First Aid

A guide to getting it right, first time, every time

Scraped knees, bee stings and tummy aches are par for the course on most school excursions. Knowing what to do quickly and confidently will help ease the situation – and ensure you provide optimum duty of care.

You’re halfway through a museum tour and a student approaches you telling you they have a tummy ache…and it’s getting worse. How do you respond?

You’re overseeing an excursion in a city park and a student comes screaming towards you, saying they’ve been stung by a bee. What do you do?

Knowing how to deal with minor medical emergencies is critical for educators – particularly on school excursions where chances are you’ll be on your own, with only another teacher or a couple of parent helpers to turn to. And should the unthinkable happen, and a student stops breathing or their heart stops, it’s comforting knowing that you can swing into action and apply CPR (cardiopulmonary resuscitation) quickly and confidently.

This guide addresses some of the most common medical conditions you might have to deal with in a school setting, and the latest advice on how to deal with them:

Nosebleeds
To manage a nosebleed:

• Reassure the child, as crying increases blood flow
• Sit the student up straight and drop their head slightly forward
• Apply finger and thumb pressure on the soft part of nostrils below the bridge of the nose for at least 10 minutes
• Encourage the student to breathe through their mouth while their nostrils are pinched
• Loosen tight clothing around the neck
• Place a cold cloth or cold pack over the student’s forehead and one around the neck, especially around the sides of the neck
• After 10 minutes, release the pressure on the nostrils and check to see if the bleeding has stopped
• If bleeding persist, seek medical aid
• Tell the child not to sniff or blow their nose for at least 15 minutes and not to pick their nose for the rest of the day. (Having a nose full of clotted blood is unpleasant and children in particular may find it difficult to avoid sniffing or nose blowing for a few hours. Fifteen minutes will at least give some time for the clot to stabilise.)
• Note Go to the doctor or a hospital emergency department if the bleeding does not stop after simple first aid management. It is important to find and treat the cause of ongoing bleeding.

Source Better Health Channel www.betterhealth.vic.gov.au

Abdominal pain
Abdominal (tummy) pain can be caused by a number of things, including gastro, a pulled muscle, period pain, nerves, excitement, worry, trapped wind or a lower urinary tract infection.

Most tummy pain is mild and will clear up without treatment. However, severe or persistent pain, especially when a child has other symptoms (such as a fever) requires close monitoring and may need further medical assessment.

Seek medical attention if the child’s pain is:

• severe and getting worse
• associated with bleeding from the bowel
• associated with difficulty swallowing
• associated with persistent vomiting.
• Note If a student has sudden, agonising pain in a particular area of their belly, seek medical help immediately. It may be a sign of a serious illness, such as appendicitis, that will rapidly get worse without treatment.

Source Health Direct Australia. www.healthdirect.gov.au

Bee sting
If a bee stings a student, remove the sting by sliding or scraping your fingernail across it, rather than pulling at it. Wash the area and apply ice to reduce the swelling. If the person has an allergy to bee stings, they can fall into a life-threatening state of anaphylactic shock. The only treatment is an injection of adrenaline. Immobilise the person, apply pressure to the bite and seek immediate medical help.

Note If a student is stung by a European wasp, first clean the affected area with soap and warm water, then apply an icepack to reduce swelling and pain. Use pain-relieving medication and creams. Be alert for signs of anaphylaxis.

Source Better Health Channel www.betterhealth.vic.gov.au

Asthma
Asthma Australia provides the following standard asthma first aid procedure, which is safe for both adults and children to follow:

• Sit the person upright — be calm and reassuring — do not leave them alone
• Give 4 puffs of blue reliever puffer medication — use a spacer if there is one — shake puffer — put 1 puff into spacer — take 4 breaths from spacer - repeat until 4 puffs have been taken. Remember: Shake, 1 puff, 4 breaths
• Wait 4 minutes — if there is no improvement, give 4 more puffs as above
• If there is still no improvement call emergency assistance (dial OOO) — say ‘ambulance’ and that someone is having an asthma attack — keep giving 4 puffs every 4 minutes until emergency assistance arrives. If calling Triple Zero (000) does not work on your mobile phone, try 112.
• Remember Call emergency assistance immediately: if the person is not breathing; if their asthma suddenly becomes worse, or is not improving; if the person is having an asthma attack and a puffer is not available; or if you are not sure if it’s asthma.
• Quick Tip Blue reliever medication is unlikely to harm, even if the person does not have asthma.

Source Asthma Australia www.asthmaaustralia.org.au

Sprains and strains
Sprains and strains are two types of soft tissue injury or damage. A sprain is a joint injury that involves tearing of the ligaments and joint capsule. A strain is an injury to muscle or tendons. First aid includes rest, ice, compression with bandages and elevation (RICE).

Suggestions for immediate treatment of acute sprains or strains include:

• Stop the activity
• Rest the injured area
• Use icepacks every two hours, applied for 15 minutes and separated from the skin by wet towelling
• Compress or bandage the injured site firmly, extending the wrapping from below to above
• Elevate (raise) the injured area above heart height whenever practical
• Avoid exercise, heat and massage, which can exacerbate swelling
• If symptoms get worse in the first 24 hours, see your doctor for further medical investigation.

Source Better Health Channel www.betterhealth.vic.gov.au

EMERGENCY
If a child stops breathing Cardiopulmonary resuscitation (CPR) is a first-aid technique that can be used if someone is not breathing properly or if their heart has stopped.

CPR involves chest compressions and rescue breaths that help circulate blood and oxygen in the body. This can help keep the brain and vital organs alive. If someone is not responding to you after an accident, injury, collapse, envenomation (bites and stings) or poisoning, and is not breathing normally (gasping is not normal breathing) then:

• Ensure you are not in danger then call triple zero (000) for an ambulance. If calling triple zero (000) does not work on your mobile then try calling 112. This number is only for mobile phones.
• Start CPR as soon as possible after calling for help. CPR involves the following steps:
• Danger – check for danger, for example power lines, snakes, spiders or traffic. Do not put yourself at risk
• Response – check if the person responds. Gently touch and talk to the person as though to wake them. If there is no response, get help
• Send for help – ring triple zero, (000) or (112) for an ambulance
• Airway – check airway is clear. Remove any obvious obstruction to the mouth or nose such as vomit, blood, food or loose teeth, and gently tilt head back and lift chin (except babies)
• Breathing – check if the person is breathing normally or not at all. If the person is breathing normally place them in the recovery position and wait for help. The recovery position helps to keep the unconscious person’s airway clear. By positioning the person on their side, with their arms and upper leg at a right angle to their body and the head gently tilted back and the chin lifted up, any saliva or vomit can drain out of their mouth and will help to ensure that the airway is open. If they are not breathing normally then start CPR
• CPR – CPR involves chest compressions and rescue breaths. Perform 30 chest compressions (almost 2 compressions per second) followed by 2 rescue breaths. Rescue breaths are performed during CPR for a person who is not breathing, and involves you taking a breath and blowing into the person’s mouth
• Defibrillate – attach an AED (automated external defibrillator) if available and follow the prompts.

Source Australian Resuscitation Council http://resus.org.au/