Children are prone to have accidents as they start to investigate the world around them. Some of these injuries need good first aid at the onset to reduce the effects of the injury on the child and promote healing. This session has focussed on the management of limb fractures, neurovascular status of the injured limb, managing pain and first aid for burns.
Over the MOOC in many of the sessions, we have had multiple discussions about pain management in children, and how it may differ from adult practice. A recent study looked at pain management in the pre-hospital
suggests that pain is one of the most frequently reported symptoms to UK ambulance services. They looked at the reasons that paediatric patients got worse analgesia management and hypothesised this was due to communication difficulties. They concluded that the regular use of tools such as FACES, and pain scoring improves likelihood of children receiving analgesia.
The important take home points are that early administration of analgesia helps pain relief and both parent and child anxiety. Other non-medication methods to control pain include splinting of a bone which reduces the movement which causes the pain. Behaviour plays an enormous role in the management of pain, and we know in hospitals that distraction and play therapy play a significant part in pain management especially when performing painful procedures such as cannulation. First aid management for burns is important to apply early to stop the burning process, and ultimately reduce scarring and other damage.
Cooling with tap water up to 3 hours after the burn has happened and for 20 minutes has been shown to improve healing outcomes. Covering the burn with cling-film reduces evaporation, improves pain, and makes it easy to regularly assess changes to the burnt area without having to remove dressings. Accurate assessment of Total Body Surface Area is important for ongoing management in hospital and guides decisions about fluids and admission. We have discussed how to assess burn depth which is difficult in the initial stages, but important for further management.