Frequently Asked Questions & **Anatomical Differences:** & **Psychological Differences:** & **Pediatric CPR Modifications:** & **Choking Response:** & **Fracture Management:** & **Infants (0-12 Months):** & **Preschoolers (3-5 Years):** & **Adolescents (13+ Years):** & **Fever and Febrile Seizures:** & **Drowning and Near-Drowning:** & **Head Injuries:** & **SIDS Prevention and Response:** & **Comfort Techniques by Age:** & Common Mistakes and Prevention & **Treatment Mistakes:**
⏱️ 9 min read
📚 Chapter 14 of 16
Your elderly neighbor fell but says she's fine, just bruised.
Decision Points:
Q: What if I call 911 and it turns out to be nothing serious?
A: That's perfectly fine. EMS providers would rather check someone who's okay than miss a true emergency. You won't get in trouble for calling in good faith.Q: Can I call 911 for someone else?
A: Yes, absolutely. You can call for anyone you believe needs emergency help. Good Samaritan laws protect callers acting in good faith.Q: What if I can't afford the ambulance bill?
A: Never delay calling 911 due to cost concerns. Hospitals must provide emergency care regardless of ability to pay. Payment plans and assistance are available.Q: Should I drive to the hospital to save time?
A: Usually no. Ambulances provide treatment en route, can navigate traffic safely, and alert hospitals. They also bypass ER waiting rooms for critical patients.Q: What if I don't speak English well?
A: 911 has interpreter services for over 200 languages. Just stay on the line and they'll connect you with an interpreter.Q: Can I text 911?
A: In many areas, yes. However, calling is preferred when possible as it's faster and provides more information. Check your local availability.Q: What if I accidentally call 911?
A: Don't hang up. Stay on the line and tell them it was accidental. Hanging up requires them to call back or send someone to check.Q: How do I teach kids to call 911?
A: Teach them their address, when to call (person won't wake up, having trouble breathing), and practice staying calm. Many areas offer programs for children.Q: Should I program 911 into my phone?
A: No need—all phones can dial 911, even without service or locked. However, do program local non-emergency numbers.Q: What if the person refuses to let me call 911?
A: If they're alert and oriented, you generally must respect their wishes. However, if they're confused or you believe they're in immediate danger, call anyway.> Final Quick Reference Box: > When to Call 911 - Remember DANGER: > - Difficulty breathing > - Altered mental status > - Neurological symptoms (stroke) > - Gushing blood/severe trauma > - Extreme pain/distress > - Repeated vomiting/seizures
Critical Final Message:
The decision to call 911 can feel overwhelming, but remember this simple principle: when in doubt, make the call. Emergency responders are trained to handle both true emergencies and situations that turn out to be less serious. Your prompt action in calling 911 has saved countless lives, while delays have led to preventable deaths and disabilities. Trust your instincts—if something seems seriously wrong, it probably is. The few minutes you might "waste" on an unnecessary call pale in comparison to the life you might save by calling promptly. Emergency services exist to help you in your moment of greatest need. Use them.# Chapter 15: Basic First Aid for Children and Infants: Special ConsiderationsThe playground accident happened in an instant. Three-year-old Maya was climbing when she fell, landing hard on her outstretched arm. As she screamed in pain, several well-meaning adults rushed to help. One tried to straighten her obviously deformed forearm, while another attempted to pick her up for comfort. Fortunately, Maya's preschool teacher, trained in pediatric first aid, quickly took charge. She immobilized Maya's arm in the position found, kept her lying still, and calmly distracted her with a favorite song while calling 911. Her knowledge that children's bones bend differently than adults' and that their pain responses require special handling prevented further injury. Later, doctors confirmed Maya had a greenstick fracture that healed perfectly thanks to proper initial care. Children are not simply small adults—their bodies respond differently to injury and illness, their communication abilities vary by age, and their emotional needs during emergencies require special consideration. Each year, unintentional injuries send over 9 million children to emergency rooms, making it the leading cause of death in children over age one. Understanding pediatric first aid isn't just helpful—it's essential for anyone who lives with, works with, or cares for children.
Children's unique anatomy, physiology, and psychology require modified approaches to first aid. These differences affect everything from assessment to treatment.
