The following recommendations will help you care for your child's minor emergencies and provide first aid for your child's major emergencies while you are waiting for medical assistance. Also, take a first aid course. You can't learn CPR (cardiopulmonary resuscitation) just by reading.

1. Animal bites

   Immediately wash the bite with lots of soap and water for 10 minutes.

   Many dog bites can be prevented by teaching a child not to pet strange dogs, not to tease dogs, and not to go near his own dog when the dog is eating or fighting. Also, teach your child not to pick up sick or injured wild animals.
    

2. Bee stings (Note: Yellow jackets and wasps don't leave stingers.)

   Carefully remove the stinger by scraping it off without squeezing it. Use the edge of a knife blade or credit card. Then put a few drops of water on the area of the sting, sprinkle on meat tenderizer, and massage the solution into the skin for 10 minutes. Don't use meat tenderizer near the eye. Putting an ice cube on the area will also relieve pain.

   Call your child's health care provider if your child develops hives or has trouble breathing.
    

3. Tick bites

   The simplest and quickest way to remove a tick is to pull it off. Use tweezers to grasp the tick as close to the skin as possible. Pull steadily upward until the tick releases its grip. Do not twist the tick or squeeze the tweezers so much that you crush the tick.

   If you don't have tweezers, pull the tick off in the same way by using your fingers. If you remove the body but leave the head in the skin, remove the head by using a sterile needle (in the same way you would remove a sliver). Wash the wound and your hands with soap and water after you remove the tick. Put on antibiotic ointment once.

   Embedded ticks do not back out when covered with petroleum jelly, fingernail polish, or rubbing alcohol. Applying a hot match to the tick also does not work. If you aren't successful in completely removing the tick, call your child's provider. Most ticks do not cause disease. However, if your child develops fever, rash, or other symptoms during the 2 weeks after the bite, call your child's health care provider.
    

4. Bleeding, severe

   Determine whether an artery or a vein has been cut. When an artery is cut, the blood pumps or spurts from the wound with each heartbeat. When a major vein is cut, the blood runs out of the wound at a steady rate.

   If an artery is cut, place several sterile dressings or a clean cloth (towels, sheets, or shirts) over the wound and apply direct pressure over the wound immediately. For arterial bleeding, the pressure must be forceful and continuous, often applied with the palm of the hand. Act quickly because the ongoing blood loss can cause shock.

   If a vein is cut, place several sterile dressings or the first clean cloth at hand (towels, sheets, or shirts) over the wound and apply direct pressure over the wound. After about 10 minutes of pressure, the dressings can often be bandaged in place until the child arrives at an emergency room.
    

5. Breathing, stopped

   Call the rescue squad (911) and begin mouth-to-mouth resuscitation.
    

6. Burns

   Immediately (within 10 seconds of the burn) immerse the burn in cold tap water for at least 5 minutes. If this is impossible (for example, if the burn is on the face and trunk), apply cool wet cloths or pour a pan of cold tap water over the burn. This will lessen the depth of the burn and relieve pain.

   Do not put butter or burn ointment on the burn. Do not break blisters.

   After you have cooled the burn, call your child's provider for further instructions.
    

7. Choking

   Most children occasionally choke on liquids that go down the windpipe instead of the esophagus. Your child's cough reflex will clear the windpipe of the liquid within 10 to 30 seconds. It is best if you do nothing except reassure your child.

   Sometimes a young child will suddenly choke on a peanut, raw carrot, or other piece of food. If your child is coughing and able to breathe, encourage him to cough the material up by himself.

   If your child can't breathe, cough, or make a sound, proceed with high abdominal thrusts, called the Heimlich maneuver. Grasp your child from behind, just below the lower ribs but above the navel, in bear-hug fashion. Give a sudden, upward jerk at a 45-degree angle to try to squeeze all the air out of his chest and pop the lodged object out of his windpipe. Repeat this upward abdominal thrust 10 times in rapid succession. If your child is too heavy for you to suspend from your arms, lay him on his back on the floor. Put your hands on both sides of his abdomen, just below the ribs, and apply sudden strong bursts of upward pressure.

