In recent years, the problem of accidental injury in children has become more and more prominent in our country. It has become the leading cause of death among children aged 0-14 years. The child mortality rate has exceeded the sum of the most deadly pneumonia, malignant tumor, congenital malformation and heart disease mortality rate. It accounts for more than 26% of the total child mortality rate. According to the survey, 61.2% of children’s accidental injuries in China occurred at home, including falls, falling 25%, burns/electric injuries accounting for 16.7%, sharp injuries accounting for 9.1%, drowning accounts for 5%, and poisoning accounting for 2.6%. In the summer, children’s accidental injuries have also entered a period of high incidence.
In order to better cope with high-risk summer safety accidents, our reporter interviewed Lu Mei, the chief of the Medical Education Training Section of Hangzhou Emergency Center. Dr. Lu said that in the event of an accidental injury, parents can minimize the level of child injury if they can take correct first-aid measures in the first place.
Children’s drowning alert “silent call for help”
Death from drowning is the first factor in the accidental death of children under 14 years of age. It is very important to create a safe and secure living environment for children.
●Preventing drowning: Parents’ companionship is the most important
The summer temperatures are high, and many children like to go to the river or play in the pool, which can both cool down and exercise. Dr. Lu reminded that children’s swimming needs to be supervised by parents. To ensure that children are within their own line of sight, try to choose a regular swimming pool with lifeguards. Do not let children go to unfamiliar waters, especially reservoirs, ponds, rivers. Waiting for swimming in the wild waters. Here, the water plants may be entangled in the feet, the gravel may scratch the feet, and the mud may trap the feet. Even if the child swims well, the risk is very high.
● When you find that your child is not right, you may be drowning.
Speaking of drowning, Dr. Lu talked about a drowning experience of his childhood. When she was young, she was at the riverside with her family. She mistakenly thought that there was a trail along the river and she fell into the water. She recalled that her consciousness in the water was still relatively clear, and she could hear the anxious call of the family on the shore, but she could not make a cry for help, and her body could not breathe in the water to attract attention. She could not speak until she was rescued from the water by her family.
The average person may be wondering: Shouldn’t the drowning person be slap in the water and scream? Then you may have been misled by the drowning plot in the film and television drama. Dr. Lu explained that when a person accidentally falls into the water, the instinctive reaction of the human body is to hold the breath. When the breath reaches the limit of human beings, the water will enter the airway and lungs of the drowning person, causing the drowning person to lack oxygen, heart and breath. Sudden stop. People can’t talk without breathing, let alone cry for help! A lot of drowning occurs in a silent state, especially when young children are even more unable to send a distress signal. Therefore, when the always cheerful children suddenly calm down in the water, parents should be vigilant. First, check if the child is drowning. If the child has loose eyes and ask the child, “Are you okay? Hear. See?” When you still can’t get a response, parents should quickly take the child to the shore for first aid.
● There is also the possibility of drowning at home
In many people’s impressions, drowning usually occurs in ponds, beaches, swimming pools, etc. Parents are paying more and more attention to this aspect of prevention. However, seemingly safe families are also frequent areas for children to drown.
Beads are one year old and two months old. At about 7:00 pm on the day of the incident, parents are preparing dinner in the kitchen. It takes four or five minutes before and after, and the mother can’t find beads in a blink of an eye. Mother shouted beads and looked for it. When the mother walked into the bathroom, she saw the beads be planted in the bathtub. There were bath water in the basin that had not yet been able to be dumped. Most of the beads were immersed in the water. Completely lost consciousness. Mom immediately picked up the beads and told her father to put the beads on the ground. Fortunately, the couple had learned a little first aid knowledge before, after dialing the first aid 120, the first time to do a cardiopulmonary resuscitation. It is these few minutes of cardiopulmonary resuscitation that saved the child’s life and reduced the risk of bead damage to the brain. After the bead was sent to the hospital, it quickly regained consciousness and the vital signs were basically stable.
It is not a lot of water, water depth will occur drowning, even if it is a small basin, small otter, once the child planted down to the water, or the water cover over the nose and mouth, especially young children, it may lead to drowning. At present, the world-recognized definition of drowning is “the process of immersion or immersion in the respiratory tract, causing respiratory disorders.” That is to say, the water depth during drowning may not exceed the height of the human body, and the shallow water is enough to kill the child! Some families have the habit of storing water and storing water. Buckets and baths that don’t look too big may be a safety hazard for children.