Head and Neck:
- Proportionally larger head (18% body surface in infants vs. 9% in adults) - Weaker neck muscles - Larger tongue relative to mouth - Smaller airway diameter - Higher larynx position - Softer skull bonesChest and Breathing:
- More flexible ribs - Rely more on diaphragm - Higher oxygen consumption - Faster respiratory rates - Smaller lung capacity - Horizontal ribs in infantsCardiovascular:
- Higher heart rates - Lower blood pressure - Better compensation for blood loss - Sudden decompensation - Different pulse locations> Quick Reference Box: Normal Vital Signs by Age > > Heart Rate (beats/minute): > - Newborn: 100-160 > - Infant (1-12 months): 100-150 > - Toddler (1-3 years): 90-150 > - Preschool (3-5 years): 80-140 > - School age (6-12 years): 70-120 > - Adolescent: 60-100 > > Respiratory Rate (breaths/minute): > - Newborn: 30-60 > - Infant: 25-40 > - Toddler: 20-30 > - Preschool: 20-25 > - School age: 16-20 > - Adolescent: 12-20
Temperature Regulation:
- Lose heat faster - Higher surface area to mass ratio - Less subcutaneous fat - Inefficient shivering - Prone to hypothermiaFluid Balance:
- Higher percentage water content - Greater fluid requirements - Dehydrate quickly - Vomiting/diarrhea more serious - Need careful rehydrationImmune System:
- Developing immunity - More susceptible to infections - Fever response varies - Serious infections progress quicklyCommunication:
- Limited vocabulary - May not localize pain - Regression during stress - Non-verbal cues important - Parents as interpretersFear and Anxiety:
- Stranger anxiety - Separation fears - Limited understanding - Magical thinking - Need comfort itemsPain Response:
- Different expression - May withdraw or become quiet - Need age-appropriate comfort - Distraction techniques crucial - Parental presence vitalStandard first aid techniques require significant modifications for children. These adaptations can mean the difference between helping and harming.
Infant CPR (Under 1 Year):
1. Check Responsiveness: Tap foot, never shake 2. Position: On firm, flat surface 3. Open Airway: Gentle head tilt (neutral position) 4. Check Breathing: Look, listen, feel for 10 seconds 5. Compressions: - Two fingers just below nipple line - Compress 1.5 inches (1/3 chest depth) - Rate: 100-120/minute - 30 compressions: 2 breaths 6. Rescue Breaths: Cover nose and mouth, gentle puffsChild CPR (1-8 Years):
1. Hand Position: One or two hands center of chest 2. Compression Depth: 2 inches (1/3 chest depth) 3. Same ratio: 30:2 for single rescuer 4. Two rescuer: 15:2 ratio 5. Smaller breaths than adultInfant Choking (Under 1 Year):
1. Support head/neck, face down on forearm 2. 5 back blows between shoulder blades 3. Turn face up, support on thigh 4. 5 chest thrusts with 2 fingers 5. Repeat until object expelled 6. Never perform Heimlich on infantsChild Choking (Over 1 Year):
1. Kneel behind child 2. Fist above navel, below breastbone 3. Quick upward thrusts 4. Less force than adults 5. Continue until clear> Practice This Now: > - Use a doll to practice infant back blows > - Practice finding compression landmarks > - Time 30 compressions (15-18 seconds) > - Practice gentle head positioning > - Rehearse age-appropriate communication
Special Considerations:
- Children have less blood volume - Can't afford to lose much - May not show shock signs early - Crash suddenly when decompensatingModified Approach:
1. Direct pressure remains primary 2. Pressure points more effective 3. Tourniquets absolutely last resort 4. Position flat with legs elevated 5. Prevent hypothermia aggressively 6. Monitor closely for shockPediatric Fracture Types:
- Greenstick: Bone bends and partially breaks - Buckle/Torus: Compression injury - Growth plate: Can affect future growth - More flexible bones - Heal faster than adultsSplinting Modifications:
- Splint in position found - Extra padding needed - Include joint above and below - May need to improvise smaller splints - Comfort items helpfulWhy Children Are Higher Risk:
- Thinner skin = deeper burns - Larger body surface percentage - Hypothermia risk higher - Fluid loss more critical - Scarring affects growthModified Rule of Nines (Infants):
- Head: 18% - Each arm: 9% - Front torso: 18% - Back torso: 18% - Each leg: 14% - Use palm = 1% for estimatesEffective pediatric first aid requires adapting your approach to the child's developmental stage.
