First-Aid Guidebookof Child Health Care
（Child Emergency）

The Okinawa Society of Child HealthThings to check before contacting emergency medical services

SUDDEN SICKNESSThis guidebook will give you information on how to figure out if
your child needs emergency medical care or home care.

Fever (over 104 F)
Under 3 months

3 months ~ 6 years

Listless and inactive
No urine
Fretful and refuses to sleep
Refusal to drink fluids
Vomits repeatedly or feels nausea

Terrible cough
Go
to
your
pediatrician
orcontactanemergency medical
center.

One ormore apply

None of theabove

If the symptoms
get worse…

Stay home and observe your child carefully.
If it is within clinic hours, contact your pediatrician.

 Point of observation
 A feverish infant might have a temperature spike at night. Even if
the child has a fever ,feels well enough to play and her appetite
has not diminished, stay home and observe.
 An infant’s body temperature is relatively high. Consider as feverwhen the temperature is over 104F .The body temperature rises after
a bath, breastfeeding, milk, meal and exercise. Check the child’stemperature when she is at ease.

 HOME CARE
 At the onset of a fever, the child might shiver with chills.When thechild be sensitive to cold or is trembling,keep the child warm. Cool
her when she gets too hot.
 Offer plenty of fluids at more frequent intervals than usual.
 A feverish child sweats profusely. Wipe the sweat clean andchange them frequently.
 You don’t have to use an antifebrile if your child looks fine.
 If your child is well enough, you can give your baby a bath toclean. The baby is chilled following the bath. Remember tomonitor her closely.

Things your doctor should know How long has it going on? How often?
 Did you see a doctor elsewhere?
 Has your child taken any medication?

FEVER

The most common cause of an infant fever is either a viralor bacterial infection. Viral pathogens are weak against
fever. Elevating the body temperature is the way the bodyfight infection. Having a high fever means your child is
infected and it is good that the body mounts such a
response. When your child gets better, the fever will begone.

At the onset of a high fever, a child may shiver and shakewith chills.
The body attempts to keep the heat in to fight bacteria byconstricting the blood vessels, leaving the hands and legs
cold. Bodily responses include shivering, which generateheat through muscle contraction. Keep your child’s hands
and legs warm to stop the shivering and chills.

Sometimes you might feel that a high fever can cause
damage to the brain. But the temperature in itself rarely
causes problems.
Do not panic when your child is running a highfever. But it is very important to observe her
closely.

Coughing
Many things can cause your baby’s cough, including
respiratory virus, inflamed windpipe and vocal cords,
exposure to environmental irritants like dust and aforeign object or a change in temperature.

Coughing serves as a protective mechanism that the
body uses to keep the airways clear, ridding phlegm or
mucus of the baby’s throat and lungs.

If coughing is the only symptom and the baby isotherwise healthy, monitor her closely.

Call your doctor immediately when your child has ahigh fever or a runny nose or sore throat.

Call your doctor as soon as possible if the following
symptoms are present: vomits repeatedly whencoughing; struggles to lie down and sits up: fusses
when not held.

Coughing or Wheezing□Wheezing, whooping cough□Short breaths, labored breathing□Shoulders rise and fall when breathing□Breathes by moving the head forward and back□Ribs are prominent and neck caves in and out with eachbreath□Listless and lethargic□Refuses to take fluids□Blue in color around the lips or mouth□Coughs like a barking dog□Coughs as if snarling□Trouble laying down, difficulty sleeping□Twitching nostrils

None of the above

One or more apply

Go to your pediatrician
orcontactanemergency
medicalcenter.

If the symptoms
get worse
Monitor at home andseek medical attention
the next day Point of observation
 A few months old toddler can have a whooping cough. If your baby
is not particularly irritable and breathing normally, this is notcause for concern.
 Quick short breaths
 Breathing hard, moving the shoulders up and down.

 Snarling coughs
 Has a bluish color to the lips or face or nails

 HOME CARE Give fluids in small amounts frequently during the bout of acutecoughing. It helps loosen mucus in the baby’s throat and easecoughing.
 If your child’s coughing gets more painful in sleep, let her lie
sideways.
 Cigarette smoke only makes it worse. Refrain from smoking.
 Open the windows now and then to let fresh air in.
 Adding humidity to the room can help ease coughing. A steamed hot
towel to the mouth can serve the purpose.
 If your child has been diagnosed with asthma, discuss treatment
options with your pediatrician.

Things your doctor should know When did the coughing start?
 Does your child have a fever or runny nose?
 Is there any particular time of day when the coughing
occurs?
 Does the coughing prevent your child from sleeping?
 Has your child just been diagnosed with asthma?

