How to administer first aid to children

If your child (or someone else's) was unconscious, had stopped breathing, was choking, having an asthma attack or any of the other scary medical crises listed here, would you be confident you'd know what to do? If you're not absolutely sure, then you need this top 10 of first aid skills that every parent ought to know.

All the information here is supplied by St John Ambulance.

For clarity, we've referred to the child or adult in question as male. And where the techniques are the same for adults, we've made that clear.

Choking | Bleeding | Unconscious but breathing | Unconscious but not breathing | Poisoning | Seizures | Anaphylactic shock | Asthma attack | Shock | Burns
 

1. Choking in a child (aged over one) or adult

• Encourage him to cough. If this doesn't clear the obstruction, support his upper body with one hand and help him lean forward.
• Give up to five sharp back blows between his shoulder blades with the heel of your hand.
• If the obstruction has not cleared, stand behind him and put both arms around the upper part of the abdomen.
• Clench your fist and place it between the navel and the bottom of his breastbone.
• Grasp your fist firmly with your other hand.
• Pull sharply inwards and upwards up to five times.
• If this doesn't clear the obstruction, repeat backslaps and abdominal thrusts up to three times.
• If it still hasn't cleared, call 999/112 for emergency help. Continue until help arrives.
   

Choking baby (under one year)

• If the baby is unable to cry, cough or breathe, lay his face down along your forearm, with his head low. Support his back and head. Give up to five back blows with the heel of your hand.
• Check the baby's mouth. Use your fingertips to remove any obvious obstructions. Do not sweep the mouth with your finger as this may push the object further down the throat.
• If the back blows fail to clear the obstruction, turn the baby onto his back and give chest thrusts. Using two fingers push inwards and upwards against the baby's breastbone, one finger's breadth below the nipple line.
• Do up to five chest thrusts. Check the mouth. If the obstruction has not been removed, repeat back blows and chest thrusts.
• If the obstruction has still not cleared, take the baby with you and call 999 for emergency help. Continue until the ambulance arrives or the infant loses consciousness.
   

2. Severe bleeding (adult, child and baby)

• Apply direct pressure over the wound with your hand using a clean dressing. If you don't have a dressing, and you are dealing with an older child or adult, ask him to apply pressure himself. This allows you to: 
  a) reduce the risk of cross-infection
  b) maintain pressure while you are getting your dressings out and preparing them to use and
  c) it gives the casualty something else to focus on other than the blood and pain.
  If it's a baby then obviously you can't do this but you still need to try and maintain pressure on the wound until you have a dressing in place. Essentially this means working quickly to get the dressing on. As practice is required for this to be done effectively, in an ideal scenario you'll have had first aid training.
• Maintain direct pressure on the wound to control bleeding.
• Help him lie down.
• Raise and support the injured limb above the level of him heart to reduce blood loss.
• Raise legs to ease shock.
• Call 999/112 and monitor him while waiting for help to arrive.
   

3. Dealing with a child (aged over one) or adult who is unconscious

• If he's unconscious, check his airway is open and clear.
• Tilt the head and lift the chin to open the airway.
• Look along the chest, and listen and feel for breaths.
• If he is not breathing, his heart will stop. CPR must be started immediately.
   

Recovery position if breathing

• If spinal injury is not suspected, put them in the recovery position.
   

Dealing with a baby (under one year) who is unconscious

• Cradle the baby in your arms with his head tilted downwards to prevent him from choking on his tongue or inhaling vomit.
   

4. Dealing with a child (aged over one) who isn't breathing – CPR

• If he's unconscious, check his airway is open and clear.
• Tilt the head and lift the chin to open the airway.
• Look along the chest, and listen and feel for breaths.
• If he is not breathing, his heart will stop. CPR must be started immediately.
• Call for help.
• Tilt his head back with one hand and lift the chin with two fingers of your other hand to ensure the airway is open.
• Pinch his nose to close his nostrils. Take a breath and seal your lips over his mouth and blow gently for one second until his chest rises.
• Maintaining the head tilt and chin lift, take your mouth away from his. Look along the chest and watch it fall.
• Give FIVE initial rescue breaths.
Lifesaver is a free app that blends live-action film with interactive features to help you learn CPR (for adults) on your computer, smartphone (Apple, Android) or tablet (Apple, Android). 

