How to deal with accidental injuries?| Summer vacation is here

The summer vacation is here, and children's accidental injuries have also entered a high incidence. In the face of 6 non -intentional injury incidents commonly in children, how to do a good job of emergency treatment? Look down together-

Non -intentional damage cannot be ignored

Children's damage includes non -intentional damage and intentional damage, of which non -intentional damage accounts for about 95%. For a long time, non -intentional damage has become a key area for public health due to its high disability and high mortality. Compared with adults, children and adolescents have more risks to hurt. The "Chinese Children's Development Outline (2021-2030)" lists the prevention and treatment of children's injury as one of the main goals.

How to deal with children's non -intentional damage

1

Drowning

In our country, the top two of the cause of drowning in children's death are high and the disability rate is very high, causing serious families and social burdens. The length of the drowning time and the long time from rescue to success determine the prognosis of the child.

Once a child is drowning, in addition to calling for help in time and calling the "120" first aid phone, you should let the drowning children leave the water as soon as possible. If it is an outdoor open waters such as rivers and lakes, people with rescue capabilities should be found as soon as possible. Those who do not have the ability to rescue cannot enter the water for rescue without authorization. It should be stretched out of the branches, ropes, swimming rings or other floating objects to the drowning place to help them float or pull out the water surface. In particular, when children find someone drowning, they must not be rescued without authorization. They should call for help in time.

After the drowning person is separated from the water, do not perform any form of water control to avoid delaying the rescue and cause bad prognosis. First of all, the consciousness, autonomous breathing and pulse of the drowning person should be judged.

If the drowning person has consciousness, autonomous breathing and pulse, you can dry his body, keep warm, and wait for rescue.

If the drowning person is lost, but has autonomous breathing and pulse, you should open the airway, clean up foreign objects such as miscellaneous objects in the mouth and nose cavity, and put the drowning person in the side lying position to prevent suffocation after vomiting. At the same time, dry the drowning Pay attention to warmth, closely observe the breathing and pulse, and start the cardiopulmonary resuscitation at any time.

If the drowning person is unconscious and the effects of effectively breathing and pulse disappear, the rescuer should immediately open the airway for it, clean up the internal and nose internal objects, and start cardiopulmonary resuscitation.

It should be noted that drowning people often have hypoxia. Rescuers should first give them 5 artificial respiration, and then press the heart and lung recovery of the heart and lungs by 15: 2 or 30: 2, and ensure that it is guaranteed to ensure that the cardiopulmonary resuscitation is performed, and it is guaranteed to ensure that it is guaranteed. There is a thoracic fluctuation during artificial breathing. So how to choose for children with drowning 15: 2 or 30: 2? Specifically, when the single -person recovery, the proportion of presses outside and artificial breathing should be 30: 2; if the double recovery (one person is responsible for prespingling outside the heart, one person is responsible for manual breathing), the ratio should be 15: 2.

It is worth noting that most drowning people will have low temperature, so they should remove wet clothes as soon as possible without affecting the cardiopulmonary resuscitation, dry their bodies, and keep warm.

2

scald

Scald is a tissue damage caused by hot liquid, steam, etc., and is a type of heat burns.

During the summer vacation, the child is thin and the skin is more exposed. Once it is scalded by hot rice, boiling water, etc., it is prone to burns. Once the child is found to be burned, the caregiver should first quickly let the child from getting away from the heat source, remove the cause of heat damage, and reduce the injury as much as possible.

After the environment is safe, the caregiver should first judge the child's state of consciousness and call the "120" first aid call; then judge the child's breathing and pulse conditions. If necessary, start the cardiopulmonary resuscitation as soon as possible. If the consciousness is clear, it can be used for partial treatment with the method of "rushing, taking off, bubble, cover, and sending".

Chong: After leaving the heat source, immediately use tap water or clean water to rinse the injury to cool down. Payment should be performed within 3 hours after burning. Because even if the temperature of the injury is still high, the local temperature is still high, and it needs to cool down as soon as possible to reduce its damage to the deep tissue. For parts that should not be washed, you can use warm water to cool down. It usually takes 15 to 20 minutes. Do not use ice cubes to cool down, and the temperature is too low may cause secondary damage.