●If you lose your reaction after drowning, you will not breathe. The first time you do cardiopulmonary resuscitation, the water control will only delay the gold rescue time.
Some people will immediately stop the drowning person to control the water after the drowning person is rescued. This is actually a wrong way to rescue. It seems that the drowning person has discharged a lot of water, and it feels very effective. In fact, it does not help. Because the water is discharged only by the water in the stomach of the drowning person, the water can be completely excreted through the body excretory organs, and the real culprit – the water entering the airway and the lungs is difficult to discharge by controlling the water. The correct way is to check the drowning person’s reaction and breathing in the first time. If there is no reaction and breathing, you should do cardiopulmonary resuscitation immediately, because at this time, the unconscious drowning person needs the most breathing and heart beating. If the brain is hypoxic, More than 4 minutes will cause irreversible damage, so it is most important to grasp the golden rescue time.
Children fall into the building, don’t let the child become the falling angel
The era of the rise of high-rises has brought new security risks – falling from high altitudes. During the summer vacation, many parents are busy with work, have no time to take care of the children, give the children to the elders or the nanny to look after, and even leave the older children alone at home. Some families did not install the necessary fences on the balcony. Coupled with the children’s curiosity, they are active, like to climb high, it is easy to climb to the balcony, window and other places, which puts children in the building to lay a safety hazard.
Mr. Li’s family in Shenzhen had an accident when he went to see the house with his two-year-old daughter. According to Mr. Li’s wife, they led the sales staff to the 10th floor to see the house. They first went to the balcony to see the scenery. After a few minutes, they found that their daughter was gone, and several rooms were not found. Later, they discovered that the guardrail on the right side of the balcony did not have glass installed, and the little girl fell down on a platform between the first floor and the second floor.
In a residential area in Hefei, Anhui Province, a 5-year-old girl climbed the 25th floor window and accidentally fell to her death. After the incident, the residential property and the police rushed to the 25th floor, but saw another 3-year-old girl looking for a stool to climb the window.
In Changsha, Hunan, a 3-year-old boy fell from the 10th floor. After the residents of the community found it, they quickly rescued them. Fortunately, the child fell on the canopy of the fifth floor balcony and saved his life.
Many parents think that they are only a short time away from home for more than ten minutes. As long as the door is locked, the child will not have any major events. However, when a child sees an adult, he will be afraid. If he wants to go out and find an adult, he will find that the door cannot be opened. At this time, he will climb windows and balconies, causing a high-altitude accident.
Therefore, in order to avoid the occurrence of high-altitude tragedy, parents must do the following: First, don’t let the children stay at home alone. If there is no other person in the family to take care of, it is best to bring the child when they go out to do things. Don’t lock it at home. Second, the safety hazards in the home are excluded. These hidden dangers include balcony railings with excessive gaps, bay windows that are too low and unprotected, and balconies without anti-theft nets. Third, educate children on safety, raise children’s awareness of self-protection, and educate children not to play on the roof or balcony.
Children’s irreparable pain due to electric shock
On August 3, 2016, in the Longevity Mountain Scenic Spot in Kaifeng, Henan Province, the 11-year-old boy touched the water in a viewing pool. He was suspected of being hit by water by electric shock. The boy’s father and another relative went to the rescue and were also hit by electric shock. After the incident, the three were sent to hospital for treatment, and they were unfortunately killed because of the ineffectiveness of the rescue.
On August 24, 2017, two 8-year-old boys caught fish in the fountain in a district of Jinan City, Shandong Province. One of the children suddenly fell into the water after being suspected of electric shock. Although they were rescued, they were eventually killed by the rescue.
● Parents need to take protective measures to avoid children’s electric shock
According to the China National Center for Disease Control and Prevention and the Global Child Safety Network (China), the survey on children’s accidental injuries and parental cognition in China’s three major cities (Beijing, Shanghai, Guangzhou) shows that only 46.5% of parents believe that children There is a possibility of accidental injury. This is because, in the eyes of most parents, the risk of electric shock and the indiscriminate use of electrical appliances have been told to the children. They should be vigilant. In fact, most children don’t know what these hazards mean, and they don’t know how to avoid injuries. Therefore, parents should take appropriate protective measures and safety education in place to prevent children from electric shock.
