a slow cooker and all the hot contents over her. She sustained serious full thickness burns over most of her body.
  • Use the furthest burner on the stovetop and keep pot handles turned away towards the back.
  • Don’t mix hot liquids in a blender as the contents can explode out onto whoever is standing nearby.
  • Be careful of long hair and loose clothing, which can catch on fire.
  • Keep paper towels, dishcloths and oven mitts away from the stovetop as they can catch on fire.
  • Keep chemicals and other flammables such as paraffin locked away at all times https://www.oneaid.co.za/10-essential-tips-to-prevent-poisoning-in-your-home/
  • If you have little children running around you should never take your eye off the kitchen if you still have something cooking.

Cooking with your kids can be so much fun. It’s hands on and a great form of ‘messy play’. It’s also a great way to get your children to explore new flavours. I find that if my daughter has been involved in the prepping of her meal she is much more likely to eat it. Next time why don’t you let your toddler better their motor skills by cracking open some eggs or measuring out some flour.

RESOURCES:

https://consumer.healthday.com/general-health-information-16/burn-health-news-87/kitchen-cooking-burns-a-real-danger-for-kids-713976.html

http://www.firechildren.org/index2.asp?include=fireburns.htm&catID=4

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3187951/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3500004/

http://www.who.int/news-room/fact-sheets/detail/burns

https://www.westerncape.gov.za/general-publication/national-burns-week-2016

Top Choking Hazards For Babies and Toddlers

We recently went to a very popular restaurant for lunch and to my astonishment there were vending machines with gumballs and other small toys, right next to the jungle gym. This is a disaster waiting to happen!

Children under 3 are at the highest risk of choking because their airways are so small. Plus, chewing and swallowing is a lot more difficult for them. They also love to put foreign objects in their mouths. There is a cylindrical tool in the US used to measure toy parts that is the same size as a young child’s throat. If a toy part fits into this cylinder it’s a choking hazard and a warning label has to appear on the toy packaging. Therefore any object smaller than 3 cm wide is a choking hazard for small children.

WHAT IS A CHOKING HAZARD?

Any object that can get caught in a child’s throat and block the airway is a choking hazard.

TOP 10 HOUSEHOLD CHOKING HAZARDS

Once your baby starts to crawl and explore, choking hazards are all of a sudden everywhere.

  1. Coins
  2. Small caps of bottles e.g. juice and water bottles
  3. Small round batteries
  4. Jewellery
  5. Buttons
  6. Toys and toy parts
  7. Balloons (uninflated or popped)
  8. Garden pebbles
  9. Nails and screws
  10. Stationary e.g. staples, paper clips and pen lids

If you have older kids too, you should keep their toys separate and make sure they learn to pack their toys away.

There are countless more choking hazards. You should probably get down on your knees and have a look at your child’s eye level. How many more choking hazards can you find?

TOP 10 FOOD CHOKING HAZARDS

Hotdogs, grapes and popcorn are the top 3 causes of choking in children under the age of 3. Young children have a hard time chewing their food since they lack the proper dentition (canines for tearing and molars for grinding). They are still trying to coordinate chewing, and as a result, often just swallow their food whole. This makes smooth, slippery, round and hard foods especially dangerous.

The foods in the list below are not recommended for children under 4 years of age. The American Academy of Pediatrics (AAP) goes even further and recommends that hotdogs, grapes and popcorn not be given to children until they are at least 5 years old.

If you do however want to give your children some of these foods, then cut them in such a way that you change their round shape. Hotdogs should be cut lengthwise before slicing and skins of other sausages removed. Grapes and other round fruit should be cut into quarters.

  1. Whole grapes, cherry tomatoes and other round balls of fruit (blueberries are ok for toddlers as they are soft to chew)
  2. Hot dogs and other sausages
  3. Popcorn
  4. Tough, large pieces of meat
  5. Fruit pips and stones
  6. Nuts and seeds
  7. Hard round sweets and caramels
  8. Raw vegetables, especially carrots
  9. Marshmallows
  10. Chewing gum

BE CAREFUL

  • Children can trip and choke more easily if playing and eating at the same time. Your child should not walk, run or lie down while eating. Children should not be distracted whilst eating. They must sit upright and concentrate on what they are doing.
  • It is also not advisable to have your young child eat in their car seat whilst you’re driving. You might not even notice if they’re choking.
  • You should always supervise your child when they are eating.

