PACKRAFTING WITH KIDS? WHAT YOU NEED TO KNOW

Packrafting invites to many activities with the family. You can go through calm waters, without having a great physical capacity or being an athlete. The basic requirements normally consist of knowing how to swim, something that the vast majority fulfill, and a minimum of resistance to be able to row without great difficulties. Of course, the requirements to face more specific situations such as whitewater, or trips that depend on survival knowledge and skills to do many miles, unevenness or extreme temperatures, are excluded from here.  There are many who adopt this type of water sport and want to do it with family, especially in summer. And so that everything always goes as well as possible, here are some considerations if you plan activities that include children:

1. MAKE SURE THEY KNOW HOW TO SWIM

Having children was never a limiting factor for couples who like to have adventures. It is not necessary to give up a lifetime of enjoying nature for them. On the contrary, it can be a very useful part of teaching children to learn how to deal with the environment, live controlled and safe experiences so that their development is adequate.

But the activities have to be adapted to the age, and the knowledge of the risks helps to discriminate dangerous situations and to anticipate to avoid them. In this way, we reduce the chances of accidents. The balance point of children is different from that of adults. The weight of the head and the proportion of their body favors them to unbalance easily, increasing falls.

You have to be vigilant when they bend over to look at the water, or try to catch any object, while they are inside the packraft. And of course, we have to be careful with our own movements so that they do not facilitate their falls from the packraft.

It is highly recommended that children know how to swim, or stay afloat, even if they wear vests. And they should not be exposed to flowing waters that pose a risk of distancing themselves should they fall or get off the packraft.

Keep in mind that the little ones will need help to get back up, since the whole activity will be interpreted as an adventure and an opportunity to play. And in summer time getting wet is tempting. Before deciding who will carry the child in the packraft, it must be ensured that the adult is able to lift it from the water, without compromising the stability of both.

2. CHECK THE COMPLETE CLOTHING

The care is valid for adults and children. We need the appropriate attire for packrafting. There are children’s sizes that cover these needs, and therefore, everyone should wear float jackets that are well adjusted to the body. If you are in warmer waters, normal swimsuits may be worth it if the activity does not take a lot of time. But we must consider the possibility that they need more clothing, regardless of how the adult perceives the ambient temperature in their body. This is because children are more susceptible to hypothermia, especially young ones. Exposed body surface area for size favors it. So if you plan an activity of more hours, wetsuits are recommended. Towels and dry clothes should always be considered for when the activity is over.

3. REVIEW THE CPR TECHNIQUES

Today many universities, doctors and health personnel are making a great effort so that this knowledge reaches everyone. CPR techniques save lives, and taking time to perform the maneuvers can represent a disastrous result with neurological or even fatal sequelae. In case of drowning:

1- PROTECT: you have to remove the child from the water. To do this, you have to recognize that the kid is drowning. Many times there is a failure in this basic step and many children are victims of drowning in the presence of adults. The signals are:

• Child with head tilted back, mouth open

• Child floating upside down

• Attempt to swim to a particular direction without making any progress

• Shortness of breath

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Once the child is rescued from the water, we check if it responds to stimuli:

• Does he breathe normal? Answer back?

2- ALERT: the result will depend on the immediacy with which the notice is made. If you do not breathe normally or do not respond, shout for help, take action and call 112 (Spain).

3- ASSIST: until the trained personnel arrive, we must assist ourselves by following the following pediatric protocol. The most common arrhythmia found in pediatric cardiac arrest is severe bradycardia (the heart beats slowly) that progresses to asystole (the heart stops beating). This is why effective basic CPR is more important than quick access to a defibrillator.

BASIC CPR: the one that does airway maintenance and ventilation and circulation support WITHOUT using equipment. Emergency oxygenation is intended to protect the central nervous system. We have to do the maintenance of the child until qualified personnel arrive to do advanced CPR, which should start within the first 4 minutes after CPR. The maneuvers must be performed sequentially, and one should not go from one step to another without being sure that the previous maneuver is performed correctly, as it would determine the failure of the resuscitation. In the image there is a summary, but we go step by step:

  • Safety
  • Stimulate
  • Yell for help
  • Air (open airway)
  • Breathing
  • Circulation
  • Reassess

1st) First of all, ensure that there is no danger to the child (or victim) or to the rescuer.

