Accidents happen, especially when children are involved. Children are not always aware of the consequences of their actions and therefore are more likely to be accidentally injured than adults are. Children with special needs are especially prone to accidental injury as they are often in less control of their bodies than typically developing children are. When it comes to keeping children safe from injury or illness, their caregivers, teachers, coaches, and other adults are responsible for their well being. For children with special needs, the importance of having clear advocates for their physical health, when they are unable to do it themselves, becomes even more pronounced.
Children with Special Needs
Children with special needs fall onto a spectrum of required care, from those children who need very little assistance to those who need much more support. Children with special needs like Autism, Downs syndrome, and ADHD, face several significant challenges in operating in a typical day, let alone when they are in an emergency medical situation. For these children, communication, self-regulation, and basic care can be challenging on any given day, and when extenuating circumstances arise, it’s all too easy for their physical health to suffer and their unique needs to fall between the cracks.
Why First Aid and CPR Matters in Child with Special Needs
Specialized First Aid and CPR are necessary for children with special needs so the adults who are providing care can take all the steps required to ensure their safety. In an emergency, an adult care provider must be able to quickly assess the situation, determine what special needs a child has, and deliver the appropriate response and medical care. When a child is seriously injured, they may not be able to communicate the problem to their caregiver, especially in situations where the child does not speak or does not communicate the way a typically developing child would. In these cases, it’s imperative to have other systems operating to protect the child from further harm and to enable their recovery.
Basic First Aid and CPR:
The most important thing for caregivers or bystanders to do in an emergency is to remain calm.
There are three key objectives when administering first aid to a child:
- Preserve life by stopping bleeding
- Prevent further harm by not moving a child after a fall to prevent spinal injury, or elevating the head of an unconscious child
- Focus on recovery by preventing shock with comforting words or providing blankets.
The most common types of injuries in children are burns, broken bones, head injuries from a significant fall, drowning, suffocation, and car-related injuries. These are treatable with first aid and CPR until emergency medical care can arrive. Healthcare professionals must calmly assess the situation to determine the scope of the injury. Caregivers should ensure that the area is safe and relocate the child to a more secure environment where appropriate, provide first aid, and seek further medical attention, either by calling 911 or driving the child to the nearest emergency unit.
Standard first aid measures include stopping bleeding by applying bandages and pressure to a wound, temporarily immobilizing broken limbs where possible, or applying cold water to minor burns. Anything beyond these measures requires CPR and emergency medical care by dialing 911.
Cardiopulmonary resuscitation (CPR) is needed when a child’s heart has stopped and/or when they are unconscious and not breathing. CPR is vital in saving lives in the event of a cardiac arrest. When the heart stops, it no longer pumps blood to the body’s major organs. Blood contains the oxygen these organs need to survive. Without oxygen, severe damage to the organs, including the brain, can occur within 4 minutes and a victim can die within 8 minutes, making it imperative for bystanders to perform CPR as soon as possible. Rescue breathing also supplies vital oxygen to the brain and heart when a child has stopped breathing, after an injury such as suffocation or a water-related accident.
Before beginning CPR, if there are two caregivers present one should call 911, and the other should check the child for responsiveness, breathing, and a pulse. If only one caregiver is present, they should begin by performing five cycles of CPR chest compressions and rescue breathing before pausing the call 911.
If an unresponsive child is breathing but does not have a pulse, then hands-only CPR should be performed. If the child is unresponsive, does not have a pulse, and is not breathing, the rescuer should administer CPR with rescue breathing.
The key steps for each type of CPR are as follows:
- Hands-only CPR:
The American Heart Association (AHA) recommends that anyone who has not received CPR certification should perform hands-only CPR and that this method be used when there is no pulse detected but the victim is still breathing.
To administer hands-only CPR to a child, the rescuer will kneel above the child, place their hands on top of one another in the center of the victim’s chest, and deliver rapid chest compressions. If the child is very small, one hand may be used. The rescuer should compress the chest to a depth of about 1/3 of the total depth of the chest which will be approximately 1.5 to 2 inches. Healthcare professionals should deliver compressions at a rate of 2 per second or 120 compressions per minute.
- CPR with rescue breathing:
Caregivers should check an unresponsive child for signs of breathing by taking no more than 10 seconds to listen for breath sounds and watch for the rise and fall of the chest. If the child is not breathing normally, caregivers must perform rescue breathing along with chest compressions.
Healthcare professionals will begin by delivering 15 chest compressions, followed by 2 rescue breaths. To perform rescue breathing, caregivers will open the child’s airway by tilting the head back and the chin upwards and remove any visible objects in the mouth. The rescuer will then place their mouth over the child’s mouth so that it forms a seal. They will perform 1 – 2 rescue breaths, about 1 second long each. Pause after the first breath to see if the victim’s chest rises. If so, rescue breathing can stop, however, if the chest does not rise, deliver the second rescue breath. The ratio of 15:2 compressions to rescue breaths should continue until emergency medical arrives or until anautomated external defibrillator (AED) is located and is ready for use.
Additional Measures for Children with Special Needs
To ensure the complete care for children with special needs, the American College of Emergency Physicians (ACEP) along with the American Academy of Pediatrics (AAP) created an Emergency Information Form for Children with Special Health Care Needs. This form allows parents, alongside their children’s physician, to provide details on their child’s medical history, allergies, mental disabilities, and any specific interventions they wish to take place in an emergency. The form may be given to emergency staff, or the information can be registered with MedicAlert so that it’s easily available for emergency care personnel. When a child cannot communicate, either due to a mental condition such as autism, or because they are unconscious, this form will give emergency care providers their complete medical history and specific instructions for their treatment.
Parents may also wish to share a copy of their child’s form with teachers, coaches, and school care giving aids so that they can assist the child properly in the event of an emergency at school or in a care center. When teachers are made aware of a child’s special health care needs they can formulate an emergency action plan ahead of time, so they can take immediate action when required.
The Importance of First Aid and CPR Certification for Caregivers
Teachers, coaches, and caregivers of children with special needs are encouraged to become certified in both first aid and CPR, so they can master the techniques required to treat injuries and save lives when necessary. Having a child’s medical history and detailed information is the first step in providing the proper care in an emergency, but complete training and certification are even more important when it comes to caring for children with special needs. CPR certification will teach healthcare professionals standard lifesaving skills along with specific guidelines for treating children. Given that children with special needs are not able to advocate for themselves, teachers and caregivers are responsible for providing the best quality of care possible, which includes emergency preparedness, and formal certification will be the only way to ensure that caregivers have the expertise that they need.
How to Obtain First Aid and CPR Certification?
First aid and CPR certification are easily obtained online, from the convenience and comfort of the home or workplace. Online training is advantageous for busy teachers and caregivers who can complete the training on their own schedule. Organizations like CPR Select offers online training courses for first aid, CPR, and AED that can give healthcare professionals with special needs the education and qualifications they need. Written by AHA-trained physicians, CPR Select’s courses are compliant with all AHA and Occupational Safety and Health Administration (OSHA) guidelines.
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