Tuesday, 8 May 2012

Spinal Injuries

Spinal Injuries:

Description:

Spinal injuries can involve many parts of the back and or neck (the weakest part). Trauma can include injury to bones (vertebrae), muscles, ligaments, or the spinal cord, which is the most serious are to damage.

 

A spinal cord injury (SCI) is damage or trauma to the spinal cord that results in a loss or impaired function causing reduced mobility or feeling. The cords is about 18 inches long and extends from the base of the brain to about the waist.

 

The nerves situated in the spinal cord are called upper motor neurons and their function is to carry messages backwards and forwards to and from the brain. The nerves that branch out from the spinal cord to other parts of the body are called lower motor neurons and they communicate with specific areas of the body, some to initiate movement and others to provide sensation such as pain and temperature. The spinal cord does not have to be severed in order for loss of function to occur. In most people with SCI the cord is intact but the cellular damage to it results in loss of function.

 

The Vertebra is a ring of bones surrounding the spinal cord and constitute the spinal column more commonly known as the back bones. It is possible for someone to ‘break their neck’ yet not sustain a spinal cord injury.

 

The vertebrae are named according to their location:

 

There are eight Cervical C1 to C8. Cervical SCI usually causes loss of function in the arms and legs-quadriplegia. There are 12 Thoracic (chest) vertebrae. Injuries in this region usually effect chest and legs –paraplegia. Lumbar vertebrae L1 to L5 and the Sacral Vertebrae S1 to S5. Injuries here usually results in some loss of function in hips and legs.

 

When to suspect a spinal Injury

 

The most important indicator is what we call the ‘mechanism of injury’. How and what has happened to the patient involve in trauma. We are looking for any abnormal forces which may have been exerted on the back or neck. Such examples can be seen below:

  • Blow to the head, neck or back.
  • Falling from a height.
  • Awkward fall whilst doing gymnastics or trampolining.
  • Diving into a shallow pool and hitting the bottom.
  • Thrown from a horse.
  • Heavy object falling across the back.
  • Multiple injuries.
  • Thrown from a motor bike.
  • High speed RTC (Road Traffic Collision).

 

These are but a few examples.

 

Signs & Symptoms:

  • Pain or tenderness in the neck or back at or near the site of injury.
  • Loss of control over limbs, movement restricted.
  • Loss of feeling, sensation in limbs.
  • Pins and needles or burning in the limbs.
  • Loss of bladder and/or bowel control.

 

Treatment:

 

Conscious Patient

  • Reassurance, tell patient not to move to prevent any further injury.
  • Maintain the position of the patient as you found them.
  • Using your hands, hold their head still keeping it in line with the upper body.
  • If on your own, support the head both sides, then dial 999.
  • Otherwise, get someone else to dial 999.

 

Unconscious Patient

  • Maintain an open airway.
  • Using your hands, hold their head still keeping it in line with the upper body.
  • If in any doubt that the patient may vomit, or you have to leave to dial 999, place them in the recovery position.
  • Keep the patient warm and still, constantly monitoring Airway & Breathing until the arrival of the paramedics

 

Managing the airway with spinal injuries

  • Jaw thrust.
  • Log roll.
  • Recovery position.

 

 

We hope you find this article useful. This is one in an alphabetical series of articles addressing various symptoms and their first aid treatments. If you would like more information on related resuscitation and first aid training, please get in touch.

 

You might also be interested in our blog. In this post, Linda Hart talks about seizures and related first aid.

 

 

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Published in First Aid

NEW COURSE ANNOUNCEMENT: Sports Club First Aid Medical Team Training

First Response have unveiled their latest course offering amateur sports clubs the opportunity to have their medical teams fully trained to HSE, JRCALC, Resuscitation Council UK 2010 and NICE standards.

Published in First Response News
Tuesday, 3 July 2012

Meningitis

Meningitis:

Description:

Meningitis is inflammation of the protective membranes covering the brain and spinal cord, known collectively as the MENINGES. The inflammation may be caused by infection by virus, bacteria or other micro organisms and less commonly by certain drugs.

 

  • VIRAL MENINGITIS is usually a mild disease but can make people feel very unwell. Although most people make a full recovery some can be left with debilitating effects such as deafness, epilepsy and cognitive defects.

