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Medical Issues |
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| Q | What is the most common injury the babysitters have to deal with? |
| A | The most common injuries that sitters deal with are the most common injuries parents deal with--minor injuries like scrapes, bruises and cuts. Perhaps children are blessed with guardian angels to protect them from serious injuries that we all fear when we see the chances they take and the fearless way they put themselves in danger. |
| Q | Why should the child lean forward with a nosebleed? You always see the person leaning backwards on TV. |
| A |
Television medicine is a lot like television
life -- not very realistic and not something you should
"try at home." During a nosebleed, blood from
the blood vessels that line the nasal passages flow
wherever gravity takes it. If the head is tilted back,
and the person leans back, the blood flows into the back
of the throat and is swallowed. If the head is tilted
forward and the person leans forward, the blood flows out
of the nose. The nosebleed may look worse because you can
see the blood and perhaps that is how the practice of
tilting the head back began.
Swallowed blood may cause the child or adult to vomit. That's another reason why it's important to tilt the head forward. Also, when the head is tilted forward and blood can flow from the nose, the person providing the first aid is able to judge if the pressure being applied to the nostrils is adequate to stop the bleeding. If you can't see bleeding, squeezing is doing the job. |
| Q | Why shouldn't ice be used on a minor burn? |
| A | Burned tissue is damaged tissue and needs to be protected from further damage. Cooling the burned area with cool water helps to return the tissue temperature to normal and to stop the damage being done by heat. Using ice or ice water instead of cool water subjects the tissue to additional thermal injury - this time from extreme cold. As always we strive to "do no harm" when we care for injuries. |
| Q | Why do we scrape, instead of pull, the stinger after a bee sting? |
| A | It is important to keep in mind the rationale for removing the stinger. The stinger contains the venom that will cause the inflammatory reaction, i.e. the red swelling at the sting site. The problem with pulling at the stinger (using your fingers or tweezers) is that by squeezing the stinger, you are likely to actually inject more of the venom into the wound. Scraping motions optimize our chances of removing the stinger without causing further harm. |
| Q | What happens when a toddler bites an electric cord? Why do you need to call 911? |
| A | Electric burns of the lips are the most common electrical burns of children. These children tend to be under three years of age and the injury tends to occur because children of these ages explore by putting objects in their mouths. The extent of the tissue damage is related to the type of current passing through the tissue. Household lines of 110-220 volts rarely cause fatal injury however, they may cause tissue damage and cardiac arrhythmias. Alternating current at low voltage is more dangerous than direct current. Alternating current produces muscle spasms which freeze the patient to the electrical source. Nerves, blood vessels, and muscles offer the least resistance to the electrical current and show the greatest destruction. The area of the mouth offers very little resistance. When a child bites on a "live" appliance or extension cord, tissue injury is caused by excessive heat in the area. Tissue temperatures can reach as high as 5400F. The burns may involve damage to the lips as well as deep muscle. Since blood vessels are are essentially "cauterized" there is little or no bleeding at the time of injury. Most often upper and lower lips are involved. Within six hours, the surrounding area becomes swollen. There may be numbness and drooling. Because cardiac arrhythmias may occur if the current flows through the body and breathing difficulties may occur, these injuries may become life threatening. Regardless of the apparent state of the child following the rescue, 911 should be contacted so that the child can be evaluated for cardiac arrhythmias and deep tissue injury. |
| Q | Why do you need to keep an infant's head down when doing back blows? |
| A | The simple answer to this question is that back blows loosen an object and gravity determines the direction the loosened object takes. To expand: when using back blows on an infant, the position of the infant is critical. When back blows are delivered to an infant placed in the head down position, gravity facilitates the moment of the foreign object from the airway toward the mouth. Chest thrusts complete the rescue by producing an artificial cough which propels the object from the airway. With this in mind, it is easy to see why it is critical that the head down position is maintained when turning the infant from the face down to the face up position. |
| Q | How does an allergic reaction (bee sting or food allergy such as peanuts) cause a breathing problem? |
| A | Everyone is familiar with tissue swelling at the site of an insect sting or with an allergic drug reaction, e.g. hives. When there is a systematic reaction to a foreign substance, the airway may be involved. The lining of the airway swells. As the swelling of the lining of the airway increases, the lumen or opening of the airway decreases. If the reaction is severe, complete blockage can occur - there is no air movement from the upper airway to the lungs. Without appropriate medications and immediate airway management, such an allergic reaction is fatal. |
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