Mid-year winter school holiday safety

Child safety: Choking, burns and severe allergic reaction

Wednesday, June 26 2019

Mid-year winter school holidays are here and while it is a fun time for children in need of a break from school it can also be somewhat challenging for busy parents and caregivers. During the cold weather it becomes more difficult to keep young children occupied and safe in and around the home.

Netcare’s Group Medical Director, Dr Anchen Laubscher, says that children are always curious and it is important that a close eye is kept on them at all times to ensure they are safe.

“While it is critical not to instil a sense of fear in our children, it is necessary to teach them what poses a danger to them and how they can keep themselves safe. They can be allowed increasingly more independence as they get older.”

Dr Laubscher advises all parents, childminders and others such as teachers who are involved with children daily, to complete a Basic CPR course. “Knowing what to do in an emergency situation can save lives. It is particularly important to learn cardiopulmonary resuscitation [CPR], an essential life-saving technique in drowning and other situations where a child has stopped breathing.”

“The technique of performing CPR on an infant is similar to that used for adults. There are, however, aspects that differ and that need to be adjusted. Chest compressions, for example, should be to a depth of 4cm and the action should be performed using one hand only, or, for tiny babies, using two fingers only.”

“Be sure to memorise the number of an emergency medical service provider such as Netcare 911 [082 911], save it on your cell phone, keep it written down next to your telephone or download the MySOS Netcare 911 cell phone app which will allow the Netcare 911 Emergency Operations Centre to automatically determine your location and dispatch the necessary resources to an emergency.”

Dr Laubscher says although it is difficult for some parents, children should never be left without adult supervision. Only leave young children with responsible adults who will be as careful about the safety of your child as you are.

Every home should be child proofed as far as possible. This includes ensuring that electrical wiring is approved and out of harm’s way, plugs are properly wired and sealed, all unused electrical wall plugs are covered with plastic protectors and avoid leaving basins or buckets of water around, as these may be dangerous for toddlers. Anything, that could be harmful to children, including any substances or equipment, should be put out of reach or kept under lock and key.

David Stanton, Head of Clinical Leadership at Netcare 911 says that choking is one of the most common life-threatening hazards to both children and adults.

“At some point in our lives, we are all likely to witness someone choking. This can be a frightening experience, particularly if it is a small child or even a baby who is choking. Parents and childminders would be well advised to familiarise themselves with what to do when someone is choking.

“Choking occurs either because of the total obstruction of a person’s airway by a swallowed object, or when something blocks the windpipe instead of going down the food passage,” Stanton explains.

The blockage in the airway limits or completely cuts off the flow of air into the lungs, which can result in the child losing consciousness. “If the airway is not cleared in time, he or she could suffocate. Choking is, therefore, a medical emergency.”

Stanton notes that suffocation can occur within minutes, as one cannot survive without sufficient air to the lungs, which supply the brain with vital oxygen. “This means that when faced with an adult or young person who is choking, time is of the essence and you have to take the correct action immediately to keep them alive until professional help arrives.”

A child with a blocked airway will be unable to cough, talk or breathe and will most probably be clutching at his or her throat.

“Assess the situation and, if necessary, have someone phone for emergency medical assistance. If you are alone with the choking child, phone for assistance but put your phone on speaker-mode so that you can begin helping them while calling for help. It is imperative that the caller explains the nature of the emergency and the precise directions to the location.”

“Encourage the person to cough forcefully, do not interfere with their spontaneous coughing which may help expel the blockage. If the obstruction becomes severe, a silent cough or laboured breathing will become evident. Worse still, the person may become unresponsive.”

Try to dislodge the obstruction by administering a series of forceful abdominal thrusts. This is also known as the Heimlich Manoeuvre, and it should be highlighted that it should only be attempted if the choking patient is over the age of one year.

“The Heimlich Manoeuvre involves an abdominal thrust that creates an artificial cough, which may be forceful enough to clear the airway. Quick, upward abdominal thrusts force a rush of air out of the lungs, similar to a cough, and this can force whatever is causing the youngster to choke out of the airway,” explains Stanton.

