Tonight we have a very special guest on the blog for our Baby Health series – My dad, Alan! Alan is a retired Paramedic with over 25 years of experience working on the road as well as in the Ambulance Education Centre. Despite being retired, he has forgone “resting” to take up volunteer chaplaincy for Paramedics and Ambulance Staff. During his time as a Paramedic, Alan has come across a wide range of jobs for patients of varying ages. I grew up hearing countless stories about jobs my dad was called in to do and people he helped. He also instilled in us a very cautious attitude – because he saw all the bad things that could go wrong! Nevertheless, growing up with a Paramedic for a father has been a great ride, and I was very excited at the opportunity to interview him for the Baby Health series tonight. I hope you enjoy our chat x
Hi Alan! Thank you for joining us this week as a part of our Baby Health Series. Tonight we’ll be looking at emergency baby health and when parents might need to seek out the support of emergency services. Before we start, can you tell us a bit about yourself and your background? (Pretend like I know nothing about it!!)
Where do I start? I became a paramedic for NSW Ambulance, in my early thirties and worked out of suburban Sydney stations for 14 years. This was followed by educating paramedics for over 11 years. As you said, my experience was wide-ranging, everything from birth to death and so many medical and and some traumatic emergencies that I could not list them all.
What was the most common job you were called out for involving babies?
Febrile convulsions. When a baby gets too hot, with spiking fevers (temperature shoots up and down and up and down) and starts to jerk uncontrollably (also called a fit, convulsion or seizure.)
Without too many gory details or scaring us new mums to death, what have been some of the most unusual jobs you’ve been called out to involving babies or young children?
Choking on a grape – a well-meaning grandma gave it to a baby when he was still too young. Police arrived at the house at the same time as we did. We had been called to a child choking – they had been called to a child being choked. – Big difference!
Usual causes of choking are small toys, beads – or any other object, nuts, carrot even shredded, shredded coconut, uncut round foods, chewy, sticky foods, .
Other common hazards are batteries, coins, marbles, small stones, balloons,
The problem with any foods which a very small child cannot chew up and swallow properly, is that it can end up in the lungs and not dissolve, causing lung problems.
To treat a choking incident – place the baby or small child over your knee with their head slightly downward and smack them between the shoulder blades. You may have to do this 4 or 5 times.
I took a child from a doctor’s surgery to the local hospital and the mother recognised me. She had another child in your class at primary school.
We had to transport a baby with a very rare medical condition to Westmead Children’s Hospital some 30-odd kilometres away and the doctor gave us some very unusual instructions on the care for the baby en-route, including to not stop at any other hospital on the way if the baby’s condition worsened.
The bub’s condition was so rare, they could only provide the right care at Westmead. Fortunately the baby remained stable for the trip and the nurses and doctors were waiting for us and ready to do what was necessary when we got there.
(Well, you told me to leave out the gory details.)
As you would know (having a worrier for a daughter!), some new mums worry at the drop of a hat (guilty!)! When should new mums call for an ambulance concerning the health of their baby?
Whose phone number, I might say first off, is Triple Zero (000) for anywhere in Australia.
But to answer the question:
Firstly, when you’re worried about your baby or child.
Initially, with your first, you know nothing about bubs, but within days, you know a lot more than you think.
Colour – If bub is blue, unusually pale, or unusually pink.
If they stop breathing. If their breathing sounds like they are having trouble breathing or is any way not normal for them.
It can be very hard to see if they are breathing while sleeping! Place your open hand gently over chest and abdomen and feel for rise and fall.
There are a number of conditions which will affect a baby or small child’s breathing; croup (a cough which sounds like a seal barking) bronchiolitis (Wheezes, trouble breathing out – like asthma in older children) chest infection (cough, wheezes breathing both in and out) colds and ‘flu-like symptoms, mucous blocking the nose, etc.
Floppy or doesn’t respond to you normally is a concern –
Sleep patterns take a while, if they ever develop a pattern, but if bub is drowsy for no reason, or is floppy like a rag doll (even when sleeping they have muscle tone, they are not floppy.)