Convulsions

Convulsions (spasm)
The convulsion stopped but
the child is unresponsive.

Seizure lasts more than 5 minutes
First seizure experienced

The convulsion won’t stop.

Under 6 months

Convulses repeatedly

Aged 6 or above

Loss of color in lips

A recent blow to the head

Confusion or loss of

Low temperature (under 104F)

unconsciousness
Listless and inactive
Vomits or has an accident

One or more
applicable

Asymmetric spasms

Call an ambulance
One or more
applicable

Go to your pediatrician or contact
an emergency medical center.

 Point of observation What kind of convulsion?
Stiffening of legs and arms
Jerking movements of legs and arms
The convulsion affects just one side of the body, not the entire body.
 Does your child regain consciousness after an episode of
convulsion?
 Check the body temperature.
 Is there a family history of convulsion?
 If your child experiences stiffening of the body after crying hard,
this is not convulsion . Do not worry, because it will recover naturally.
 Fever in infants often causes twitching.

 HOME CARE
 Do not shake or apply pressure on your child when she is having a
seizure.
 Children do not bite the tongue during a convulsion, so do not put
anything in the child’s mouth. The child may vomit. Ensure to turnhim on one side. Loosen any tight clothing to make your child
comfortable.
 Please observe asymmetric convulsions or the time that convulsion
was followed.
 Monitor your child closely until she regains her consciousness.

Things your doctor should know Describe the convulsion






Stiffening of legs and arms
Jerking movements of legs and moves
The convulsion affected just one part of the body.
Asymmetric convulsion in legs and hands or eyes.
Did your child regain consciousness after the episode of
convulsion?
Check the body temperature.
Any family history of convulsion?

Vomiting(Strong nausea)

Vomits after every breast feeding
Enlarged stomach
Green-colored material or blood in vomit
Listless and lethargic
Diarrhea
Stomach pain
Convulsion
Consciousness is confused
No urine for half a day
Dry lips
Strong color and smell of urine
One or more apply

None of the above

If the symptoms

Go
to
your
pediatrician
orcontact an emergency
medical center.

get worse

Monitor at home andseek medical attention
next day Point of observation
 The problem lies in the fact that the entrance of the stomach (cardia)
is not well-developed in infants and tends to let milk to go back up. If
your child is gaining weight and developing normally, this is not acause for alarm.
 How many times vomited? Has a stomach or headache?
 Has your child lost an appetite? How is the mood state?
 Is she passing urine?

 Any diarrhea?
 Is there a pain in the abdomen? Does it hurt when touched?

 HOME CARE While nausea is strong ,avoid force-feeding and monitor your child.
When the vomiting settles, offer fluids (hot water, tea, ion drinking
water, etc…) in small amounts (30-50cc each.)
Offer easily digestible solid foods gradually once your child starts
drinking enough.
 Avoid carbonated drinks, citrus fruits (orange, mandarin etc.)

Things your doctor should know Check the frequency of vomiting Contents of the vomit:
Smells sour, smells like poo,the color is dark like coffee,
green-colored material or blood in vomit.
 You could save contents for doctor to examine.
 Check the color and odor and frequency of the child’surine. If your child’s stool odor or color are not normal,collect a stool sample for your doctor to examine.

DIARRHEA

Listless and inactive
Has not passed urine for half a day
Strong color or odor of urine
Vomits repeatedly
Dry lips or mouth
Refusal to take fluids
Sunken eye sockets
Convulsions
Consciousness is confused
None of the above

More than one applies

If the symptoms

Go
to
your
pediatrician or contact
an emergency medical
center.

get worse

Monitor at home andseek medical attention
next day Point of observation
 Count the number of times the child passes watery diarrhea.






Is your child’s appetite diminished?
Does your child pass urine?
Vomiting？

 Gently touch the child’s stomach to see if it hurts.
 What kind of diarrheal stool？
 Is it watery? Does the smell strong? Is there blood in it?
 Wash your hands well after removing the stool.

 HOME CARE
 Avoid solid foods to let the stomach settle.
 Offer plenty of fluids
You may keep breast-feeding.
 Avoid citrus fruits and carbonated drinks. (orange, mandarin etc.)
 Start with digestible foods like cooked carbohydrates, rice
porridge, zosui (porridge), udon noodles. Avoid greasy or sugary
food, dairy products and strong irritant

Things your doctor should know Count the number of times the child passes waterymotions and how long has continued.
 Describe the watery stool
It smells rotten or sour or normal? What about thecolor? Is it whitish or dark or greenish or blood-stained?
 If possible, collect stool sample for the doctor.
 Is any other family member experiencing diarrhea?
 Does the baby take enough fluids?
 The frequency, color and odor of urine.

