CPR and Choking Emergencies

CPR and Choking Emergencies     

As a childcare professional it is important to know what to do and how to respond in the event of an emergency situation within the preschool environment. Training in disaster preparedness, communicable diseases, CPR and first aid are critical in being able to approach and handle these situations effectively. The following two scenarios are designed as hypothetical emergencies that could arise in the childcare setting.

·         Choking Emergency: You are at school and a 3 year old preschool child pulls a game designed for children ages 5 and older off of the shelf and finds that it has small game pieces inside. They then proceed to explore the pieces by putting it into their mouths upon which they accidentally swallow it and begin to choke. Unable to make a sound they put their hands over their mouth and begin to gasp for air. You notice the child starting to turn blue. What do you?  Stay calm and act quickly (Roberston, 2010)! Direct another teacher to call 911 and while you attend to the child. If you are alone yell for help while attending to the child. Talk to the child, asking them if they are ok. Direct them to speak to you and tell you they are ok. Children have a tendency to nod their heads but if they are unable to speak then they are in need of assistance. Children who are coughing, making sounds or talking should not be treated for choking. If the child is unable to talk. Get down on their level (on your knees) behind them. Make a fist with your hand and position it on the stomach with the thumb turn in towards the navel. Place your other hand on top of this hand and proceed to give the child strong thrust that go in and up. Do this until the objects pops out, the child is able to talk, or the child loses consciousness.

·          CPR: If the child loses consciousness then you will now need to begin CPR. It is a fact that most children stop breathing due to respiratory emergencies such as airway obstruction (choking). There have been new changes to the CPR guidelines that include the absence of the look, listen and feel technique (ASHI 2010). If a child (or adult) appears to not be breathing, then instantly begin CPR. If you have not done so already, instruct another teacher to call 911 ( In CPR emergencies in which you are alone and did not start off as choking emergencies, give the child two minutes of CPR before calling for help). Lay the child on his back giving two rescue breaths looking to see a rise and fall in the chest. In a victim who is experiencing an obstruction of the airway, you will not be able to see this until the object is retrieved or moved. Kneel over the child placing the arm and hand at a 90 degree angle with the chest just below the nipples in the center of the chest. Give the child 30 chest compressions either with the heel of one hand or the heels of both hands (one on top of the other). Look in the mouth for the sign of an object. If you see it then remove it before proceeding. If not, give one breath and then proceed with 5 cycles of compressions and breaths until either the object is removed, moved to allow breathing or emergency personnel arrive (American Safety and Health Institute, 2010).

It is important to have an emergency plan in place that is read, reviewed and practiced by all important personnel to ensure a quick response in the event of a real emergency. Constantly scanning your childcare environment for potential hazards such as small toys, misplaced objects on the floor, age appropriate equipment, and other choking hazards can help prevent these types of emergencies. Having CPR and first aid training are necessary certifications and skills needed in order to provide an effective response in these types of situations. Knowing what to do will also give the teachers and care providers much more confidence in their ability to handle preschool emergencies.

Also be sure to have on hand a classroom binder that includes accident/injury forms, emergency medical authorization forms, and parent contact information. This will give emergency responders (EMT) and medical personnel the information they will need on scene to treat the child. Make sure to contact the parents as soon as possible giving them all necessary information regarding the incident and location of their child. Make sure to document the incident thoroughly in a form designed for major accidents and injuries. As a provider it is also important to have liability insurance to protect your business, the children in care and their families in the event of an emergency.

REFERENCES

Robertson, C. (2010). Safety, Nutrition and Health in Early Education. Fourth Edition Belmont,CA: Wadsworth.