Fevers – gets overheated. Simple test – use the back of your hand on your own forehead, then on bub’s. (I know you’ve had a lot of expenses, but a good thermometer is a good investment.)
Temps vary depending on whether taken on forehead, in ear or under the armpit. Don’t take it under the tongue and definitely leave rectal temps to the hospital.
36.6 to 37°C is the normal range. Babies and children will get a number of fevers – each time they pick up an infection, when they are teething, after vaccinations and so on.
Up to 37.5°C is probably ok. They can have an age appropriate medication (infant Panadol, nurofen, etc) and actually, the fever is the body’s way of fighting an infection.
BUT – over 38°C (up to 3 months) over 39°C (3 mth – 6 mth) see a doctor.
If they go floppy or the opposite – go rigid or arch their back without relaxing, or if they have uncontrolled, uncoordinated, jerky movements then you should call an ambulance.
Small babies can overheat quickly. Yes you have to keep them warm – and it IS winter, now – but keep an eye (a hand) on how hot they are in all that clothing.
Nappies – You soon learn what’s normal for the number of dirty or wet nappies your bub has each day, (and the smell of them) if that is drastically different – too many or too few – that is a cause for concern.
Toddlers will get a number of scratches and bumps and bruises. One day they just get tall enough to bump their head on the table they used to walk under!
When putting ice on a bump or bruise ALWAYS put some material between the ice and the skin. (The cold will reduce swelling, bruising and pain.)
Bleeding – how much is too much? Bubs under 5 kg 100mls (half a cup) is a lot. 200mls for a 1 year old.
How do I know? Tip half a cup of water onto different surfaces after reading this blog. Then do it with one cup. On different surfaces: tiles, lino, concrete, into a nappy or towel. Get a picture in your mind of how much that is. (Blood’s a similar consistency to water.)
Stop bleeding by applying just enough pressure to stop the bleeding.
Burns and scalds – any burn larger than the size of a 10 cent piece on a baby, or 20 cent piece size on toddlers.
Use running cold water on burns immediately. If it is a large area of the body – under a hose or a shower if you have access to that. Don’t use ice.
Vomiting and diarrhoea, by itself, is not a cause for alarm, but 3 or more vomits or diarrhoea episodes over 24 hours in a baby can be serious. (As they get some months get older, maybe 48 hours of symptoms.)
Don’t give over the counter medicines to stop it, the body is trying to expel whatever is causing it. However a doctor can prescribe something once they determine the cause.
Keep up fluids to prevent dehydration – once a child is old enough for water, sips of that. Otherwise it’s milk. If they are not taking it, they definitely need to go to hospital where they will be given fluids.
If a new mum (or dad) calls for an ambulance in an emergency, what else can the new parents do for their baby while they wait?
Have a baby bag ready at all times, if you go to hospital, you will want supplies (For baby and for yourself.)
Have your baby’s Personal Health Record “Blue-Book” (Red book, green book, purple book – depending what state you live in) with you.
Depending on what you have called for, the Ambulance Control centre will keep you on the phone and give medical advice.
Having a phone you can put on loudspeaker or hands free is invaluable.
If you’re not still on the phone to Ambulance, or if there is another person with you, organise someone to babysit any siblings, contact your significant other, etc.
If calling for a fever, strip bub down to just nappy, sponge all over with tepid water (not freezing. Put a little warm water in cold water.)
If they are old enough to drink water, give them sips of water.
If not see if they can be coaxed to have some milk.
Babies dehydrate (lose fluid from their bodies) very quickly and they need to be topped up.
If calling for bleeding, apply firm pressure directly over wound. Just enough pressure so that the bleeding stops.
If it is night, turn on an outside light.
If you have help with you, someone could wait at the footpath to make it easier for the paramedics to find you.
They could make a clear pathway to the door or the yard, for them to come in without tripping on toys or having to move furniture. If you don’t have someone with you, don’t worry about trying to do this.
Try and remember your bub’s last weight – but don’t fret over this, either, it should be in their “Blue Book.”