Stomach Pain

Starts crying and then is settled for a while before starting again.

The child’s tummy looks hard and tightTense stomach when touched or pressed
Draw up legs and curl up in pain
Passes watery or blood-stained stool
Vomits repeatedly or feels strong nausea
Swelling in the groin area
Testicular swelling
Won’t stop crying, bad mood

None of the above

One or more apply

Go to your pediatrician
or contact an emergency
medical center.

If the symptoms
get worse

Monitor at home andseek medical attention
next day Point of observation Is your child feverish or feeling nausea?
 Any sign of diarrhea?
 Gently touch the child’s tummy to figure out where it hurts. Is there
any specific part that persistently hurts?
 Pain in the abdomen can be associated with frequent crying or not stop
crying

 HOME CARE Has your child passed motions? If not, let her try.
 Gently stroke the child’s stomach in circle.
 If the pain is light and does not cause vomiting, get the child to drink
fluids in small amounts frequently.

Things your doctor should know How long has it going on? (How many minutes?) Does the child experience pains on and off?
 Check the vomit. Is it greenish or has blood in it?
Collect stool sample for the doctor to examine.
 Is your child passing motions?
Check the frequency. Is it watery or small and hard?
If it’s different than usual, take a sample and show the
doctor.

Rashes(skin problem)
Rashes can be catching and infect other children. Be
sure to inform the receptionist before seeing the doctor.

The baby getsmedication

Difficulty breathing
Loss of face color
Raspy voice
Labored breathingrashesfollowing

Swelling of lips and face
Many small bruises on thelegsHigh fever
Itching, scratching
Nosebleeds, joint pains

Call an ambulance

One orapply

Go to your pediatrician orcontact an emergency
medical center.

more

None of theabove

If the symptoms
get worse

Monitor at home andseek
medicalattention next day Point of observation
 Describe a rashSize, place, color, watery Itching, scratching Swollen lips or eyelids
 Acute coughing, wheezing, raspy voice Wrong color in the face, nails and lips

 HOME CARE If the skin itches, and the size is relatively small, cool the area withwater or towel.
 A rash does not warrant a visit to nighttime emergency center.
 Take pictures of the rashes with a digital camera or mobile phone.
Bring the pictures with you when you visit your doctor.
 It could be catching. Call the receptionist before visiting.

Things your doctor should know When did the child develop rashes?
 Get a fever or runny nose?
 Itching Do you know any other child with the same
symptoms?
 Does your child take any medication?
 Has this occurred before?

Uncontrollable Crying
Different from his
usual cryThe baby is: Under 3 months and has a fever
Cries hard every 10 to 30 minutes
Passes stool with a strawberry jam-like blood in it

Cries weaker and smaller than usual
Swelling in the groin area
Pain in the ears
Loss of face color, bad moodComplains stomach or head ache
Stops crying suddenly and becomes lethargic
None of the above

One or more apply

Go
to
your
pediatrician or contact
an emergency medical
center.

If the symptoms
get worse

Monitor at home andseek
medicalattention next dayThings to check before contacting emergency medical care

Injuries & Accidents

Accidental Ingestion(When your child eats foreign objects)

Conscious

Unconscious
Trouble breathing

Call an ambulance

Button batteries

Cigarettes

Heating oil

Bug repellent

BenzinNaphthalene

Polish remover

Medicinal

Detergent

products

BleachOthersCosmetics
Shampoo
Soup
Crayon
Silica gel
Match

Block of camphor

Clay

Coins, others

Refrigerant
OthersDo
notinduce vomit

Induce vomitHome

immediately

MonitorContact an emergency
medical center.

If symptoms
get worse Point of observation
 Is your child conscious?







Difficulty breathingWrong face color
Vomiting or convulsions
What kind of foreign objects your child has eaten? How much?
When ?

 Home Care
 Turn your child on one side when she is having nausea. This is toprevent choking on a object or vomit.
 Is your child put sharp objects as pins or glass shards, do not let
her throw up and seek medical treatment.
 Treatments vary depending on what kind of medicine or chemicals
the child swallowed. Try calling the poison centers below anddiscuss treatment options.
Osaka Chudoku 110 (Time: 24 hours, 365 days)
072-727-2499 (Information providing ：Free)
Tsukuba Chudoku 110 (Time: 9am~9pm, 365 days)
029-852-9999 (Information providing ：Free)
 Toddlers can swallow objects of 3.5 cm diameter. Keep it out ofyour child’s reach.

Things your doctor should know
 What, when, how much drank?
 Vomiting When you go to your doctor, remember to bring thefollowing: what is left of the object or liquid that she
swallowed: the container: the box and manual of the
medicine she ate.

