Supplementary material to be used in role play

1. From CHILD HEALTH Questions You May Ask

What should be done if a child falls from a height?

If a child falls from a height first thing you should do is to see whether he gets up on his own and comes to you crying or if he has got superficial injury and cries for a while. In both these situations there may not be much damage. But if a child lies there without wanting to get up or becomes unconscious, then it is serious. I am afraid you will have to consult your doctor. If there is an injury do not massage it. You could do a lot of damage by massaging and setting it in the wrong direction.

 

If a child gets burnt with hot water, what can be applied before he is seen by the doctor?

The degree of the burn will decide the nature of the treatment. If there is some redness of the skin no treatment is required. But if the redness is pronounced and becomes more than a slight patch, it may lead to vesication and finally it may cause an open wound. In such case nothing is applied on the wound, the clothes are removed so that they do not rub against it or get stuck to it. If some material has stuck, do not try to remove it forcibly, take the child to the hospital at the earliest possible. Again in the case of burns, the damage is done not only by the bum wound itself, but also by the fluid loss from the burns. It is very necessary that the infection of the wound be avoided. So dirty clothes should not get into the wound and medical attention should be sought at the earliest.

In case of an ordinary burn, if cold water is applied immediately it may prevent vesication and is soothing as well. So ordinary cold water is the best first aid one can use.

 

If a child swallows a fish bone or a pin, what should be done?

Any obstruction, whether by a fish bone or by a pin or any other article, will make the child choke if it is in his respiratory passage. If it comes down through the food pipe it may be passed out in the stool. But in case of choking at times the calamity may be avoided by putting the child upside down. It is a very serious condition. Call the doctor at once.

 

What would you advise in case of an animal bite?

If the bite is by a small insect, then there may be swelling of the affected part which will subside on its own, in a few days time. But if it is superficial and causes cosmetic or other worries then you may ask your doctor, and he will give you an anti-allergic drug for the swelling to subside.

But if the bite is by a snake, then I would suggest you to take the child immediately to your local doctor for observation. If the bite is on the arm or the leg, it is advisable to tie a tight bandage above the wound and take the patient to the hospital as soon as possible. Besides it is necessary to kill the snake and take it along so that the doctor can decide if it was poisonous or not.

If the bite is by a dog it will have to be observed. If the dog is alive nothing should be done. If the dog dies within ten days I am afraid you will have to give the child a whole course of anti-rabic injections, If the bite is by a stray dog or if you could not keep the dog under observation for ten days, it will have to be treated like the bite of a rabid dog.

As far as the local wound is concerned it needs to be cleaned with some antiseptic solution after being washed with soap and water. Any antiseptic solution which you may have ready at home could be used.

 

What is food poisoning? How do you know it?

Food poisoning means that the child has taken food, which is infected and will lead to diarrhea and/ or vomiting. Any child who becomes sick after eating something and has diarrhea or vomiting should be suspected of food poisoning. This needs treatment in a hospital, as it could be serious.

 

Please tell us what should be done when a child falls down and has cuts and bruises.

If a child does not fall, he will never grow up, and if he falls it's natural to get cuts and bruises. If a child has bruises, I would suggest you press them with ice or cold water, with this the pain will be less and the bruise will become localized. If he gets a cut from which there is some oozing of blood, it is again necessary to apply ice on top. With this the oozing will stop and so will the pain. Even if there is a lot of bleeding, it is advisable to tie a tight bandage two inches above the wound if it happens to be on the limbs. This bandage should not be kept for more than 10 to 15 minutes, and the child should be taken to the doctor. For minor cuts, I would advise you to wash them with soap and water and apply some ice to reduce the pain and bleeding.

 

If a child puts a pin in his ear or has an insect in the ear, what should be done?

Pin in the ear is a serious problem. I will not advise you to put anything in the ear to take it out. Any attempt on your part to remove it may push it further inside and perforate the eardrum. So take him to the doctor who can remove it with care.

In case of a small insect getting into the ear, put any oil into the ear so that the insect dies, and when the child inverts his ear, the insect come out. Sometimes the insect may be dead and stuck up inside the ear. Take the child to the doctor for getting it out. Please do not try to remove the insect yourself with a pin etc.

 

If a child swallows sleeping-pills, what is to be done?