Have handy any pension, health care or Health Insurance card (Bupa, Medibank, HCF, NIB, whatever.)
Have your keys ready to take with you.
Is there any resources you recommend for new parents to have in their home to prepare them for an accident or emergency? g. First aid kit, any phone apps you know of, etc.
Yes, I’d recommend a small first aid kit.
Some pads or dressings, some Band-Aids. A small elastic or crepe bandage. A pair of tweezers (optionally, a small pair of scissors.) Some tape like hypo-allergenic micropore.
You can use clean water instead of antiseptic for scratches, abrasions or cuts. It is also best for burns.
Your local chemist can advise what is best if you want antiseptics or burn gels. (Creams are bad for burns but there are some burns gels on the market now which are appropriate, they have cold properties and an antiseptic in them.) You could add the gel used for teething, like Bonjela, nappy rash cream like Sudocrem, something for stings and itches. I don’t want to push any brand names – use whatever has been recommended to you by the doctor or nurses or chemist.
The “My First Aid Kit” which you reviewed on your blog has good basics. I would also recommend doing a first aid course tailored to babies and children. Once again, you have reviewed a course on your blog. “Wonderwoman Children First Aid.”
I know of another company called “Little People First Aid.”
A handy smartphone App to have is “Emergency+”, which you can find here: http://emergencyapp.triplezero.gov.au/
It has the 000 phone number, plus Police and SES, it calls up a Google Map of your location and Gives your address/location and Latitude and Longitude and has the government HealthDirect number you can phone to call a nurse.
POISONS INFORMATION PHONE NUMBER
13 11 26
And website https://www.poisonsinfo.nsw.gov.au/
At your leisure, you could cast your eye over the following web sites:
Keeping Baby Safe: https://www.productsafety.gov.au/news/keeping-baby-safe
Info about storing poisons, cleaning products, keeping saucepan handles turned away from the edge of the stove, not using tablecloths when they get to toddler/climbing age, etc., etc.
What tips or advice would you pass on to new mothers about responding to an emergency involving their baby?
Take three slow, deep breaths!
Is there anything dangerous near them which you have to remove or move your baby from?
Are they responding to you in a normal manner? Are they super drowsy? Are they floppy?
Send for help – phone, or if someone else is with you get them to do that.
Is anything blocking their airway (mouth, nose)?
Never tilt a baby’s head back like you see done for an adult’s airway if you’ve seen CPR being performed.
Are they breathing normally?
Is there a lot of bleeding?
Are they more Cold or Hot than their normal temperature?
These are the first steps performed by all Doctors, Paramedics, Nurses and those trained in First Aid.
You fix each event as you come to it.
The best sound you can hear if a child hurts themselves, is their crying. If they go quiet, it is likely to be a more serious incident.
Although we forget a lot of what we learn in first aid courses, (that’s why we have to keep doing them to refresh ourselves) I can’t recommend too strongly that you try and do a course. It’s amazing what you’ll recall when you need to.
If it warrants taking them to the GP or hospital, take your baby bag, his or her Blue Book, a mobile phone and your purse and keys!
We are emotionally involved in an emergency involving our own baby. If someone else can drive so much the better.
Refer back to what I said about “when you should call an ambulance.”
If YOU feel you need an ambulance, don’t hesitate.
Take three more, slow, deep breaths.
When you call, you will be asked by the operator if you want Police, Fire or Ambulance.
Try not to panic so they can understand your replies.
Tell them Ambulance.
You will be asked for where the emergency is and your phone number and what is wrong.
This is so they can dispatch an ambulance and can call you back if the line drops out during the call, or if the paramedics have trouble locating you.
They will ask more questions, but an ambulance has been dispatched once they have your address – or the location you are at with your baby and what you are calling for.
Thank you so much for sharing your wealth of information with us Dad! Remember if you are ever concerned about the health of your baby, it is better to be safe than sorry so have them checked out ASAP, and phone 000 in any emergency.
If you’re looking for more information about Baby Health, check out the other interviews in our series HERE (with a Chiropractor, Dentist, Doctor and Podiatrist!)