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Interview with Dr. Susan Aronson
Seeing a child down and bleeding on the ground, most caregivers' first instinct would be to run over, scoop up and comfort the child, but doing so could actually hurt the child, warns Susan Aronson, MD, FAAP.
"You don't move someone who is down," says Dr. Aronson, chairperson and editor of Pediatric First Aid for Caregivers and Teachers (PedFACTS), a new course launched by the American Academy of Pediatrics (AAP) in October 2005.
Instead, the caregiver first should take a brief moment to see what happened and, without touching the child, determine if calling 911 is necessary. The caregiver must make sure that other children in the group are safe, and then continue to care for the injured child. Rather than scooping up the injured child, the caregiver should check the appearance of the child, check for breathing, check for bleeding, determine whether the child can move the injured body part and then look for other things that may be wrong. A good trick is to ask the child to point to the part of the body that is hurt.
"First aid is mostly common sense. Unfortunately there is a great deal of misinformation out there," said Dr. Aronson. For 35 years Dr. Aronson has worked to improve child health practices in early education and child care settings while providing primary care and teaching pediatrics in both community and academic settings.
"If you want to improve children's health and safety," Dr. Aronson explained, "you go where the children are." With 84% of U.S. children in nonparental group care at some point before starting school, PedFACTS provides pediatric first aid lessons for teachers, child care providers, and parents.
"The approach is clear and fun and uses well-established adult learning principles," Dr. Aronson said, adding that instruction is presented in simple, easy-to-remember terms. "It is very practical and teaches by explaining the rationale behind suggested actions."
For example, each chapter featured in the PedFACTS participant textbook contains sections on What You Should Know, What You Should Look For, and What You Should Do. "There's a 'I can do this' awareness that develops among people taking this course," Dr. Aronson said.
Since the launch, PedFACTS has been approved in 16 U.S. states and eight countries around the world, with more than 300 instructors trained.
Course materials include a student textbook, video or DVD, and a one-hour game that is accessible via the PedFACTS Web site at www.PedFACTSonline.com. "The book is good reference material, but it alone is not the course," Dr. Aronson explained. "The course is the interaction between the instructor and the students; the game and the manikin practice are the parts of the course that people remember."
To learn more about PedFACTS, contact the AAP at 800/433 - 9016, ext. 4798 or visit the Web site listed in this article.
To order PedFACTS materials, visit the PedFACTS Web site or contact the AAP Customer Service Center at 888/227 - 1770 or visit the AAP Bookstore at www.aap.org/bookstore. On the bookstore homepage, enter "PedFACTS" in the "Browse the Bookstore" section of the site.
 AAP Orientation for Child Care Providers
Did you know that ...
... a child under age 3 can choke on plastic-backed bandages or dressings that are picked off a wound and put into the mouth? If the plastic-backed bandage blocks the airway, the child may not be able to breath. Use fabric bandages instead for this age group.
... syrup of ipecac is NOT effective in managing poisoning? Even if it causes children to vomit the ingested poison, too much poison still can remain in their stomachs.
... one or more blistering sunburns during childhood or adolescence render a person twice as likely to develop skin cancer? Children playing outside should always wear sun-protective clothing, seek shade, use sunscreen, and reapply sunscreen regularly.
These are just a few of the life-saving tips that are available from the American Academy of Pediatrics (AAP) for child care providers, teachers, parents, grandparents, and anyone else involved in the care of children.
In addition to Pediatric First Aid for Caregivers and Teachers (PedFACTS), a new, comprehensive first aid course launched by the AAP in October 2005, the AAP offers a wide variety of books, brochures, videos, CDs, DVDs, and Internet resources providing valuable information on child safety, health, and education.
Various AAP child health resources can be found by clicking on the following links on the AAP Web site:
Meet PedFACTS Steering Committee Member Kay Froemming
 Pediatric first aid is not just a matter of scaling down adult interventions for pint-sized bodies, but rather tailoring basic life support to suit immature bodies, according to Kay Froemming, PNP. The Pacific Northwest clinician serves on the Pediatric First Aid for Caregivers and Teachers (PedFACTS) Steering Committee as a representative of the National Association of Pediatric Nurse Practitioners (NAPNAP.) To learn more about Kay, read on.Name: Kay Froemming
Occupation: Pediatric nurse practitioner
Hometown: Eugene, Oregon
Family: Married 35 years to husband Terry; daughters Kimberly, 28, and Holli, 26
My first job was: In a neonatal intensive care unit
Education: BSN, Oregon Health Science University, 1971; pediatric nurse practitioner certification, Oregon Health Science University, 1976
The last good book I read was: The Hours, by Michael Cunningham
I'm involved in NAPNAP because: I enjoy the professional relationships with other PNPs around the United States and the educational offerings we get. I have served on several NAPNAP committees and am the vice-chair of the Child Care Special Interest Group.
I first learned of PedFACTS through: NAPNAP
I'd give anything to meet: Mother Theresa before she left us, or Tom Hanks, whom I also find inspirational.
My goal for my tenure with PedFACTS is: Putting the program into practice by teaching others about the program, teaching child care providers and representing NAPNAP and the Academy at conferences promoting the program.
My favorite pig-out food is: A variety of Thai foods.
One fact about PedFACTS that I'd like to shout out to the world is: That PedFACTS is designed to meet the specific needs of the preschooler. Too many people want to approach them like miniature adults and have difficulty relating to their specific physical and emotional needs.
At the end of a busy day, my favorite way to relax is: To sit in front of the wood stove and watch the fire, listen to music, talk with my husband, or read a good book. In summer we spend almost every evening in our small wooded area under the gazebo enjoying all of nature.
