Child Care: First Aid During Heat Prostration and Bites in Children


In India, where summers are extremely hot with the mercury climbing to 46-48° C; emergencies due to heat prostration are very common, particularly if one is doing manual work outdoors and undergoes a lot of exertion in the open blazing sun. There are two types of ill-effects due to extreme heat:

1. Heat Exhaustion: Patient continues to sweat in this condition (as compared to the entity called “heat stroke” described below). The patient loses a lot of water and salt from his body due to the continuous ongoing perspiration. As a result the patient feels weak, dizzy, and may have blackening before the eyes and fall down on the ground in a state of disorientation.

Gradual acclimatisation to the strong heat and a liberal intake of salt and water can prevent this. Water intake by itself, though helpful, may not be adequate and should be supplemented by salt. It is not a serious condition. Immediate first aid measures include taking the patient to shade, loosening his clothing, blowing cool breeze over him by fanning and most importantly, offering him plenty of water and salt supplementation.

2. Heat Stroke: In this, the patient’s body temperature rises very rapidly and is usually over 40° C i.e. 106° F. The tendency to sweating is impaired and thus you have a unique combination of a person with a high fever and yet dry! (not sweating). The patient will be in a state of deranged sensorium and delirious. The first aid measure consists of removing the patient in a cool place and then showering the patient with a stream of cold water along with fanning. Urgent arrangements should be made to take the patient to the nearest hospital, as the sickness may prove dangerous. On the way to the hospital also, the above first aid measures should be carried out.

BITES (Snakes, Scorpions)

1. Snake bites : Most of the snakes are non-poisonous. Therefore a feeling of panic should be replaced with a calm and cool approach. Even if the snake is poisonous, medical care today can save 95-99% of poisonous snake bite victims provided they reach the hospital without much delay.

As immediate first aid, the following points are important:

• Nearly half of the deaths due to snakebites occur due to the intense fear of impending doom. An utter sense of helplessness and resignation preys on the patient’s mind. Therefore a very important aspect of first aid is “solid” reassurance to the patient to allay his intense anxiety. Some form of sedative to allay the anxiety is also useful and can be given to the patient.

• Contrary to popular belief, the patient should not be kept awake and walking; instead he should be made to lie down, the bitten part should be at a lower level than the rest of Ids body and immobilised. The patient should be encouraged to relax and go to sleep.

• Incising opens the bitten part to ensure a free flow of blood in the hope that the snake venom will be washed out “with the free flowing blood” has been found to be of little value. Similarly sucking the bitten part in the belief that you will suck out the snake venom and then spit it out is no longer recommended. So don’t do them.

• Applying ice over the bitten part or giving electrical shock to the bitten part is also harmful and should not be done.

• The only thing, which should be done, is to tie a tourniquet (a tourniquet is a circular band applied around the arms or the legs and in emergencies can be made of any material including a piece of cloth). It should not be tied tightly. An acceptable way to judge the “tightness” of the tourniquet is that you should be able to pass a finger beneath it quite easily (the tourniquet should be loosened every 10 minutes and relied).

Numerous cases have been seen where the patient has lost his whole limb due to the choking of the blood supply by the tourniquet. This happens because the bitten limb tends to swell very rapidly. Thus a tourniquet which initially was loose enough now becomes a very tight constricting band. Hence the need to open and retie the tourniquet every 10 minutes.

• Shift patient urgently to the nearest hospital where further treatment can be given.

2. Scorpion Bites : The same general measures as discussed above for snakebites apply with the exception that local application of ice is recommended as it helps in relieving the pain a lot.

3. Bites due to wasps, hornets, bees: They are by and large harmless, except in occasional cases who are hypersensitive to the sting in which case they may start having swelling of the lips, will complain of lightheadedness and breathing difficulties. Such patients should be urgently rushed to the hospital. Apart from these cases, the best first aid is to apply meat tenderiser locally and if it is not available, to apply papain powder locally, which causes rapid relief of pain.

4. Bites (animals and humans): The bitten part due to animals (common offenders being dogs, monkeys) or human beings should be thoroughly and copiously washed with a running stream of tap water for at least 15-30 minutes. You can then apply a mild antiseptic over it like spirit or betadine. Do not try to cover the bitten part, but after this first aid, take the patient to a doctor immediately, the major concern being the risk of developing tetanus or rabies. The doctor will decide as to what further steps should be taken.

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