Assessment Challenges:
- Cannot verbalize pain - Limited mobility - Subtle signs of distress - Parents crucial for historyApproach Strategies:
- Keep parent in sight - Warm hands before touching - Assess feet to head - Watch for behavior changes - Use soothing voiceKey Considerations:
- Crying may be reassuring - Quiet infant may be sicker - Check fontanelle (soft spot) - Temperature instability - Feeding changes significantBehavioral Considerations:
- Extreme stranger anxiety - Limited vocabulary - "No" is favorite word - Magical thinking - Parallel play stageEffective Techniques:
- Let them hold comfort object - Demonstrate on parent/doll first - Use simple words - Distraction techniques - Quick examinationsCommon Challenges:
- Won't cooperate - Can't localize pain - Regression common - Tantrums under stress - Clings to parentDevelopmental Stage:
- Better language skills - Wild imagination - Fear of body damage - Beginning logic - Asks "why" constantlyCommunication Tips:
- Explain simply - Be honest about pain - Use proper terms - Let them help - Praise cooperationSpecial Techniques:
- "Magic" bandages - Letting them choose - Story telling - Deep breathing games - Sticker rewardsCapabilities:
- Understand cause/effect - Can follow instructions - Want to be brave - Peer opinion matters - More body awarenessApproach Methods:
- Explain procedures - Give choices when possible - Respect modesty - Include in decisions - Acknowledge fearsUnique Challenges:
- Risk-taking behaviors - Body image concerns - Privacy needs - Peer pressure - Independence desiresEffective Strategies:
- Treat more like adults - Respect autonomy - Confidentiality issues - Include in treatment - Address directlyChildren face unique emergency situations requiring specialized knowledge and response.
Understanding Pediatric Fever:
- Part of immune response - Height less important than child's appearance - Under 3 months: Any fever is emergency - Fever phobia common in parentsFebrile Seizure Response:
1. Stay calm - Usually harmless 2. Time seizure - Most <5 minutes 3. Position on side 4. Don't restrain 5. Call 911 if: First seizure, >5 minutes, difficulty breathing after 6. Cool gradually after seizure Statistics: Leading cause of injury in young childrenImmediate Response:
1. Call Poison Control: 1-800-222-1222 2. Don't induce vomiting unless directed 3. Save container/substance 4. Note time and amount 5. Follow Poison Control directions exactlyPrevention Reminders:
- Lock all medications - Store cleaners high - Use cabinet locks - Keep products in original containers - Post Poison Control numberUnique Pediatric Risks:
- Can drown in 2 inches of water - Often silent (not splashing) - Diving reflex may protect brain - Secondary drowning possibleResponse Protocol:
1. Remove from water (protect spine if diving) 2. Check breathing 3. Begin CPR if needed 4. Call 911 always 5. Prevent hypothermia 6. Hospital evaluation required even if seems finePediatric Considerations:
- May not recognize symptoms - Can't verbalize throat closing - Behavior changes may be first sign - Weight-based medication dosingEpiPen Jr. Guidelines:
- For 33-66 pounds - Same technique as adult - May need adult dose if larger - Always call 911 after useWhy More Concerning:
- Larger head proportion - Weaker neck muscles - Developing brain - May not show symptoms immediatelyRed Flags Requiring 911:
- Loss of consciousness - Vomiting repeatedly - Confusion - Unequal pupils - Clear fluid from nose/ears - Seizure - Can't wake normallyEach age group presents unique challenges requiring specialized knowledge and approaches.
Special Situations:
- Temperature instability - Breathing irregularities - Feeding difficulties - Color changes - LethargyWhen to Seek Immediate Care:
- Temperature <97°F or >100.4°F - Difficulty breathing - Blue color - Not feeding - Excessive crying or too quietReduce Risk:
- Back sleeping - Firm mattress - No loose bedding - Room sharing without bed sharing - Breastfeeding protectiveIf Found Unresponsive:
- Begin CPR immediately - Call 911 - Continue until help arrives - Know it's not your fault - Support for family crucialSpecial Equipment:
- Tracheostomies - Feeding tubes - Oxygen dependency - Ventilators - Seizure disordersEmergency Preparedness:
- Know child's baseline - Have emergency plan - Backup equipment - Clear instructions posted - Direct communication with parentsAddressing emotional needs is as important as physical care in pediatric emergencies.
Universal Principles:
- Stay calm yourself - Use soothing voice - Maintain eye contact - Include comfort items - Keep parents closeAge-Specific Comfort:
- Infants: Swaddling, pacifiers, singing - Toddlers: Bubbles, favorite toy, counting - Preschool: Stories, "helper" role, choices - School-age: Explanation, breathing exercises - Adolescent: Privacy, control, honest informationProven Methods:
- Bubble blowing - Singing favorite songs - Counting games - Story telling - Electronic devices - Guided imagerySupporting Parents:
- Give them a role - Explain what you're doing - Answer questions honestly - Let them comfort child - Recognize their expertiseWhen Parents Interfere:
- Acknowledge their fear - Give specific helpful tasks - Use calm, confident voice - Explain necessity of treatment - Have someone support themUnderstanding common errors helps provide better pediatric care.