It’s important that all parents and caregivers learn first aid for choking and CPR. There are many training academies that offer such courses around the country that are usually done over one day and will make you feel more confident when dealing with childhood emergencies.

RESOURCES

Altkorn, R. et al. (2008) Fatal and non-fatal food injuries among children (aged 0–14 years). International Journal of Pediatric Otorhinolaryngology, [online] 72 pp. 1041—1046. Available from: https://www.sciencedirect.com/science/article/pii/S0165587608001298 [Accessed 24 October 2018].

CDC (2018) Choking Hazards [online]. Available from: https://www.cdc.gov/nutrition/infantandtoddlernutrition/foods-and-drinks/choking-hazards.html [Accessed 24 October 2018].

Keep Your Swimming Pool Safe This Summer

South Africa has updated its pool safety regulations this year and now all private swimming pools not only need to be fenced off, but they also need to be fitted with either a pool cover or safety net when not in use. The new regulations form part of the SANS 10134 which is a SABS standard for the safeness of private swimming pools.

Lets take a look at the regulations and some additional measures that can be taken to safetyproof your swimming pool. No single safety measure is foolproof therefore its better to rather use as many as you can together.

SAFETY MEASURES

1. Swimming Pool Fence

According to the South Africa Bureau of standards (SABS) a fence must surround a body of water that holds more than 30 cm of water.

The fence gate must be self-closing and self-locking. The fence must be at least 1.2m high and sunk into the ground by at least 50cm. The vertical slats should be no more than 100mm apart.

Children should not be able to climb over or through the fence and should not be able to open the gates themselves.

2. Swimming Pool Cover

The SA safety standard also requires a swimming that holds more than 30cm of water to be covered by a cover or safety net. DIY installed nets are no longer allowed. An “accredited responsible party” must professionally install a cover and a cover is not approved if a child can unfasten it.

If your pool is small (less than 2.4m at the widest point) the cover must be able to hold the weight of one adult and one child. If you have a larger pool then the cover must hold the weight of two adults and one child in case the first adult falls into the pool during a rescue mission.

3. Swimming Pool Alarm

A swimming pool alarm is an additional safety measure you can have installed. Detectors with sensors that extend into the water are mounted onto the sides of the pool. You can also get free floating alarms. Waves form on the pool surface when a child comes into contact with the water, which triggers these alarms.

Aquawatch pool alarm

Lifebuoy alarm

 

 

 

 

 

You can also have a pool alarm installed on the swimming pool gate, which is activated when the gate is opened.

4. Swimming Pool Chemicals

Make sure all pool chemicals are locked away out of sight and out of reach. Children may mistakenly drink these and contact with the skin can cause chemical burns.

DO NOT FORGET

  • The same rules apply to water features and fishponds. Cover these with safety nets as children can drown in as little as 2.5cm of water.
  • It’s also a good idea to keep the pool brush or net nearby. The pole can be used to help someone in the water if needed.
  • Regularly inspect your safety measures. It’s not uncommon for dogs to chew the safety nets causing them to become lax and ineffective.
  • There are many different products and brands available. Make sure whatever you choose is SABS approved.

RESOURCES

Intemark (2018) Aquawatch Pool Alarms. [image] Available from: http://intemark.co.za/Aquawatch/ [Accessed 18 October 2018].

Lifebuoy (2018) Lifebuoy features. [image] Available from: https://www.lifebuoyalarm.com [Accessed 18 October 2018].

SABS (2015) The safeness of private swimming pools [online]. Available from: https://store.sabs.co.za/catalog/product/view/_ignore_category/1/id/218720/s/sans-10134-2008-ed-1-02/ [Accessed 18 October 2018].

Safepool (n.d.) Swimming pool by laws in South Africa [online]. Available from: http://safepool.co.za/swimming-pool-fence-by-laws-in-south-africa/ [Accessed 18 October 2018].

de Wet, P. (2018) These are the new safety standards for private swimming pools – and a fence is no longer good enough. Business Insider South Africa, [online] pp. https://www.businessinsider.co.za/private-swimming-pool-standard-sans-10134-mandatory-safety-net-to-prevent-drowning-2018-7 [Accessed 18 October 2018].

A Bump To The Head: When Should You Worry?