To contact Kay Froemming, send her an e-mail at kaypnp@aol.com.
Share Your Knowledge
"There's just so much first aid out there, but it's not about children," said Nancy Alleman, RN, CPNP, CSN. Nancy Alleman is one of the driving forces behind the Pennsylvania Pediatric First Aid for Caregivers and Teachers (PedFACTS) effort to promote pediatric first aid skills among teachers and child care providers.
Alleman mentors PedFACTS instructors and serves as one of two central PedFACTS contacts in Pennsylvania. She also is lead trainer and technical assistance coordinator for the Early Childhood Education Linkage System (ECELS.)
PedFACTS launched in October 2005 and thus far has been approved in 16 states and eight countries worldwide. To help you increase awareness about PedFACTS in your locale, Nancy offers the following "Share Your Knowledge" suggestions and tips:
Top 10 Ways to Bring PedFACTS to Your Town
Pick a Person. Designate one (or two) central contact person(s) for all PedFACTS information in your state.
Build Logically. Identify instructors via existing educational networks, such as the American Red Cross, local emergency medical technicians, hospitals and health care centers, home care agencies, state agencies that record child care licensing/certification, and community colleges. "This may be where child care providers take courses for licensing or certification," Nancy said.
Also, call child care centers to find out who taught their most recent first aid class and contact that instructor to introduce the new PedFACTS course.
Know Your Students. PedFACTS is for teachers, child care providers, parents, grandparents and extended family, so language comprehension, reading levels, adaptability and learning styles may vary. Be ready to accommodate this diversity.
Be Prepared. "Here in Pennsylvania, we send each of our instructors a library of 10 PedFACTS participant books, an Instructor's Resource Manual, and a video or DVD," Nancy said. She spends an average of 30 to 60 minutes with most instructors before they first present the course.
Keep it Inexpensive. PedFACTS is grant-funded in Pennsylvania, so in this case the cost can most often be kept to only $10 per person for the four-hour course— easy on the wallets of child care professionals.
Be Patient. "October was really the first time our instructors used the new material," Nancy said. "We actually found some test questions needed to be corrected, and we came up with another way to play the PedFACTS Challenge game (accessible via the PedFACTS Web site at www.PedFACTSonline.com.) Maybe we are the pilot program and we don't know it," Nancy added with a laugh.
Think Souvenirs. Create a participant packet that students can take home.
Leave Your Mark. Be sure to leave a PedFACTS participant book behind at each location where a course is taught. Pennsylvania instructors give out a free book or two at each location (while current, grant-funded supplies are available) and replenish their teaching "library" of PedFACTS participant books after each course is taught.
Follow Up. Conduct post-course interviews with instructors and students to monitor what did or did not work. Your feedback will shape future PedFACTS manuals and course materials.
Stay Current. Talk often with other local instructors and check the PedFACTS web site, www.PedFACTSonline.com, for the latest instructor tips.
For more ideas or to share some of your own, call Nancy at 717/303-0406 or send her an e-mail at nalleman1@verizon.net.
PedFACTS Feedback: Tell us what you think!
Do you have an idea or opinion about the Pediatric First Aid for Caregivers and Teachers (PedFACTS) course, online newsletter, and/or web site? If so, we want to hear from you!
Please take a few minutes to complete this quick questionnaire (cut and paste it into an e-mail) and send it to lifesupport@aap.org. Or, fax your completed questionnaire to 847/228-1350.
Thanks for your feedback and interest in PedFACTS!
1. Tell us how the PedFACTS web site and online newsletter can better meet your needs.
2. Do you think the PedFACTS web site is user-friendly? If so, why? If not, why not?
3. Do you have additional ideas or suggestions to make this a better course, a better online newsletter, and/or a better web site?
4. What's going on with PedFACTS in your city, state, region or country?
PedFACTS Stats-in-a-Box
CPR Guideline Changes
On November 28, 2005 the American Heart Association (AHA) released new CPR guidelines that will slightly impact the Pediatric First Aid for Caregivers and Teachers (PedFACTS) course in regards to the ratio of chest compressions to ventilations.
According to the 2005 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care, the new guidelines recommend performing 30 chest compressions, alternating with two ventilations instead of the previous recommendations of performing five chest compressions, alternating with one ventilation. The rationale for the new guidelines is that coronary artery perfusion is better maintained with this ratio and that teaching one ratio for all rescue situations (infant, child and adult) will be less confusing.
"This simplification is unlikely to either benefit or harm infants and children compared with the old approach. The chest compressions serve to move an obstruction in the airway, but will do nothing to help children who have an open airway but are not breathing," explained Susan Aronson, MD, FAAP, chair of the PedFACTS Steering Committee and editor of the PedFACTS participant manual. "The presumption is that the two breaths between the 30 chest compressions will keep enough oxygen in the lungs to allow the blood to remain oxygenated by the cardiac activity that most unresponsive children will still have if they are viable at all."
It's important to note that the new guidelines clearly state that, "these new recommendations do not imply that care involving the use of earlier guidelines is unsafe." With that, instructors who have already held PedFACTS trainings based on the previous guidelines do not need to conduct new trainings involving the new guidelines until current certificates expire. However, instructors who conduct new trainings from this point moving forward should teach the 30 chest compressions, alternating with two ventilations approach.
For more information about the 2005 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care, visit the AHA web site at www.americanheart.org/eccguidelines or contact the American Academy of Pediatrics Division of Life Support Programs at lifesupport@aap.org.
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