● Tips for preventing children’s electric shock at home
An electrical outlet that can be protected with a protective function ensures that the latch is securely inserted into the outlet and the furniture is placed in front of the outlet to remind the child not to play nearby.
Keep the wires out of reach of the child and make sure the child can’t catch or bite.
Don’t put too many appliances in your child’s bedroom.
Tell your child not to turn the lights on, turn off the lights, and touch other electrical switches.
When thundering or lightning, turn off the radio, TV, etc., and tell your child not to touch the socket, electrical appliances and metal objects.
Do not put electric appliances such as hair dryers or curling irons in places where there is water. After all the appliances are used up, they should be unplugged in time to avoid contact with children.
●Electric emergency first aid essentials
Turn off the power When there is a child’s electric shock, we should find the power switch as soon as possible to ensure its own safety, and turn off the power switch. If you can’t find the power switch in the first time, you can find an insulated object, such as a dry branch, and pick up the child’s electrified items without touching the child to disengage the child. If it is high-voltage electricity, we should not approach easily, but inform the relevant power department, and then rescue the power after cutting off the power.
Before judging the vital signs, check whether the child has vital signs by judging the child’s consciousness and breathing. We can check the reaction by tapping the child’s shoulders and calling out loudly. If there is no response, call immediately and call 120. The phone, and people take the automatic external defibrillator (AED), and then observe whether he has breathing. The observation time is 5-10 seconds. If you find that the chest and abdomen are not undulating, you should immediately rescue him from cardiopulmonary resuscitation. Cardiopulmonary resuscitation can be performed in the order of chest compressions – open airway – artificial respiration. If the nearby AED is taken immediately, the AED combined with cardiopulmonary resuscitation patients will have more chances of survival.
If the chest compression is less than one year old, the child’s head should be held by one hand when the chest compression is performed, and the index finger and the middle finger of the first hand should be pressed together under the midpoint of the child’s breast connection, and the compression depth is three-thirds of the thickness of the chest wall of the child. One or so, about four centimeters, the frequency of pressing is 100-120 times per minute. If the child is over one year old, use one hand or both hands to press the center of the child’s chest vertically, and the lower part of the sternum is pressed 100-120 times per minute. Artificial respiration was performed after 30 times.
Before artificial respiration, the airway should be opened before the child’s head is reclined. Then the first-aid person wraps the child’s mouth with his mouth. If the child is younger (small mouth and nose), he can be mouth-to-mouth. Blowing. It takes 1 second for each mouth-to-mouth blow. When the air blows, the chest has obvious undulations. Blow 2 times, press 30 times, then blow 2 times, and cycle through 30:2 until the AED arrives and starts to use. AED, chest compression, artificial respiration combined with AED operation patients have a significantly improved chance of recovery.
Different rescue methods are used for people with different foreign body throats
On September 10, 2018, a tragedy occurred in a kindergarten in Yiyang, Hunan: a 4-year-old boy suspected a foreign body at the desk and tried to dig his own throat to save himself. The process lasted for nearly 3 minutes, and the children next to it didn’t know what happened and the teacher didn’t find it. It was not until the child was struck by the teacher that the teacher’s attention was noticed, but the child did not receive timely and appropriate assistance. When the child was taken to the hospital, everything was too late.
Food and foreign body throats are common in children who eat, or when they have foreign bodies, laughing, playing, or crying, often in children and the elderly. Because food or foreign matter is invaded in the glottis or falls into the trachea, causing suffocation or severe breathing difficulties, manifested as sudden coughing, inability to pronounce, wheezing, shortness of breath, and purple skin. In severe cases, loss of consciousness may occur rapidly. Breathing heartbeat stops. When the human body is severely hypoxic for 4 to 5 minutes, the brain cells begin to die, causing irreversible brain damage, which can lead to death if not treated in time. Once this happens, you should call for help immediately and have it on the spot.
●Adult or older children (over one year old) use Heimlich First Aid
What if the baby has a foreign body? Is it water? Feeding vinegar? Or something else? Everyone knows that the most common way for adults or older children (over one year old) to get stuck in a foreign body is the Heimlich first aid method. The specific process is as follows:
The rescuer stands or kneels behind the patient and surrounds the patient’s waist with both arms.