Sleeping-pills are dangerous. They depress the respiration. Hence if you can make the child vomit, make him do so and then take him to the hospital at the earliest so that his respiration can be watched and treated.

 

If a child swallows strong alkali or acid, what is to be done?

Strong acids and alkali are dangerous and the only thing you can do at home is to avoid vomiting. Take the child to hospital as fast as possible. If you have vinegar at home, you can give a teaspoon in alkali poisoning. With acid poisoning a teaspoon of baking soda can be given, but in both these conditions the child must be taken to the hospital immediately.

 

If a child swallows aspirin, what is to be done?

Aspirin is a dangerous drug. I suggest you make the child vomit as quickly as possible and take him to the hospital at the earliest possible. Let the doctor decide the line of treatment.

 

Could you tell us some more about drug poisoning in general?

Lots of the drugs which are stored at home like pain-relievers or sedatives, are used by the family frequently. These are the drugs which the child may swallow. With all these drugs, unless they are strong acids or alkali, it will be advisable to make the child vomit and take him to the hospital at the earliest possible so that the child can be seen and advised in regard to that particular poisoning. All the drugs should be kept locked up and out of the reach of the child. Many of these accidents happen because of the carelessness of the adults and can be prevented.

 

If a child swallows soap or alcohol, what should be done?

If a child takes in some soap, it is a mild alkali and hence if you have some vinegar at home, make him drink it with some water, otherwise nothing needs to be done. If the quantity is large, the child will vomit it himself.

If he swallows some alcohol, a small amount will make him very active, and nothing needs to be done, since this stage will pass off and the child will sleep after this. If it is a large quantity, the child will either vomit it out himself or you can make him vomit, and then let him sleep it off.

 

2. First fill in the gaps with: must, should, must have, should have, could, will have to, then play the parts of the doctor and the patient:

                                               At about 2 o'clock on a cold winter night a man telephoned a doctor and asked him if he... come at once. "You... hurry", he added. The doctor drove seven miles in answer to this call. When he reached the place the man who had called him in said, "Doc, I... overtired myself. I have not got any pain, but I have a terrible feeling that I... die soon". The doctor examined his patient, felt his pulse and took his temperature. "Have you made your will*?" he asked. "Why, no, Doctor» the man looked frightened. "You... done it long ago'" said the doctor. "Have you got a family?" "Yes," said the patient. "You must send for them immediately, and your parents... be called, too." "I say, Doc, do you think I'm going to die?" "No, I don't," responded the doctor, "but I don't want to be the only man you have made a fool of on the night like this". *will - завещание

 

 

3. SOME ADVICE ON FIRST AID IN AN EMERGENCY

CHOKING

A foreign object sticking at the back of the throat may cither block the throat, or induce muscular spasm. This is known as choking. Adults may choke on a piece of food that has been inadequately chewed and hurriedly swallowed. Young children like putting objects inside their mouths; boiled sweets are a particular danger.

RECOGNITION There will be:

• Difficulty in speaking and breathing. There maybe:

• Blueness of the skin (cyanosis).

• Signs from the casualty - pointing to the throat, or grasping the neck.

TREATMENT

YOUR AIM IS:

• To remove the obstruction and restore normal breathing.

FOR AN ADULT

1 Reassure the casualty. Bend her forwards so that her head is lower than her chest.

2, Give up to five sharp blows to her back, between the shoulderblades, with the flat of your hand.

3. If backslaps fail, try abdominal thrusts. The sudden pull up against the diaphragm compresses the chest, and may expel the obstruction.

IF this does not free the blockage, try again four times, then alternate five back blows with five thrusts.

IF the casualty becomes unconscious, treat as described opposite.

 

FOR A CHILD

Place the child over your knee, head down. Slap him between the shoulder-blades, using less force than for an adult.

IF back blows fail, use the abdominal thrust only if you have been trained to do so on a child. Otherwise begin resuscitation.

 FOR A BABY

Lay the baby along your forearm. Slap her between the shoulder blades, using less force than for a child.

IF the baby becomes unconscious, begin resuscitation.

DO NOT use the abdominal thrust.

FOR A CASUALTY WHO BECOMES UNCONSCIOUS

1.  Loss of consciousness may relieve muscle spasm, so check first to see if the casualty can now breathe. If not, turn her on her side and give 4-5 blows between her shoulder blades.

