CPR and Choking Emergencies

CPR and Choking Emergencies Week
First Scenario
A four-year old boy, in a preschool classroom, is having a snack of raw carrots with dressing. A whole piece of the carrot has lodged in his throat. The teacher notices that he is not breathing.
First, the teacher looked to see if the object could be seen and easily removed. It was not visible to the eye. Staying with the child she instructed the teacher assistant to call 911 and the parents. The teacher then proceeded to kneel behind the child, putting her arms around his waist. She then made a fist with her thumbs tucked in. With the thumb side against the child’s abdomen, midway between the base of the rib cage and navel, pressed into his abdomen with quick, inward and upward thrust. She continued the abdominal thrust until the child became unconscious.
Remaining with the boy, the teacher placed him flat on the floor on his back. She did not assess the ABC’s because she already knew he was choking. Straddling the child, she then opened the airway by head tilt/jaw lift techniques and inspected his mouth again for the object. With no visual again gave two small breaths. Still not breathing, she placed the heal of one hand on his abdomen slightly above the navel, well below the breastbone. Positioning the other hand on top of the first hand gave an upward thrust. The carrot dislodged and the boy started to breath. The child was rolled onto his side in a recovery position. The teacher remained close to observe until medical personnel arrived. The teacher accompanied the child to the hospital because the parents had not yet arrived.
A complete report was made recording all that transpired during the incident. A copy was provided for the parents. Additional copies were provided for the child’s school records and the teachers personal records.
Second Scenario:
A three-year old girl fell from a climbing bar on a preschool playground. She had a head laceration that bled profusely. The teacher assistant called emergency medical assistance and parents. The teacher also instructed the assistant to get an ice pack and clean towel from inside the school.
In the meantime the teacher acted quickly to control the bleeding. First using Universal Precautions, the teacher, using latex gloves, placed sterile gauze over the wound and applied pressure with the flats of his fingers. Elevating the girl’s head he applied the ice pack to help slow bleeding and reduce swelling. Because of the large amount of blood loss the teacher had to apply more gauze upon the original gauzed used for continued absorption.
Upon the arrival of emergency medical technicians, the teacher gave them all the gauze used so that the doctor can estimate the amount of blood loss.
Because a Serious Injury and Illness Plan was already in affect at the preschool the teacher and teacher assistant were already trained in the proper procedures for handling an emergency. They knew when it is necessary to summon emergency medical assistance and parent contacts. They were also trained in emergency techniques to apply while awaiting their arrival.
School administration and teachers can include updating emergency medical information as part of their weekly checklist. Administration can ensure that all personnel that have contact with the children are properly trained in first aide, CPR, and all schools emergency policies and procedures. Posting of emergency procedures should be visible to all staff. Emergency contact information should always be readily available to teachers indoors and outdoors.