Take off: After the cooling water cools down, you can gently remove the child's clothing. If it is difficult to remove, you can cut it with scissors. If the clothing and the skin are sticking together, you must not be pulled forcibly to avoid aggravating damage to the skin, and you can treat it further after medical treatment.

Bubble: After removing the heat source, if the blister is not broken, there is still pain in the injured area, so you can continue to soak or apply cold water until the pain is relieved to reduce the damage and pain caused by the thermal effect.

Cover: After the aforementioned operation is completed, the wound can be covered with gauze or clean cloth to avoid pollution.

Send: In severe cases, they should be sent to medical institutions with ability to treat.

Do not apply any substances that have no exact treatment effect on the surface, such as soy sauce, vinegar, sesame oil, toothpaste, honey, etc., so as not to affect the doctor's judgment of the wound or cause wound infection. If blisters occur, do not cut it by yourself. If the blisters have been damaged, they should also keep the blister completely as much as possible.

3

Mistake administration (poison) object

Mistakening is one of the common non -intentional injuries for children. In addition to being curious, it is not uncommon for children to take the wrong drug dose or the name of the drug because of the misleading.

Once the drug is taken by mistake or excessive, the caregiver should calm down and clarify what medicine (poison), how much they eat, and taking time, and bring residual drugs, vomit, medicine bottle and/or outer packaging. Take your child as soon as possible. If you are non -corrosive drugs, you can drink more water for your children as appropriate. It is not recommended to spitting routine, especially children with unclear consciousness or convulsions. The drugs taken in the interior can allow them to drink plenty of water and try vomiting, but the movements should be soft to avoid local damage. If you eat corrosive items (such as cleaning toilet spirit, pipeline dredging agent), etc., you must not spitting, nor should you drink a lot of water, milk or other drinks, and seek medical treatment immediately. If the child's intake of drugs or poisons, nausea, vomiting, abdominal pain, diarrhea and other digestive tract symptoms, asthma, cough and other respiratory symptoms, when the nervous system symptoms such as unclear, drowsiness, irritability, and convulsions should bring it. Just seek medical treatment in time.

If the child is lost in consciousness, but the autonomous breathing and pulse exist, in addition to timely call for help, the caregiver should let him be at the side position and closely observe the respiratory and pulse. Once the child's breathing and pulse disappear, the cardiopulmonary resuscitation is performed immediately.

It should be noted that adolescent children should not be eager to blame the psychological guidance, or seek the help of a psychologist.

4

Teaming, cutting injury

During the summer vacation, the caregiver did not pay attention, and the child had "color". Bad and cutting injuries are common types of damage during children's activities, and the degree of damage varies.

After the injury, he should stop bleeding and cleaning the wound. You can use a clean cloth or bandage to directly press the bleeding site for at least 10 minutes to stop the bleeding. Do not check the wound repeatedly during pressing to avoid affecting bleeding. Polluted wounds can be rinsed with water first, especially when there are pollutants such as gravel at the wound. After full rinse, use soapy water to clean the wound surface, then rinse soapy water with water, then apply iodine to disinfect. Antibacterial ointment. If necessary, it can be covered with sterile gauze to prevent wound infection, but it needs to be replaced daily to ensure dry and cleaning the dressing.

If the wound is deeper, penetrates the whole layer of skin, or is a laceration that is not neat on the edge of the wound, or the wound is obviously stained with dirt, you should go to the hospital as soon as possible. In addition to the treatment such as debridement sutures, doctors will also decide whether to inject tetanus vaccine and/or immunoglobulin based on the vaccination situation and wound conditions of the child.

During the recovery of wounds, you need to pay attention to the signs of infection. If the redness of the injury is increased, pus, odor, and increased skin temperature, all indicate infection and should seek medical treatment in time. If the wound has only a small amount of transparent or yellow liquid, it is normal. Most cuts and bruises can heal themselves on 7 to 10 days.

5

Ankle sprains, fractures

Live and active is the nature of children. The summer vacation has arrived, and children's various activities have increased. When running, wrestling, climbing, and chasing troubles, ankle sprains are prone to occur, and ligament breaks or fractures may occur in severe cases.