2. If back blows fail, kneel astride the casualty, and perform abdominal thrusts.

Put the heel of one hand below the ribcage, and cover it with the other hand. Press sharply inwards and upwards up to five times.

IF she starts to breathe normally, place her in the recovery position and call an ambulance. Check and record breathing and pulse rate every 10 minutes.

IF she does not start tobreathe again, dial 999 for an ambulance and start resuscitation

 

FEVER

A sustained body temperature above the normal level of 37"C (9§.6°F) is known as fever, and is usually, though not always, caused by infection (by bacteria or viruses). Conditions associated with a high temperature include influenza ('flu), chicken pox, measles, meningitis, and local infections (for example, an abscess).

When to call a doctor A moderate fever is not harmful, but a temperature of above 40 C (102°F) can be dangerous, and may trigger fits in infants and young children. Call a doctor, even if only for advice, if in doubt about the casualty's condition.

RECOGNITION

There will be:

• Raised under-the-tongue temperature. In the early stages, there may be:

• Pallor.

• A "chilled" feeling - goose pimples, shivering, and chattering teeth.                    As the fever advances there may be:

• Hot, flushed skin, and sweating.

• Headache.

• Generalized "aches and pains".

• Raised armpit temperature

TREATMENT

YOUR AIMS ARE:

• To make the casualty comfortable.

• To bring down the fever.

  To seek medical aid, if necessary.

1. Make the casualty comfortable in surroundings that are evenly warm, preferably in bed, and let her rest.

 If the fever is very high, or if the casualty is a young child, cool by sponging with tepid water.

2.  Give the casualty plenty of bland fluids to drink. A small "hot toddy" may comfort an adult and may induce restful sleep. Give no more than one double measure of spirits.

3. An adult may take two paracetamol tablets. A child may be given the recommended dose of paracetamol syrup (not aspirin), and should be sponged with tepid water to lower the temperature.

 

HEADACHE

A headache may accompany any illness, particularly a feverish ailment such as 'flu, but may be the most prominent symptom of some serious condition (for example, meningitis or stroke). Mild "poisoning" by a stuffy or fume-filled atmosphere, or by unwise consumption of alcohol or other drugs, can induce a headache in an otherwise healthy person. Headaches may develop for no apparent reason, but can often be traced to tiredness, nervous tension, stress or emotional upset, or undue heat or cold.

TREATMENT

YOUR AIMS ARE:

• To relieve the pain.

• To seek medical aid if necessary.

 

1. Help the casualty to sit or lie down comfortably in a quiet place.

2. If possible, deal with any likely cause of the headache, such as loud noise, bright light, or lack of fresh air.

Headaches range from constant low-grade discomfort to "blinding" pain that is completely incapacitating.

When to call a doctor

Always seek urgent advice if the pain:

• Develops very suddenly.

• Is severe and incapacitating.

• Is recurrent or persistent.

• Is accompanied by impaired consciousness, or loss of power or sensation.            • Is accompanied by a stiff neck.

• Follows a head injury

 

Migraine

Many people are prone to these severe, "sickening" headaches. They can be triggered by a variety of causes. Migraine sufferers usually recognise, and know best how to deal with, an attack. They may carry special medicines.

RECOGNITION                                                                                                   Migraines usually follow a pattern:

• There may be a warning period with disturbance of vision, in the form of flickering lights and/or a "blind patch".

• An intense throbbing headache, which may be one-sided, may develop.

• There may be discomfort in the upper abdomen, nausea, and vomiting.

• The casualty cannot tolerate any bright light or loud noise.

TREATMENT

What you can do

Treatment is as for any headache, but help the casualty to take any special medication he or she may have (tablets or nasal sprays) and provide towels and a container in case he or she is sick.

3. An adult may take two paracetamol tablets, or her own painkillers

IF the pain does not ease within two hours, or if you are worried about the casualty's condition, call a doctor.

 

HOUSEHOLD POISONS

Almost every household contains poisonous substances, such as bleach, paint stripper, glue, paraffin, and weedkiller, which can be spilled, causing chemical bums, or swallowed. Children in particular are at risk from accidental household poisoning.