The Lifesaver app comes from The Resuscitation Council, a medical charity that produces the official UK guidelines for CPR that are followed by the NHS.
• Kneel next to the child's chest and place one hand at the centre of his chest where you will apply pressure.
• Lean over the child with your hand vertical on the breastbone with the heel of your hand.
• Give 30 compressions at a rate of 100 per minute.
• Return to the child's head, open the airway and give two more breaths.
• Continue CPR until emergency help arrives, he starts to breathe normally or you're too exhausted to continue and have no-one else who can take over.
   

Dealing with a baby (under one year) who isn't breathing – CPR

• Place the baby on a flat surface. Open the airway by placing one hand on the forehead and one fingertip from the other hand under tip of the chin.
• Place your lips around his mouth and nose to form a seal. Blow steadily until the chest rises.
• Take your mouth off the baby's, while maintaining the head tilt and see the chest fall.
• Give FIVE rescue breaths.
• Place two fingertips on the centre of his chest. Press down vertically on the breastbone by one-third of its depth.
• Release the pressure but keep the fingers on the breastbone.
• Repeat to give 30 chest compressions at a rate of 100 per minute.
• Return to the baby's head, open the airway and give two more breaths.
• Continue CPR until emergency help arrives, he starts to breathe normally or you're too exhausted to continue.
   

5. Poisoning

Poisoning can lead to vomiting, impaired consciousness, abdominal pain, seizures and/or an irregular or slow heartbeat. Look for plants and berries or empty or used containers etc in the vicinity.

• If he is conscious, try to reassure him.
• Dial 999 for an ambulance. Give as much information as possible about the swallowed poison. This information will assist doctors so they can give appropriate treatment once you reach hospital.
• If the poison looks as though it is burning his lips then try to give him small sips of water.
• Never attempt to induce vomiting as this can lead to further damage.
• If he becomes unconscious, open the airway and check breathing. If he's breathing, he can be placed in the recovery position but if he's not breathing then you need to start CPR, using a face shield (or a barrier such as a plastic bag with a hole in it) to protect your mouth.
   

6. Seizures

In young children, seizures are most often the result of a raised body temperature associated with an infection.

• Place pillows or soft padding around the child so that even violent movement will not result in injury. Do not restrain the child in any way.
• Cool the child by removing any bedding and clothes, eg t-shirt or pyjama top; you may have to wait until the seizure stops.
• Ensure a good supply of fresh air but don't overcool the child.
• Once the seizures have stopped, maintain an open airway by placing the child in the recovery position. Call 999 for emergency help.
• Reassure and monitor.
   

7. Anaphylactic shock

• Call 999/112 for emergency help. Tell the ambulance control person that you suspect anaphylaxis.
• Offer reassurance and help him to sit up in a position that relieves any breathing difficulties. If he becomes pale or his pulse weakens, lie him down with legs raised as for shock.
• Monitor until help arrives.
   

8. Asthma attack

• If he already has a reliever inhaler – usually blue – help him use it. If this is his first attack, call an ambulance.
• It's really important that you keep calm and reassure him, staying with him to stop his panicking.
• Sit him upright and slightly forward, encouraging him to take slow breaths.
• Call an ambulance if the inhaler has no effect, if he's finding it difficult to talk, or if he's becoming exhausted.
   

9. Shock

• Shock is a life-threatening condition. If there's an obvious cause, like burns or bleeding, treat that first if you can.
• Reassure him and lie him down. Raise his legs above the level of his heart. Keep him warm with a blanket and dial 999 for an ambulance.
   

10. Burns

• Immediately cool the area under running water for at least ten minutes while gently removing any jewellery, watches or clothing from the area before it begins to swell.
• Cover the burn with clean, non-fluffy material to protect from infection - a clean plastic bag or loose cling film make good dressings.
• With babies or young children you should always seek medical advice if you're at all concerned.
• If it's severe, call an ambulance while you're cooling the burn and treat for shock; raise the legs if possible, and keep him warm, comfortable and reassured until help arrives.

St John Ambulance is committed to ensuring everyone has the basic first aid knowledge which could save someone's life. To get your free pocket-sized guide, just text LIFE to 85010 or visit the St John Ambulance website for more information. You can also get advice on your iPhone with the St John Ambulance first aid app.

*Research conducted by ICM, Feb 2010, using a weighted sample of 2045 adults aged 18+.

All the advice supplied and checked by St John Ambulance in May 2010.

Disclaimer: All the advice here is provided for general information only, and should not be treated as a substitute for the medical advice of your own doctor or any other health care professional. Mumsnet is not responsible or liable for any diagnosis made by a user based on the content on Mumsnet. Always consult your own GP if you are in any way concerned about your health.