2nd) check the child’s degree of response, unconsciousness, ask for help, position the victim. But the child should never be roughly moved. Try calling by name. Awake! Are you okay?

– Conscious: it is left in the same position if it is safe and help is requested if necessary, monitoring its situation periodically.

– unconscious: request help without leaving, if possible. If there are 2 rescuers, one can leave to make the call if it was not made before while the other stays with the minor. If you are alone, we will take this step later in case you do not have your mobile phone at hand and you can dial 112 (emergency) over the loudspeaker. We must continue with the minor.

If you have been able to call 112: specify the location, give them the phone number since the call was made, specify the emergency, approximate age of the child if you do not know, tell them the severity, that the child requires advanced CPR, for example. Do not end the call until the EMS (Emergency Medical Service) staff assures you that they already have all the information they need.

3rd) open the airway and check if the kid breathes

The unconscious child is often unable to keep the airway patent. We can perform 2 manoeuvres:

Checking that you breathe consists of SEEING, HEARING and FEELING, we will spend less than 10 seconds to find out the situation:

See (chest and abdominal movements)

Hear (breath sounds and sounds)

Feel (air flow at the level of the mouth and nose)

– Breathe? If it is agonic it means respiratory arrest. If there are doubts, we consider respiratory arrest and proceed as such.

– The child breathes and there is no suspicion of cervical trauma: we put him in a safe position and seek help. We will check the child and his breathing every 1-2 min.

If the child is not breathing, we continue with step 4.

4th) Breaths: The child is not breathing. The most important and damaging consequence is hypoxia. We try to restore adequate ventilation and oxygenation before circulatory arrest and irreversible neurological damage. If you know how to do it, you can provide immediate ventilation even in the water, if you are in shallow water.

  • mouth-nose ventilation: if it is difficult to occlude the nose, stop the head and open the airway in the water.
  • mouth to mouth

5 rescue breaths are applied before activating the emergency. Each insufflation should be slow, of 1 second, to increase the amount of O2 reaching the lungs. The rescuer has to take a deep breath between each insufflation to optimize the amount of oxygen. After each one of them we let the air out. If the chest does not rise when performing the ventilations, reposition the airway and perform new ventilation. If after 5 ventilations at least 2 with chest elevation are not achieved, it should be treated as an airway obstruction. In infants we try to do the “mouth-to-mouth-nose”.

There is elevation of the thorax, we go to the 5th step.

5th) check vital signs or pulse. If he does not breathe, we start CPR: in less than 10s we have to check vital signs, such as coughing, breathing, movements, trying to palpate the central pulse at the same time if you are healthcare personnel.

– child: carotid pulse

– infant: brachial pulse

– children and infants: femoral pulse

6th) cardiac massage: 30 compressions and 2 ventilations. We do it with the heel of one hand or with two hands. If they are infants, we use the two thumbs to compress the sternum, one finger below the intermamillary line, while the rest of the fingers hug the thorax. Another option is to use both fingers (middle and ring or index) one finger below the intermamillary line, perpendicular to the sternum. We hold the child’s forehead in case of using only one of the hands.

We will do it at least 100, not more than 120 bpm (beats per minute). At a depth that depresses 1/3 of the anteroposterior diameter of the thorax.

– less than 1 year: 4 cm

– over 1 year: 5 cm

Some recommend following the rhythm of the “Macarena” for an effective rhythm, especially if you have never performed CPR before, mental music to help you can be very useful. Don’t forget to count compressions out loud. This way you will know when to stop for insufflations, or that the other rescuer knows when to apply it.

If you are healthcare personnel: 15 compressions / 2 ventilations. If you are a single rescuer, in case of fatigue, go to 30/2.

7th) activation of the 112 emergency system (one minute after starting the CPR). We will report the event (what, who and where).

8th) continue CPR – every 2 minutes checking its effectiveness (respiration and pulse).

CPR should last until there is recovery of circulation and breathing, the qualified team arrives, until the rescuer is exhausted or after 30 minutes of no response. Prolonged CPR is warranted in hypothermia and should not be interrupted until the emergency team arrives.

CHECK HERE SOME VERY USEFULL CPR VIDEOS:

BIBLIOGRAPHY

ERC Guidelines 2021 – https://cprguidelines.eu/

ERC Guidelines 2021 español: aquí

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