   If your child is less than 1 year old, first use back blows. Place him face down at a 60-degree angle over your knees. (Gravity may help get the object out.) Deliver 5 hard blows with the heel of your hand to the area between your child's shoulder blades. If this is not successful, lay him on his back and give 5 rapid chest compressions over the lower sternum (breast bone) using two fingers. If he still hasn't started breathing, begin mouth-to-mouth resuscitation and call the rescue squad (911).
    

8. Convulsions with fever

   Bringing your child's fever down as quickly as possible will shorten the seizure. Remove most of your child's clothing and apply cold washcloths to her forehead and neck. Sponge her body with cool water. (Do not use rubbing alcohol.) As the water evaporates, your child's temperature will fall.

   When the seizure is over and your child is awake, give her an appropriate dose of acetaminophen or ibuprofen and encourage her to drink cool fluids. If your child starts to vomit, place her on her side or abdomen. If her breathing becomes noisy, pull her jaw and chin forward by placing a finger behind the corner of her jaw on each side. Don't put anything into her mouth. Have someone call your child's health care provider.
    

9. Drowning

   Begin mouth-to-mouth breathing as soon as possible, in a boat, a life preserver, or at the latest, when the rescuer reaches shallow water. Continue rescue breathing until the child reaches a medical facility. Some children have survived long submersions, especially in cold water.

   If there is any possibility of a neck injury (for example, a diving accident), protect the neck from any bending or twisting.
    

10. Eye, chemical in

    Most chemicals such as alcohol or hydrocarbons (for example, gasoline or lighter fluid) cause only temporary stinging and superficial irritation. However, acids and alkalis splashed into the eye can severely damage the cornea. When any chemical is accidentally splashed into your child's eye, treat it as an emergency until your provider or a Poison Control Center expert tells you otherwise.

    Immediate and thorough irrigation of the eye with tap water is essential to prevent damage to the cornea. (Do not use antidotes such as vinegar.) Hold your child's face up under gently running tap water. Or have your child lie down while you continuously pour lukewarm water from a pitcher or glass into his eye. It is very important to try to hold your child's eyelids open during this process. For most chemicals, you should irrigate the eye for 5 minutes; for acids, 10 minutes; and for alkalis, 20 minutes.
     

11. Eye, foreign body in

    If the particle is in the corner of your child's eye, try to remove it with the corner of a clean cloth or a moistened cotton swab. If the particle is under your child's eyelid, try to remove it by opening and closing her eye several times while her eye is submerged in a cup of water. If the object stays on the lid and you can see it, try to remove it with a moistened cotton swab. If you can't see the particle or remove it, call your child's provider.
     

12. Fracture, suspected

    If you think your child has broken a bone, take him in for a medical exam and an x-ray. Don't let your child put weight or pressure on the bone. Put a splint on the suspected fracture before you move your child so the edges of the fracture won't damage blood vessels.

    • Shoulder or arm: Use a sling made of a triangular piece of cloth to support the forearm at an 80° to 90° angle to the upper arm. If you can't make a sling, at least support the injured part with the other hand.
    • Leg: After placing a towel between the legs for padding, use the uninjured leg as a splint by binding the thighs and legs together with straps. If you can't do this, at least carry your child and don't permit him to put any weight on the injured leg.
    • Neck: Protect the neck from any turning or bending. Do not move your child until a neck brace or spine board has been applied. Call a rescue squad (911) for transportation.
       
13. Sprained ankle or knee

    Remember the acronym RICE for treatment of most sports injuries: rest, ice, compression, and elevation.

    Apply continuous compression by wrapping an elastic bandage around the ankle or knee. Numbness, tingling, or increased pain means the bandage is too tight. Keep the bandage on for 24 to 48 hours.