With a fist in one hand, the thumb side of the fist is pressed against the midline of the patient’s umbilicus and under the sternum.
Grab the hand of the fist with the other hand, press the patient’s abdomen upwards quickly, and repeat the above techniques until the foreign body is discharged or the patient becomes abnormal.
● For conscious infants, use a back slap combined with a chest slamming method.
Back slap method: (Figure A) The first aid puts the baby’s body on one side of the forearm, fixes the baby’s mandibular angle with the other hand, and gently lowers the baby’s head, opens the airway, and palms The roots slammed the baby’s back between the shoulders and the shins five times inward.
Chest slamming method: (Figure B) The first-aider puts the baby’s body on the forearm on one side in a supine position, while the palm rests the back and neck, the head is lower than the torso, and the baby’s two nipples are quickly pressed with the index and middle fingers. 5 times below the connection.
A and B can be repeated until foreign matter is discharged.
● Cardiopulmonary resuscitation is required when the baby does not respond.
When an infant with airway obstruction becomes unresponsive, you need to stop taking the back immediately, start cardiopulmonary resuscitation, and check the foreign body in the mouth and remove it before each airway is opened.
Nearly available “life-saving artifacts”
Within four minutes of the rescue of the gold, if the patient can get the electric shock defibrillation therapy, the heart will be beaten, which will greatly improve the success rate of the rescue. Automatic external defibrillator (AED) began to enter our lives. In the city’s airports, stations, shopping malls, grassroots communities and other crowded public places, AED became the standard for accident rescue. When an accident occurs, we can quickly find nearby AED equipment through “Mobile WeChat – I – Payment – City Service – City Emergency Center – AED Navigation” to timely defibrillation of patients. On April 19 this year, a man suddenly fell to the ground during the check-in at Hangzhou East Railway Station. He was rescued by the emergency rescue of the AED defibrillator.
The AED is used as follows:
Once the AED arrives, use the AED immediately, power it on and follow the AED’s voice prompts.
When the AED analyzes heart rhythm and defibrillation, the rescuer must ensure that the patient is not exposed.
Cardiopulmonary resuscitation begins immediately after defibrillation or without defibrillation until 2 minutes after the AED analyzes the heart rhythm or emergency personnel arrive.
In case of accidental injury, dial 120 at the first time and follow the instructions of the dispatcher.
Speaking of the previous first-aid experience, Dr. Lu remembered the accidental injury of the little girl who happened in the Nanyuan Community in Hangzhou on June 2. According to the first-aid colleague at the time, after the electric shock accident occurred, the little girl did not call 120 for the first time, but called the person who knew the medicine in the mobile phone address book to call for emergency. After receiving the timely assistance, I remembered calling 120, which delayed the gold rescue time.
Dr. Lu said that in the event of accidental injury, the first time must be dialed 120. 120 dispatchers will send different ambulances at the same time, according to the caller’s complaint to enter different emergency plans. The caller must patiently answer the questions asked by the dispatcher. The Medical Priority Scheduling Rating System (MPDS) will judge the condition based on the answer, so that the dispatcher can give timely and effective medical guidance to the caller to maximize the success of the treatment. rate.
At the beginning of this year, Mrs. Wang, a resident of Sandun, a resident of Xihu District, Hangzhou, suffered from sudden illness and fell to the ground. After dialing the first aid 120, Mr. Wang made a chest compression for his wife according to the instructions of the wiring staff. Although Mr. Wang was the first to do cardiopulmonary resuscitation, he was very flustered. Under the guidance of the operator, Mr. Wang continued to give first aid. On the way to the hospital where the ambulance staff sent Mrs. Wang to the hospital, Mrs. Wang finally recovered her heartbeat. According to the rescue doctor, it was fortunate that Mr. Wang did a cardiopulmonary resuscitation for him, which laid a good foundation for the success of the later rescue. Dr. Lu said that even those who have no first-aid experience, as long as they are willing to actively cooperate with the dispatcher’s first-aid guidance, even if the first-aid action is not standardized, it can play some role, and win valuable rescue for the emergency personnel who came later in the critical moment. Timing can improve the chances of survival for patients.