I have attended to many children in the ER who have taken a tumble. In the US, falls account for around half the injury-related ER visits in children under 5 years of age. Most of these falls involve furniture such as changing mats, high chairs, baby walkers and beds.

Parents are almost always concerned about head injuries. Majority of head injuries from a fall are usually minor.

Children under one who fall are more likely to sustain head injuries regardless of the height from which they fall. Whereas older children are more prone to extremity fractures. This is because an infant’s head is much larger than the rest of their body. As a child grows, their head mass becomes more proportional and they develop upper body strength, which enables them to brace falls with their arms or legs.

WHEN TO SEE A DOCTOR

If your child is awake, alert and behaving normally after a bump to the head with no other signs and symptoms then he or she will most likely be fine and you don’t have to rush to hospital right away. It’s a good idea to observe your child for 1-2 days afterwards, since symptoms of a brain injury may present late.

Seek Medical Attention:

  • For any bump to the head in an infant;
  • If your child has lost consciousness, even if brief;
  • If your child has any signs and symptoms of a concussion (see below);
  • If your child is inconsolable;
  • If your child is vomiting;
  • If your child is difficult to wake;
  • If your child has a seizure; and/or
  • If you suspect a broken bone.

If your child has had a bad fall and you suspect a neck injury DO NOT move your child. Call an ambulance right away! Always trust your gut. If you are unsure rather head straight to your nearest emergency room.

CONCUSSION

A concussion is a brain injury caused by a blow to the head. The signs and symptoms may be vague and may even take a few days to develop. It’s important to know that not all concussions cause a loss of consciousness.

Concussions can be more difficult to diagnose in children, as they are not as vocal about their symptoms. Children older than 2 years will show more behavioural symptoms.

Signs & symptoms will therefore depend on age and include but are not limited to:

  • Irritable and fussy;
  • Unusually sleepy;
  • Crying more than usual;
  • Change in appetite;
  • Nausea and/or vomiting;
  • Lack of interest in play;
  • Headache;
  • Confusion;
  • Child is unsteady on his or her feet;
  • Sensitivity to light and noise;
  • Blurred or double vision;
  • Dizziness;
  • Unusual speech e.g.: slow or slurred;
  • Poor concentration and memory; and/or
  • Problems with co-ordination.

DIAGNOSING A CONCUSSION        

The doctor will do a thorough evaluation. A CT scan and MRI cannot diagnose a concussion. A CT scan will however, most likely be ordered to exclude a brain bleed or skull fracture depending on the mechanism of injury and presenting symptoms.

The majority of falls in children are caused by modifiable factors and are therefore preventable. It’s impossible to bubble wrap our kids and we shouldn’t have to. Falls and tumbles can teach our children valuable lessons, but we can spend time baby proofing our homes and being more cautious to prevent serious injury. Remember to always buckle your baby in their high chair and never leave him or her unattended on a changing mat, not even for a second – it takes seconds for an accident to happen.

RESOURCES

Burrows, P. et al. (2015) Head injury from falls in children younger than 6 years of age. Arch Dis Child, [online] 100 (11), pp. 1032-1037. Available from: https://0-www-ncbi-nlm-nih-gov.innopac.wits.ac.za/pmc/articles/PMC4680174/ [Accessed 3 October 2018].

CDC (2017) Traumatic Brain Injury & Concussion [online]. Available from: https://www.cdc.gov/traumaticbraininjury/symptoms.html [Accessed 3 october 2018].

Chaudhary, S. et al. (2018) Pediatric falls ages 0–4: understanding demographics, mechanisms, and injury severities. Inj Epidemiol, [online] 5 (suppl 1). Available from: https://0-www-ncbi-nlm-nih-gov.innopac.wits.ac.za/pmc/articles/PMC5893510/ [Accessed 3 October 2018].

Kendrick, D. et al. (2015) Risk and Protective Factors for Falls From Furniture in Young Children Multicenter Case-Control Study. JAMA Pediatr, [online] 169 (2), pp. 145-153. Available from: https://jamanetwork.com/journals/jamapediatrics/fullarticle/1939058 [Accessed 3 October 2018].

Samuel, N. et al. (2015) Falls in young children with minor head injury: A prospective analysis of injury mechanisms. Brain Injury, [online] 29 (7-8), pp. 946-950. Available from: https://0-www-tandfonline-com.innopac.wits.ac.za/doi/full/10.3109/02699052.2015.1017005 [Accessed 3 October 2018].

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