Reltney McFee

Responses: Do It Yourself Emergency Care

Contributor : Do It Yourself Emergency Care

Bad Dancer says:

October 21, 2022 at 9:50 am

Thank you for the article and links Reltney McFee I’ve read it several times and will go through it again to make notes soon. I appreciate you sharing your experience and advice.

I’m building a few kits as Christmas presents this year. Are there any supplies you recommend added for a family that has a 1-2 year old?

Thank you for reading.  Outstanding question! With regard to families that have toddlers (or infants), my first pass suggestions would sound very much like, “What did you want on your last camping trip, that you did not have?” along with, “what sort of comfort item does your child love?”

If I were to add to that, I would look to my own “Grand Kids Are Here:  What Might I Need RFN?” (GKAHWMINRFN) supplies. Now, remember, I’ve been a paramedic, paramedic instructor, ED Registered Nurse, and mid level provider since Jimmeh Cahteh was the HMFIC (OK:  President).

On the top of my “GKAHWMINRFN” bag is a pediatric BVM (Bag-Valve-Mask:  commonly referred to as if they were all branded as Ambu Bags).  You might be happy with a pediatric sized rescue breathing mask of some sort, or, easier to pack, mastery of mouth-to-mouth resuscitation.

Near the top would be comfort items, so as to both distract the child, as well as help the child “buy in” to the procedures to be performed. Blankets, pacifiers, stuffed animals: whatever floats the child’s boat.

Remember that children, particularly infants and toddlers, are NOT simply pint sized adults.  Due to differences in body surface area, kidney function, maturity of their livers and other factors, they may metabolize medications quite differently from adults. So, just slapping some QuikClot on Little Johnnie’s wound may be a problem.  OTOH, here is what I did find in a reference that I use, myself, clinically every day:

“Compared with standard sponges, the use of the kaolin-impregnated sponges in 31 infants undergoing the Norwood procedure had a significantly lower intraoperative use of blood products and lower incidence of perioperative bleeding requiring return to operating room for hemostasis (0 versus 41 percent) [44].” (source: https://www.uptodate.com/contents/overview-of-topical-hemostatic-agents-and-tissue-adhesives?search=quick%20clot&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1#H2249912903

That means, better bleeding control. THAT suggests that a kaolin-impregnated sponge (QuikClot), at least, is not inappropriate for use on bleeding in children that is not otherwise controllable by dressing, direct pressure, and (in extremis) tourniquet-ting. So, small (2×2, 3×3) dressings impregnated with QuikClot appear to be reasonable.

Splinting materials for fingers, limbs, or whatever, are going to be a challenge, both because children do not, as a rule, comprehend the entire “lay still while I splint you” thing, nor the bit about “do not wiggle about, you will work you way out of this splint, and your injured (whatever) will hurt, and be injured further.”  So, however much tape or gauze you THINK that you will need, you are wrong, and will require considerably more than you guessed. Unless, of course, you have made it a habit to secure IV armboards to infants and toddlers, several times a day, for the past several years.  If you have done so, and done so successfully, please tell me when/where your classes will be, and save me a seat.

Another tangent from adult IFAK/Jump Bag/Holy Fertilizer kits, and child directed emergency care, is that children will both dehydrate, as well as become hypothermic way, way more rapidly than adults, and, once they have burned through their reserves, will crash and burn, often irretrievably. The axiom is that children generally do OK with their injuries, until they don’t.  And, when they don’t, they crash biggly. Adults generally slowly decline, until they die. Therefore, measures to protect a child from heat loss are important.  That means blankets and knit caps in appropriate sizes.  The foil “emergency blankets” are a mixed bag:  they are not going to get saturated in whatever bodily fluid is present (good thing), but they are not going to trap heat in a maze of air pockets formed by a Mark 1, Mod Ø fuzzy/fleece/wool blanket. (and you will notice the difference). Select thoughtfully.

Another feature of kid injuries, particularly infants and toddlers, is that they are top heavy.  Their heads are a greater proportion of their body weight than adults, and that means that their initial point of impact may be more likely to be their heads, than their hands/wrists/forearms. Therefore, when you are in the hot seat, you need to be suspicious of the possibility of a head injury, when children fall. You have learned to spine board/cervical collar/secure for transport, head (and that is often spelled N-E-C-K) injured patients, right?

Right?

Another needful skill, that you pray is never needed.

That is it for my off the cuff, just got home from work and warmed up my laptop, answer to your question.

Thank you for the stimulating inquiry.  Gonna be food for more rumination!

Contributor : Do It Yourself Emergency Care

Author: Howdy, I’m Reltney McFee, although the agencies licensing me know me by another name, altogether. I am now a midlevel working in urgent care in the heart of Flyover Country. I have been an RN since around 1980 (recently let my license lapse: I simply do not see my elderly ass pulling night shifts in any ER anywhere!), having most of my Nursing time in ER, with some ICU and nursing supervision here and there. I was licensed as a paramedic for around 20 years, and worked in Da City as well as a volunteer in some rural rescues. I have been a midlevel for about 15 years. Feel free to critically appraise my suggestions here. While I am pretty good, I ain’t purfekt!

First disclaimer: LOONNGGG post warning!

Second disclaimer: for the terminally thick, NO, I AM NOT ADVOCATING THAT YOU AVOID PROFESSIONAL MEDICAL CARE, WHEN IT IS AVAILABLE!

Third disclaimer: I apologize for my computer fumble fingery, but the hyperlinks do not show as hyperlinks for most of this post.

Feel free to copy and paste the links into your browser.

So, the preceding obligatory disclaimer having been presented, why might you want to be able to provide your own medical care?

Well, if professional medical care is not available, you might have a zero-sum choice to make. Kind of like Graham’s Kill HouseRules.

  • NOBODY IS COMING TO SAVE YOU.
  • EVERYTHING IS YOUR RESPONSIBILITY.
  • SAVE WHO NEEDS TO BE SAVED.
  • KILL WHO NEEDS TO BE KILLED.
  • ALWAYS BE WORKING.

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