Step by step guide to the Heimlich Manoeuvre (children over the age of one year only)

  • Lean the child forward slightly and stand or kneel behind them.
  • Make a fist with one hand. Put your arms around the person and grasp your fist with your other hand above the choking person’s navel and just below the ribcage.
  • Make a quick, forceful movement, angled inward and upward, in an attempt to assist the person to cough up the object.
  • This manoeuvre should be repeated at least five times. Keep checking to see if the object has been dislodged from the patient’s airway and repeat the manoeuvre five times if necessary.
  • If the Heimlich Manoeuvre does not work initially, hit the person firmly between their shoulder blades several times using the heel of your hand, then repeat the Heimlich Manoeuvre.

Dealing with choking in small children (younger than a year old)
If a child younger than one year is choking, you have to be extremely careful when trying to remove a foreign object in order to avoid injury, says Stanton.

  • Sit down and place the child facedown on your forearm, which rests on your thigh for stability.
  • Angle the child so that their head and neck are lower than the torso.
  • Thump the middle of the child’s back firmly with your other hand several times.
  • This motion and gravity should together help to clear the blockage from the airway.
  • Keep checking the mouth to see whether the object has been dislodged.
  • If this doesn’t work, you can turn the infant onto their back, and give five sharp chest compressions, in the middle of the chest.


“Should a person of any age lose consciousness, you need to start performing cardiopulmonary resuscitation [CPR]. Continue CPR until the object is visible and can be removed, or the paramedics arrive.

“It is a good idea to sit down with your family and anyone who regularly looks after your children, and talk through the steps of helping a choking patient. You never know when this vital information might save the life of one of your loved ones, or even your own.”

“Remember, it is essential that emergency medical services are summoned as soon as possible when someone is choking because, if these steps do not work, choking can very quickly result in the person losing consciousness and suffocating. The sooner paramedics are called, the sooner they will arrive on scene and the greater the chance of a positive outcome.”

Anaphylactic shock
Netcare’s Group Medical Director, Dr Anchen Laubscher says that children develop allergies from exposure to all kinds of substances including certain foods (such as shellfish and peanuts), medicines, house dust mites, pollens, mould spores, animal danders, insect spore, latex rubber, insect bites and stings, and many others.

“Peanuts, penicillin and bee stings are among the best-known allergens and in some individuals can cause a dramatic reaction such as severe skin inflammation, vomiting and stomach cramps. For some adults and children with an allergy to these substances, they can even be dangerous.

“The severity of an allergic reaction can vary widely. Generally they are mild and may involve a slightly runny nose and hardly be noticed. Occasionally a patient may have a severe reaction, however, and this can even be life threatening in some children.

“A severe reaction is known as anaphylaxis. A person who is suffering from anaphylaxis may develop shortness of breath, wheezing, a swelling of lips or joints and/or an itchy rash all over the body. Although it is rare, parents should watch out for anaphylaxis, as it can be dangerous, even life threatening, and parents should seek urgent medical attention should they be concerned that their child is suffering anaphylaxis,” notes Dr Laubscher.

“Most reactions to bites and stings are also mild, causing stinging or itching that goes away within hours or even minutes, but a few individuals develop severe reactions to certain insect venoms and they should get to a doctor or hospital as soon as possible if they show signs of doing so. Some people - an estimated three percent of the population - are more susceptible to animal venoms than others. Children and the elderly can be particularly sensitive and at risk.”

What constitutes a severe allergic reaction, or anaphylaxis? Dr Laubscher says that the following may be signs:

  • Swelling at the throat or mouth that may constrict breathing
  • Difficulty breathing or swallowing and choking or wheezing
  • Pain in the abdomen and/or chest
  • Nausea and vomiting
  • Feeling faint
  • A severe headache
  • General or localised skin changes such as a rash or itching

“Children who are allergic to bee or wasp stings, nuts or who have other serious allergies should be kept away from these things. They should also wear a medical bracelet and carry an adrenalin injection with them at all times as per the advice of a medical doctor. Antihistamine pills should also be kept at hand.”

Dr Laubscher says that burns are a leading cause of death and injury to young children in South Africa. It has been estimated that one fifth of all deaths in children under the age of one year is as a result of burns.

Burns are a common injury that can range in severity from minor discomfort to life-threatening emergencies. The extent to which a burn will heal often depends on the quality of first aid received immediately after the injury. Burns may be caused in a number of different ways including from fire, electricity and chemicals. Hot substances such as boiling water may be especially dangerous for children.

