Student Class Modules

A: All Safe Sitter® first aid recommendations take into account the tremendous variation in the physical size and emotional and cognitive maturity we know to be characteristic of this age group. Regardless of swimming skill or water safety training, many 11-and 12-year old sitters would simply not be physically capable of subduing a thrashing, desperate child in deep water.

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.

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.

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.

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.

A: There are multiple learning opportunities in the Guest section of the course. The opportunity to practice meeting and greeting a child and parent as well as interviewing a parent for Important Numbers and the four routines are important elements of the Guest section. It is true that children who have been around many toddlers already have a basic knowledge of what to expect; however, they probably have not observed a toddler from the perspective of what it would be like to be responsible for that child.

A: Since most Safe Sitters are relatively young, and very few have witnessed epileptic seizures, most sitters in that situation -- and in fact many parents - fear for the child's life during the seizure. The actual risks depend on the cause of the seizure, the length of the seizure, and complications from the seizure, for example aspiration of secretions or vomit. Because Safe Sitters do not have the medical background to assess the actual risk, sitters are directed to contact 911 so that appropriately trained individuals will be immediately available for further assessment and management.

A: When sitters face the situation of handling a potential poisoning without symptoms occurring "on their watch," they will have many emotions. Their first reaction will (hopefully) be fear for the health of the child. The fear will motivate them to get adult help and support. The sooner an adult is involved the better. When the fear fades, guilt will likely set in along with embarrassment and the desire to cover up the problem. The problem, however, must be dealt with and the Poison Center must be called. The available adult's presence assures the call will be made. Of course, in isolated geographic areas where there is no available adult, the sitter should make the call to the Poison Center.

A: A broken bone is extremely painful. The pain is so severe the individual may vomit or pass out at the time of the break. Once the initial pain caused by the break subsides, the child (or adult) will do everything possible to prevent movement of the injured part so that the bone pieces will not be disturbed and cause another "rush of pain." The injured individual naturally splints the injured part. This is "nature's way" of preventing further damage. Unless the person providing first aid understands the reason and the importance of not moving the injured part, their attempts at first aid, specifically splints, can do more harm than good.

So, if the available adult is knowledgeable and knows how to splint the bone to stabilize the bone fragments without doing harm, the available adult should do just that. The child will then need to be seen for further evaluation and treatment.

If the available adult is unsure of the proper technique, the injured area can be stabilized with a pillow and the child made comfortable. These simple measures are frequently all that needs to be done to transport the child for care.

A: There is no standard method or instrument for taking a temperature. Individual households vary in the thermometer available. Likewise, physicians direct parents to take temperature at different sites, e.g. axillary, oral. Reading a thermometer is not always easy. The combination of these factors results in the risk of temperature taking by a young sitter being greater than the benefit.

A: The most common injuries that sitters deal with are the most common injuries parents deal with-minor injuries like scrapes, bruises and cuts.

A: Electric burns of the lips are the most common electrical burns of children. These children tend to be under three years of age when they 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 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.

A: The teaching philosophy of Safe Sitter® is based on the medical dictum "First Do No Harm" AND the developmental realities of the young teen sitter. In the case of respiratory rescue or CPR, this philosophy translates to instructing the sitter to observe the infant for 15 seconds before taking any action. Babies, especially young babies in the age range of SIDS, have very irregular and intermittently shallow respirations. It can be very difficult to determine if a baby is breathing without careful observation over a reasonable time.

Safe Sitter® sensitizes the students to the possibility that they may face a situation that requires CPR. In some ways we prime the students to expect an emergency. The 15-second observation period is meant to correct for the over zealous sitter and for the irregular and shallow respirations of the young infant. Lastly, you should know that even infants who are being monitored for their risk of sudden infant death by apnea monitoring have a 15-second apnea alarm delay.

A: The American Heart Association teaches adult rescuers to do rescue procedures for one minute and then activate the EMS. The young adolescent is more likely to need backup for this emergency than an adult. Problems of technique, fear, guilt, and paralyzing anxiety may interfere with a successful rescue. The earlier help is summoned, the better. In an emergency situation in which a child chokes and becomes unconscious, the likelihood of intact survival diminishes with each elapsing second. By allowing the young adolescent to call immediately at the point the victim becomes unconscious, expert help is mobilized.

Safe Sitter® is not changing the sequence from the recommendations of the American Heart Association (the only change is in the timing of the telephone call).

A: On the first day, the emphasis should be on the determination of need for CPR/care of the choking infant or child as well as demonstration and explanation of the procedures. The second day provides an opportunity for practice and refinement of technique.

Introduce all new concepts on the first day and use the scenarios in the Instructor Manual when practicing. There are scenarios for both the first day when the skills are introduced and for practice on the second day.

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.

A: As with most problems, prevention is the best answer. Many sites find it necessary to have extra help during testing so that the students will be finished with testing in time for the Ceremony. This is especially important when you are using new Instructors who are very likely to test more slowly.

It also helps to remind Instructors to pace themselves. If you know the number of students you need to test and the time you have to accomplish testing, then you can calculate the time you have to spend with each student. Testing is one segment of the class where it is particularly important to start on time.

Although testing the students on Greeting Skills, Injury Management, and Behavior Management is ideal, occasionally you may feel you are unable to complete all parts of the Oral Testing in the allotted time. If this occurs, you may delete the Greeting Skills since this part is typically mastered in class. Instructors may also choose to test the students on Injury Management or Behavior Management, rather than both of these segments.

A: Having an open book written test helps students recognize the value of having their Manuals with them on babysitting jobs to use as a reference. The test incorporates critical thinking. Students learn not only where to quickly find information in the Student Manual, but also how to use the information.

We want students to succeed - to love Safe Sitter® and love babysitting. People enjoy doing what they think they do well. It is important for students to do well in the class and during testing. Most students will be parents someday and success in Safe Sitter® empowers them to be better babysitters now and better parents in the future. Instructors should use testing as an opportunity to teach with appropriate praise ("What a good job you've done!") and correction of technique.

Safe Sitter® does not recommend students use their Student Manual during rescue skills testing because the return demonstration simulates a real-life emergency situation. In a true emergency, there is no time for sitters to get their cards - they would just need to respond to the emergency. Using the rescue skills involves a "rhythm," and it would be difficult for the sitter to get "into the rhythm" by looking at the cards. Encourage your students to review their rescue skills cards before each babysitting job.

A: It works best if one Instructor grades all of the tests. Sometimes a student may write an answer which isn't in the exact wording on the answer key, yet an Instructor would be able to determine whether the student understands the concept being tested.

It saves time to first grade the tests without reading the essay. Then turn all of the tests with the essay page face up and read all of the essays at the same time. If a student's essay is not satisfactory, have the student re-write the essay rather than taking points off.

Although passing score is stated as 70, failure on the written test is left to the discretion of the Instructor based on the student's ability to improve performance by answering the written questions orally.

Since the test is an open-book test, it is acceptable for the students to grade their own tests and then have an Instructor read the essays if you are running out of time.

A: To teach or test choking rescue modules, you must be current in any CPR course that requires a minimum of a skills performance test or infant and child CPR and relief of choking such as Heartsaver® CPR (American Heart Association).

To teach or test CPR modules, you must be current in any CPR Instructor course such as Heartsaver® Instructor Course (American Heart Association) OR be a Safe Sitter® Instructor who meets the qualifications to teach the choking rescue modules and uses the Safe Sitter® CPR DVD to teach.

These requirements also apply to Safe Sitter® Instructors.