Eyes, Ears, Nose, Bites & Stings

A four-year-old has a speck of sand in her eye and is blinking and crying. What should you do?

• ARub the eyelid firmly to move the speck
• BRinse the eye gently with clean water✓
• CLift the speck out with a cotton bud
• DCover the eye and take her straight to A&E

Answer: A loose particle in the eye is flushed out with clean water and the child is told not to rub. Rubbing or poking with a cotton bud can scratch the surface of the eye and push the grit further in. Covering the eye and going to A&E is the response to an object embedded in the eye, not to a loose speck.

A child has fallen onto a stick and a splinter of wood is sticking out of the surface of his eye. What is the correct action?

• APull it out quickly, then rinse the eye with water
• BLeave it in place, cover the eye and go to A&E✓
• CEase it out with clean tweezers, then cover the eye
• DRinse the eye until the splinter washes out on its own

Answer: An object embedded in the eye is never removed by a first aider, because pulling it out can cause further damage; it is left in place, the eye is covered without pressure and the child goes to A&E. Rinsing or using tweezers to free it risks the same harm. Keep the child still and discourage him from touching the eye.

A cleaning product has splashed into a child's eye at nursery. For at least how long should the eye be irrigated under running water before going to A&E?

• A10 minutes
• B2 minutes
• C20 minutes✓
• D5 minutes

Answer: A chemical splash needs a long, continuous flush of at least 20 minutes under running water to dilute and wash away the chemical before it burns deeper. Two, five or ten minutes is not long enough to make the eye safe. The child then goes to A&E for assessment.

You are irrigating a child's left eye after a chemical splash. How should the child's head be positioned during the irrigation?

• ATilted so the left eye is lowest and water drains away from the right eye✓
• BTurned so the right eye is lowest and the water flows across the face
• CHeld upright and still so that the water runs down over both eyes
• DTilted back so the water pools in the left eye and soaks it thoroughly

Answer: The injured eye is kept lowest so that the running water carries the chemical away from the face without washing it into the uninjured eye. Letting water pool, run over both eyes or flow from the injured side across to the good eye risks spreading the chemical and injuring the second eye. Keep flushing continuously, then go to A&E.

A three-year-old has pushed a small bead up his nose and it will not come out. What should you do?

• AAsk him to blow his nose as hard as he can, then pull it out with tweezers
• BHook it out gently with a bent paper clip or the end of a cotton bud
• CKeep him calm, tell him to breathe through his mouth and seek medical help✓
• DLay him flat and pour a little warm water into the nostril to float it out

Answer: A foreign body in the nose or ear is left for a medical professional to remove; the first aider keeps the child calm, has him breathe through his mouth and arranges medical help. Probing with tweezers, paper clips or cotton buds, forceful nose-blowing or pouring water into the nostril can push the object deeper or injure the lining of the nose.

A two-year-old has pushed a small stone into her ear and it is stuck. Which of these should you NOT do?

• ATell her parents what has happened and what you did
• BArrange for her to be seen by a medical professional
• CKeep her calm and stop her poking at the ear
• DTry to hook the stone out with tweezers✓

Answer: Probing an ear with tweezers, cotton buds or anything else can push the object deeper and damage the ear canal, so removal is left to a medical professional. Keeping the child calm, stopping her from poking at it, arranging medical help and telling her parents are all part of the correct response.

A child has been stung by a bee and the sting is still visible in the skin. How should you remove it?

• ARub the area briskly with a wet wipe until it comes away
• BGrip it with tweezers and pull it straight out
• CSqueeze the skin on either side until it pops out
• DScrape it out sideways with the edge of a card✓

Answer: A bee sting is scraped out sideways with a card edge or fingernail so that the venom sac attached to it is not squeezed. Gripping it with tweezers or squeezing the skin can force more venom in, and rubbing the area spreads irritation without reliably removing the sting. Afterwards wash the site, apply a cold compress and watch for signs of a severe reaction.

A five-year-old has been stung by a wasp on the inside of her mouth after drinking from an open can of juice. What should you do?

• AGive her cold water or ice to suck and seek urgent help in case of swelling✓
• BGive her a warm sweet drink and watch her at nursery for the rest of the day
• CScrape the inside of her mouth with a card edge and then let her sleep it off
• DGive her a dose of antihistamine from the first aid box and carry on as normal

Answer: A sting inside the mouth or throat can swell and threaten the airway, so urgent medical help is needed while cold water or ice to suck helps limit the swelling in a child old enough to manage it. A warm drink, sleeping it off or scraping inside the mouth do nothing about the swelling risk, and a first aid box should not contain medicines to hand out.

A child was stung by a wasp on the hand ten minutes ago. Which finding tells you the reaction has become anaphylaxis and 999 must be called?

• ARedness and itching around the sting itself
• BWheezing with swelling of the lips and tongue✓
• CA raised sore lump where the sting went in
• DCrying and asking for the hand to be rubbed

Answer: Wheeze, noisy breathing and swelling of the tongue, lips or throat within minutes of a sting are signs of anaphylaxis, along with a hoarse voice, faintness, pale or grey skin and a floppy child; use an adrenaline auto-injector if the child has one and call 999. Local redness, itching and a sore lump are a normal reaction to venom, and being upset about the pain is expected.

After a woodland walk you find a tick attached to a child's leg. What is the correct way to remove it?

• ASqueeze its body between finger and thumb and twist it out quickly
• BTouch it with a hot match head so that it backs out of the skin
• CCover it with petroleum jelly so it lets go and drops off by itself
• DGrip it close to the skin with fine-tipped tweezers and pull steadily✓

Answer: A tick is gripped as close to the skin as possible with fine-tipped tweezers or a tick tool and pulled out steadily, without squeezing its body. Smothering it, burning it, squeezing it or jerking it out are not recommended and can increase the risk of infection. Clean the bite afterwards and record the incident.

In the weeks after a tick was removed from a child's leg, the parents mention a mark near the bite. Which appearance should prompt them to see a GP promptly?

• AA faint pale patch where the tweezers gripped the skin
• BA circular red rash that is slowly spreading outwards✓
• CA tiny pink dot that has not changed since the bite
• DA small dry scab that is starting to flake away

Answer: A spreading circular rash around a tick bite in the weeks after the bite is an early sign of Lyme disease and needs medical assessment. A healing scab, an unchanged pink dot or a faint mark from the removal are ordinary features of a small wound and do not suggest infection. Tell parents what to look for after any tick bite.

A child at nursery has been bitten on the hand by another child and the skin is broken. What is the correct first aid?

• ADab it with antiseptic cream from the first aid box, then leave it uncovered
• BApply a plaster straight away, without washing, so the wound stays dry
• CPress an ice pack on it for twenty minutes, then send the child back to play
• DWash it thoroughly under running water, cover it and seek medical advice✓

Answer: A bite that breaks the skin carries a high risk of infection, so it is washed thoroughly under running water, covered with a clean dressing and medical advice sought, which may include a tetanus check. Creams from the first aid box, an ice pack alone, or covering it without cleaning leave bacteria in the wound. The incident is recorded and parents informed.