Summary of experiences on safety and first aid for preschool children

First, 90% of preschool children’s safety risks can be avoided by pre-emptive inspections. First aid is always the last line of defense. “Being good at first aid” must not be regarded as a guarantee for neglecting prevention and control.； Second, children’s first aid cannot copy adult standards at all. The priority of “light, slow, and accurate” is much higher than that of “fast, violent, and complete.”

Last month, a child in the middle class in the kindergarten took advantage of the moment when the teacher turned around to distribute crayons. He secretly took the pecan nuts he had in his pocket and stuffed them into his mouth. When he was running, he fell and choked the child directly into his trachea. His face turned purple instantly. At that time, the teacher in charge of the class had just obtained the first aid certificate for half a year. When she came up, she wanted to apply adult Heimlich pressure. I pulled her and put my elbow on the baby's abdomen. I pushed it with my wrist three times and then vomited it out. Regarding the treatment of foreign body obstruction in the airway of young children, there have always been two factions in the industry: the mainstream general first aid training system emphasizes that those under 1 year old can only alternate back pats and chest compressions, and abdominal thrusts are prohibited for fear of damaging the abdominal organs that have not yet fully developed. ； However, in the practical camp of the maternal and child health hospital that we participated in last year, the director of the pediatric emergency department mentioned that as long as the rescuer puts the supporting hand under the xiphoid process of the child and avoids the ribs and soft organs, the child aged 1-3 years old can use light abdominal thrusts, which is actually 30% more efficient in expelling the child than a simple back slap. This is also an adjustment plan currently being piloted in some kindergartens. There is currently no unified standard. In our kindergarten, both plans are practiced. If the situation arises, first look at the weight and condition of the child before choosing.

To be honest, the more familiar I am with the first aid process, the less I dare to use it casually. If you do this for a long time, you will find that most of the scenarios that require first aid should never happen. In our industry, we often say that preschool safety management requires "eyes and ears to listen to all directions, quick hands and legs, and a diligent mouth". It is really not an exaggeration. Last week I looked through the safety ledger of the park. Last year, a total of 12 minor accidents were reported that required temporary treatment: 8 injuries due to bumps, 3 cases of foreign objects stuck in the throat, and 1 case of febrile convulsions. 11 of them were due to negligence of management and care: 3 times the throat was stuck, all involving children. I secretly brought small snacks into the kindergarten, and I bumped into them 6 times because the folded plastic mat in the outdoor area was not discovered in time. In addition, the febrile convulsions happened because the parents concealed the fact that the baby had a fever of 37.8 degrees Celsius in the morning. When they were brought over, they said they just had a runny nose. Now every morning when I pick up my baby, I pinch the baby's coat pocket after touching her forehead. When I meet a young baby, I will jokingly ask, "Did you bring some candy to share with the teacher today?" Don't think it's troublesome, it can really eliminate a lot of risks.

Oh, yes, last time there was a child in the small class who fell on her forehead while running and had a big swelling. When grandma took it, she rubbed it vigorously and said that the swelling would go away after rubbing it. I stopped her after a long time and put an ice pack on her for 20 minutes. Most of it disappeared the next day. Regarding the treatment of trauma in young children, there is a huge gap in understanding between ordinary parents and professional practitioners: nosebleeds and raising your head will cause blood to choke into the trachea, rubbing first after a sprain will aggravate internal bleeding, and applying toothpaste to burns will tend to leave scars. In fact, many people do not know these common senses. Our kindergarten now holds parent safety classes every quarter, and every time we meet many parents who say, "Oh, I did it wrong before." Taking the treatment of convulsions in young children as an example, there are now two schools of thought: the nursing experience of the older generation believes that pinching can promote awakening, but the evidence of modern evidence-based medicine shows that pinching has no actual effect, and it is easy to pinch the skin. Our current handling standards in kindergartens are based on evidence-based standards, but when explaining to parents, we will also take into account their inherent cognition, and will not insist that the experience of the elderly is completely wrong.

In fact, I still dare not say that I have a thorough understanding of child safety and first aid. After all, every baby's physical condition and condition are different. All the rules I learned before are just for reference. When something happens, the first thing to do is not to recall the process, but to stabilize yourself first and see clearly the baby's condition before taking action. After all, in our industry, what we hold in our hands is not work performance, but the safety of every little one. No matter how careful you are, you can never be too careful.