The most common manifestations of ankle sprains are ankle pain, tenderness, swelling, bruising, limited and unable to load. When a child has an ankle sprains, the treatment method follows the "RICE" principle (rest, cold compress, pressing, and raising).

Rest (REST): Stop the activity of the affected limb, especially do not let the affected limb bearing bearing.

Cold compress (ICE): 24-48 hours after sprains, you can wrap the ice pack cold compress locally with a towel, once every 1 to 2 hours, and 15 minutes once. After the damage, the ice should be applied for at least 6 hours.

Compression: Wrap the ankle with elastic pressing bandage to help reduce swelling and support the ankle. Avoid tightness to avoid blocking blood supply.

Elevation: Lift the injured ankle higher than the level of the heart. For example, when the position is lying, use a pillow or a blanket to raise the foot, and place the injury on the table or chair when sitting to reduce the swelling.

Some caregivers see the child's ankle swelling and believe that local massage can reduce swelling and stasis. As everyone knows, this operation can aggravate swelling and blood stasis within 48 hours of injury, so it should be avoided.

If the ankle pain is severe, severe, severe, cannot be load -bearing, or ankle deformity, cannot apply force, cannot be restored to normal positions, or cannot determine the degree of injury, you should seek medical treatment in time to avoid delaying the condition.

The most common symptoms of fractures are local pain and significant swelling. When pressing the injured area, the pain is significantly intensified. Local deformities, bruises, and even skin rupture. Among them, spinal fractures can damage the spinal cord, leading to symptoms such as sensory and exercise loss, urine retention and even dyspnea.

What can we do if the child fractures, before the medical treatment (or the emergency car arrives)? If the child has bleeding, you can clean the towels or clothing to stop bleeding. Do not move the injured children at will, do not move or pull the damage part, deal with the injured parts for fixation. If there is conditions, you can apply local ice to relieve pain and swelling.

It should be noted that if the spine or other parts of the spine is suspected, do not move the children at will, and try to wait for the arrival of emergency personnel to come properly. If you have to move the injured children, you must move axis, that is, the head, neck, and trunk must be regarded as a whole, and children are moved without exercise.

6

Animal bite

With more and more home -raising pets, animal bite has become one of the common injuries of children. Dog bite (60%to 90%) and cat bite (5%～ 20%) are listed in the top two of mammals bites. If the child is bitten by animals, what else can be done as a caregiver as soon as possible? For children under the age of 4, about 2/3 of the dog bite injury is located on the head and surface and neck. For children with severe head and face damage, while waiting for emergency personnel, they should also pay attention to their conscious state and breathing conditions to keep the airway open. If there is vomit, it should be cleaned in time; if the consciousness is lost, the autonomous breathing, and the pulse disappear, the cardiopulmonary resuscitation should be started immediately.

If the child is generally acceptable, the caregiver should immediately deal with the wound.

Stop hemostasis: If the wound continues to bleed, it should be directly used to stop bleeding with clean towels or clothing.

Rinse: Perform sufficient wounds and cleaning within 3 hours after being bitten, which is conducive to reducing wound infection and rabies. It is recommended to rinse the wound with a large amount of soapy water and flowing water for 15 minutes. If possible, you can press it. After rinse, you can disinfect it with iodophor, and then seek medical treatment as soon as possible. Larger and deeper wounds need to be treated as soon as possible, especially head and facial wounds. Cat bites are mostly wounds on the limbs, which are often deep than dog bite, which is more likely to cause infection.

Whether animal bite needs to inject tetanus toxins or tetanus immunoglobulin should be determined according to the immunization of the child and the wound condition, and follow the doctor's advice.

Most children's non -intentional damage can be prevented. In a sense, children's damage is not accidental. In addition to learning the first aid knowledge of children's damage, the caregiver should work hard on how to prevent children's damage. Everyone is the protagonist to prevent children's damage.

Author | Zhao Guangyuan, Department of Emergency, Beijing Children's Hospital Affiliated to Capital Medical University

Review | National Health Science Popularization Expert Library Expert

Wang Quan, Director of Emergency Internal Medicine, Beijing Children's Hospital Affiliated to Capital Medical University

Planning | Tan Jia

Edit | Liu Yang

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