“Serious burns are very painful and can cause disfiguring injuries. People who have been seriously burnt, particularly children, are usually also very traumatised. Many burn victims require months in hospital to assist them in their recovery.

“Many serious child burn victims today can be saved if they are treated properly and quickly at a specialised paediatric burns unit. For this reason it is important to get anyone who has suffered a severe burn to be taken to a hospital as soon as possible. Each burns case is very different as people are burnt in different areas of their bodies and some burns are more serious than others.

“To protect your children, parents should be sure to put all hazardous chemicals, lighters and matches out of reach of their little ones. Never leave youngsters unsupervised around heaters, candles, paraffin lamps or open fires including braais. Avoid leaving your bar and gas heaters on when going to sleep as they may set fire to bedding or other inflammable materials.

“One of the most common ways children get seriously burnt is when they scald themselves with hot substances. In some cases youngsters pull hot pots of food or water or a hot beverage on to themselves.

“Parents can take precautions against this. For example, they can keep their children out of the kitchen and as far as possible cook using the back plates of their stove that cannot be reached by children. One should also take care not to drink hot cups of tea and coffee when with a child and also always keep these out of reach of children.”

Emergency services such as Netcare 911 attend to many children who are burnt after falling into hot baths. It is advised that parents rather run the cold water into a bath before the hot to ensure the safety of their little ones.

Some homes have not been properly wired by an electrician and have dangerous electrical cabling lying around, which can cause fires and children to be electrocuted. Get an electrician to wire your home properly and do not do major electrical wiring yourself.

“Whether it’s a minor burn caused, for instance, by a steaming cup of coffee or a more serious burn, the correct first aid can assist to improve the outcome. Avoid underestimating the severity of a burn; rather consult a medical professional,” advises Dr Laubscher.

What to do if your child gets burnt
Run cold water over the affected area for as long as the burn is painful in the case of minor to moderate burns. This may help to limit the damage to deeper skin tissues, and is also effective for chemical burns, as the water can help to dilute the harmful substance.”

Call an emergency medical service provider, such as Netcare 911, as soon as it is practical to do so. As each burn is different, give the call operator at the emergency operations centre as much information as possible. This will help them to give you the most appropriate advice and assistance.

“Wrap the victim in a clean sheet and take them to a medical facility or wait for an ambulance, whichever will be quicker and more appropriate in the circumstances.

“Avoid putting ice on the burn, as this can further damage the tissue. In the case of extensive burns, do not cool with water for too long because this could cause hypothermia.

“Also do not put oily substances, pastes, turmeric, egg white, toothpaste or topical ointments on the burn, or press cotton wool or fluffy material directly onto the burn as this could increase the chance of infection. However, you can use a burn dressing, and this should be covered with a bandage or cling film to prevent infection. Never peel off or open blistered skin, as this could expose the burns victim to infection,” advises Dr Laubscher.

Dr Laubscher provides some general safety tips to keep children safe:

  • Only leave the care of your child to responsible adults that you can trust.
  • Always make sure that a close eye is kept on your child. Do not let them wander off on their own or be without the supervision of a responsible adult.
  • When travelling by motor vehicle ensure that your baby is buckled up in a safety seat in the back seat, and drive responsibly.
  • Learn first aid or at least learn CPR. It could save a life.
  • Child proof your home or the place you are staying by making sure that all dangerous substances and items are out of reach. Make sure that all electrical wiring is safe and swimming pools are sealed off with an SABS approved safety fence.
  • Do not drink too much alcohol if you have children in your care.
  • Ensure that you stay with your toddler at all times when they are bathing. Empty the bath immediately once you have finished bathing them.
  • Keep a close eye on toddlers when they are using a paddling pool or are playing near any body of water. Paddling pools should be emptied straight after use.


To find out more about the services offered through Netcare hospitals and other of the Group’s facilities, please contact Netcare’s customer service centre either by email at [email protected] or phone 0860 NETCARE (0860 638 2273). Note that the centre operates Mondays to Fridays from 08:00 to 16:30.

For more information on this media release, contact MNA at the contact details listed below.

Issued by:           Martina Nicholson Associates (MNA) on behalf of Netcare and Netcare 911
Contact:               Martina Nicholson, Graeme Swinney, Meggan Saville or Estene Lotriet Vorster
Telephone:        (011) 469 3016
Email:                   [email protected], [email protected], [email protected] or [email protected]