Management At Home
Treatment

Drink Water

Cigarette butts・leaf
TobaccoLiquid soaked
cigarette
Medicine, drugs
Refresher, fragrance
Perfume, Hair Tonic, skin lotion
Laundry detergent, kitchen detergent
Insect repellent (Naphthalene, camphor)（Milk X）

Wax

（Milk X）

Petroleum products (benzene, oil)

Chlorine-based refresher(toilet refresher, bleach)

Toilet refresher
Agricultural pesticide
Button Batteries

Make her vomit

Nosebleeds

Keep your child upright or hold her up, and lean her
forward
Do not tilt her head back or let her lie face-up. Thatwould allow the blood to run down her throat, which
could make her vomit.
Pinch the soft part of her nose shut. Apply pressure forabout 15 minutes.

If these don’t stop, consult an
emergency medical center.

Watch Out

Do not pack the child’s nose with a tissue. Bleeding canstart right back up again when you remove the tissueand disrupt any clots that have formed.

BurnsBurns

 Use running water to cool the burned area.
(At least 20-30 minutes)
 Do not pop a blister.
 Do not apply anything on the burn.

The burn is smaller
than a palm and alittle reddish.
No blistering

Blistering
Bigger than the sizeof the child’s hand.
Burns on the face, joints
or on the genitals.

The skin appears
charred.

The skin appears
white.
The burn is extensive
or entire body.

Call an ambulance

Monitor at homeand seek medical
attention next day

Go
to
your
pediatrician
orcontactanemergency
medical center.

 Point of observation
 Is it blistering?






Is the skin charred?
Is the skin white?
If the burn is on the face, joints or external
genitals, take the child to the doctor. It canincrease the risk of causing damage tofunctions.

 HOME CARE
 Rinse the areas with running water (about 20 minutes)
 If the child was clothed when injured, cool the area clothed.
Do not pull it off if the skin is attached to the clothes.
 Fever-lowering sheets are not useful for cooling burns.
 Do not apply ointments like aloe.
 Never break blisters.
 Precautions to prevent burns in the first place.
Do not use tablecloths

Keep potential burn hazards like stoves and irons out of reach.
Prolonged exposure to a heating carpet or electrical carpet can cause
low temperature burn.

Things your doctor should know How did the child get injured?
Examples include: hot water, oil, stove, rice cooker, steam
from pot
 Attempted treatments

Head Injuries

Unconscious

Conscious

You see a dent in the

It took more than ten seconds before your child cried.

child’s head.

Loss of face color, nausea or vomiting

The bleeding won’t stop.

Bleeding

Convulsions

A bump bigger than the size of an adult’s thumb

Repeated vomiting

Swelling of the wound

Lethargic

Has a runny nose
Acting strangely, changes in behavior

One or more apply

One or more
apply

Call an ambulance

None
above

of

the

If the symptoms
get worse

Go to your pediatrician or contact
an emergency medical center.

Monitorhomeat Point of observation
 Observe your child carefully for the next 48 hours.








How is the conscious?
Dizziness
Prone to fall
Nausea, vomiting
Convulsions
 Do you see something different than usual ?

 HOME CARE If a bump appears, place a wet towel to cool the area.
 When is bleeding, apply strong pressure with a clean dry towel to stop
the bleeding.
 Even if your child stops crying soon and you sense no abnormalities,
check for disturbances in color, mood, walking or vomiting.

Things your doctor should know How did it happen?
Fall, tumble, hit Place where did it happen? How high was the fall?

Bee Stings

Multiple bee stings (more than 10)
Loss of consciousness
Breaks out in hives all over the body
Loss of face color
Difficulty breathing
Short breaths
Blue in color around the lips or mouth
One or more apply

None of the above

Call an ambulance

Stay home and monitor yourchild or go to your pediatrician
orcontactanemergency

medical center.
If the symptoms
get worse

Go to your pediatrician or contact
an emergency medical center.

Jellyfish Stings(chironex yamaguchii)

Chironex yamaguchi jellyfish stings formedraised welts on the skin.

 Never touch the tentacles withbare hands.

 Loss of face color.
Blue in color aroundthe lips or mouth.
 Labored breathing Apply plenty of vinegar and slowly
remove them with gloved hands.
 Do not use water or alcohol on thetentacles.

Jellyfish

tentacles

release an irritating toxin.
Also, scrubbing sand on the sting
will not help, as this causes
stinging cells to release venom.
 Hold an ice pack to the area torelease pain.

Call an ambulance

Go to your pediatrician orcontact an emergency
medical center.

Please Note
The translation isn’t 100% accurate.
There is a possibility that some words orexpressions could be translated inaccurately.