 

Preventing poisoning in the home

• Keep dangerous chemicals out of children's reach (not under the sink).

• Keep medicines in a locked cupboard.

• Leave poisonous household substances in their original containers - never put them in old soft-drinks bottles.

• Buy medicines and household substances in tamper-proof containers.

 

TREATMENT

YOUR AIMS ARE:

• To maintain airway, breathing, and circulation.

• To obtain medical aid.

• To identify the poison.

 

FOR CHEMICALS ON THE SKIN

1. Wash away any residual chemicalon the skin with plenty of water. Make sure the water drains away from the casualty.

DO NOT contaminate yourself with the dangerous chemical or the rinsing water.     2. Use your judgement to call a doctor or dial 999 for an ambulance. Give information about the spilled chemical

 

FOR SWALLOWED POISONS

1.Check and, if necessary, clear the airway.

 The recovery position lessens the risk of vomiting.

IF the casualty is unconscious, check breathing and pulse, and be prepared to resuscitate. If artificial ventilation is necessary, a plastic face shield will protect you if there is burning around the mouth. Place the casualty in the recovery position; she may well vomit.

DO NOT try to induce vomiting.

2. Use your judgement to call a doctor or dial 999 for an ambulance. Give information about the swallowed poison.

IF a conscious casualty's lips are burned by corrosive substances, give her frequent sips of cold water or milk.

 

ALCOHOL POISONING

Alcohol (ethanol) is a drug that depresses the activity of the central nervous system. Small quantities generally produce only a slight change of mood. Prolonged intake can result in all physical and mental abilities becoming severely impaired, and deep unconsciousness can ensue.

Dangers of alcohol poisoning

• An unconscious casualty is in danger of inhaling and choking on vomit.

• Because alcohol dilates the blood vessels, hypothermia may develop if the casualty is exposed to the cold.

• A casualty with head injuries who smells of alcohol may be misdiagnosed.

RECOGNITION

There may be:

• A strong smell of alcohol.

• Unconsciousness. The casualty may be reusable, but will quickly relapse.

• A flushed and moist face.

• Deep, noisy breathing.

• A full, bounding pulse.

In the later stages of unconsciousness:

• A dry, bloated appearance to the face.

• Shallow breathing.

• Dilated pupils that react poorly to light.

• A weak, rapid pulse

 

TREATMENT

YOUR AIMS ARE:

• To maintain an open airway.

• To seek appropriate medical attention.

 

1.  Check the casualty's level of response. Carefully shake his shoulders and shout at him to see if he responds. Shake and shout^ “Can you hear me?” or “Open your eyes!”

IF the casualty is unresponsive, check breathing and pulse, and be prepared to resuscitate if necessary. Place him in the recovery position.

2. Use your judgement to call a doctor or dial 999 for an ambulance.

3. Protect the casualty from the cold; insulate him from the ground, and cover with a coat or blanket.

 

POISONOUS PLANTS

Although there are relatively few poisonous plants in the United Kingdom, they can cause serious illness if eaten. Young children are most at risk, as they are

attracted to brightly coloured berries and seeds, and are liable to eat them.

 

PLANTS THAT ARE POISONOUS IF SWALLOWED: mushrooms (death cap, brown roll rim, spotted fly agaric, Cortinarius speciosissimus (often mistaken for the edible chanterelle); seeds, bulbs, and rhizomes (Laburnum, Lupin, Daffodil, Iris); berries (deadly nightshade, holly, laurel, mistletoe, yew, wild arum (lords-and-ladies).

TREATMENT

YOUR AIMS ARE:

• To maintain airway, breathing, and circulation.

• To obtain medical aid.

DO NOT try to induce vomiting. It is often ineffective, and may harm the casualty further.

I. Check and, if necessary, clear the airway.

IF the casualty is unconscious, check breathing and pulse, and be prepared to resuscitate if necessary. Place the casualty in the recovery position: he or she may well vomit.

2. Use your judgement to call a doctor or dial 999 for an ambulance. If in doubt, always call an ambulance.

3. Try to identify the plant, and which part of it has been eaten. Preserve pieces of the plant, and samples of any vomited material, to show the doctor or send with the casualty to hospital.

 

                                     PART IV

                  FIRST AID ACTIVE VOCABULARY