    Put a plastic bag of crushed ice on the ankle or knee. Do this 20 minutes of every hour while your child is awake for the first 4 hours after the injury. Ice and compression reduce bleeding, swelling, and pain.

    Keep the injured ankle or knee elevated and at rest for 24 hours.

    Call your child's provider for further instructions.
     

14. Poisoning

    If your child has swallowed something poisonous, first sweep any pills or solid poisons out of your child's mouth with your finger. Then, if your child swallowed a chemical, immediately give her one glass of water or milk to rinse her esophagus; this is not necessary if your child swallowed a medicine. Call the National Poison Center Hotline at 1-800-222-1222 for advice. Do not induce vomiting.
     

15. Nosebleed

    Pinch the soft parts of the nose against the center wall for 10 minutes. Tell your child to breathe through his mouth during this time. If blood continues to come out of the nose while it is pinched, you may not be pressing on the right spot.

    If the nosebleed hasn't stopped after 10 minutes, insert a piece of gauze covered with vasoconstrictor nose drops (for example, Neo-Synephrine) or petroleum jelly into the nostril. Squeeze again for 10 minutes.

    If bleeding persists, call your child's health care provider but continue applying pressure in the meantime.
     

16. Skin injuries

    Call your child's provider immediately if you have any difficulty stopping the bleeding, if the wound is caused by a dirty object, if there is any chance that a foreign body is in the wound, or if the skin is split and will need stitches. Any deep cut that needs stitches must be sutured within 12 hours. After 12 hours the wound is no longer clean enough to close with stitches.

    • Abrasions or superficial cuts

      Wash abrasions or superficial cuts for 5 minutes with soap and water; then rinse well. Put on an antibiotic ointment and Band-Aid or sterile gauze dressing and change it daily.

    • Puncture wounds (as from stepping on a nail)

      Soak the area in hot water and soap for 15 minutes. Try to make the puncture wound bleed some more. If there is any chance that an object has broken off inside the puncture wound or if your child has not had a tetanus booster in the last 5 years, call your child's health care provider.

    • Bruises

      Put ice on the bruise for 20 minutes. No other treatment should be necessary.

    • Slivers and splinters

      Most slivers can be removed with a needle and tweezers. Before you use them, sterilize the needle and tweezers with alcohol. Wash the skin surrounding the sliver with soap before you try to remove the sliver. Grasp the sliver firmly with tweezers and pull it out at the same angle it went in. Call your child's health care provider if you can't remove a sliver.
       

17. Head injuries
    • Observation and rest

      Observe your child for the first 2 hours after the injury. Encourage your child to lie down and rest until he no longer has symptoms. It is all right for your child to sleep; trying to keep him awake continuously is unnecessary. Have your child sleep near you so you can periodically check on him.

    • Diet

      Give your child only clear fluids (ones you can see through) and no food until he has gone 6 hours without vomiting. Vomiting is common after head injuries.

    • Avoid pain medicines

      Don't give your child acetaminophen or ibuprofen because your provider needs to know your child's reaction to the injury. If your child's head hurts badly enough to need a pain reliever, your provider should check him.

    • Special precautions and awakening

      Although your child is probably fine, watching him for 48 hours will ensure that you don't miss any serious complication. After 48 hours, however, your child should return to a normal routine and full activity.

      • Awaken your child twice during the night: once at your bedtime and once 4 hours later. (Awakening him every hour is unnecessary and next to impossible.) Arouse him until he is walking and talking normally. Do this for 2 nights. If his breathing becomes abnormal or his sleep is otherwise unusual, awaken him to be sure a coma is not developing. If you can't awaken your child, call 911 immediately.
      • Checking pupils is unnecessary. Some health care providers may ask you to check your child's pupils (the black centers of the eyes) to make sure they are equal in size and become smaller when you shine a flashlight on them. Unequal pupils are never seen before other symptoms like confusion and unsteady walking. In general, pupil checks are necessary only for a hospitalized child with a severe head injury.