 

  • BACTERIAL MENINGITIS is life threatening and needs urgent medical attention

 

  • NEONATAL MENINGITIS occurs in babies under 1 month old

 

Meningitis can be life threatening because of the inflammation's proximity to the brain and spinal cord so should be classified as a medical emergancy.

 

Signs & Symptoms:

  • High temperature or fever.
  • Violent vomiting.
  • Loss of appetite.
  • Severe headache.
  • Neck stiffness.
  • Joint or muscle pains.
  • Drowsiness & Confused.
  • Disorientated.
  • Dislike of bright light (Photophobia).
  • Dislike of loud noises (Phonophbia).
  • Seizures.
  • Skin rash (small purple/re "pin prick" Rash does not fade when the side of a glass is pressed against it.

 

Sometimes, especially with small children only non specific symptoms may present such as irritability and drowsiness. If a rash is present it may indicate a particular cause eg meningococcal bacteria. This rash is characterized as a small purple "pin prick" which does not fade when the side of a glass is pressed against it.

 

A rash does not fade under pressure is a sign of meningococcal septicaemia which is a medical emergency. However if someone is ill and getting worse do not wait for the rash as it can appear later or not at all.

 

Babies:

  • Downiness, restless and high pitched crying.
  • Reluctance to feed.
  • Slight tenderness and swelling of the soft parts of the skull.

 

Treatment:

  • Call your GP, If any delay Dial 999.
  • If you think the child./baby may have meningitis , seek medical advice immediately Dial 999.

 

Diagnosis is usually made by performing a lumbar puncture which involves inserting a needle into the spinal canal to extract a sample of cerebrospinal fluid that envelopes the spine and brain. Depending on the type of meningitis treatment would involve antibiotics or anti viral or in some instances corticosteroids.

 

Caution:

  • DO NOT delay seeking medical help or advice.

 

 

We hope you find this article useful. This is one in an alphabetical series of articles addressing various symptoms and their first aid treatments. If you would like more information on related resuscitation and first aid training, please get in touch.

 

You might also be interested in our blog. We also love bringing you useful infomration from other organisitions. One of our favourites is this video on recognising a cardiac arrest from the Resuscitation Council.

 

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Published in First Aid
Wednesday, 20 June 2012

Hyperventilation

Hyperventilation:

Description:

Hyperventilation or over breathing is the state of breathing faster or deeper than normal. This causes excessive explosion of carbon dioxide, leaving low levels in the blood, and can be associated with a psychological state such as a panic attack or a physiological state such as metabolic acidosis (a condition whereby the body is producing too much acid or the kidneys are not getting rid of enough perhaps due to renal failure).

 

Excessive or fast breathing is commonly described as (Hyperventilation). It is usually the result of acute anxiety and can lead to the patient having a panic attack.

 

Hyperventilation can easily be mistaken for Asthma but: this can be identified because a patient having an asthma attack generates a wheeze in their breathing pattern, whereas in the Hyperventilating patient breathing can be heard entering and exiting the lungs normally

 

Signs & Symptoms:

  • Patient will look anxious and be struggling to breath.
  • Speech will be difficult.
  • Dizziness or faintness.
  • Palpitations.
  • Feeling of choking or suffocation.
  • Sweating.
  • Trembling or marked tingling /pins and needles in the hands.
  • Cramps in the hands & feet.
  • Patient fearful of dying during an attack.

 

Treatment:

HYPERVENTILATION IS NOT A RESPIRATORY DISEASE BUT AN EMOTIONAL CONDITION. Therefore staying calm is the most important method to help control the symptoms. The aims of the treatment are to increase CO2 (Carbon dioxide) levels in the lungs and increase O2 (oxygen) levels to vital organs

 

THE USE OF A PAPER BAG IS NO LONGER ADVOCATED AS IT CAN CAUSE DANGEROUSLY LOW O2 LEVELS SO:

 

  • Be firm but reassuring.
  • Lead the patient to a quiete place.
  • Explain to the patient what is happening.
  • Ask patient to hold their breath, this will reduce the respiratory rate.
  • Encourage slow deep breathing.
  • Breathing through their nose will help reduce the loss of carbon dioxide.
  • The patient could take sips of water to help reduce the numbers of breaths taken.

 

Caution:

  • Care must be taken not to mistake Asthma with Hyperventilation.

 

 

We hope you find this article useful. This is one in an alphabetical series of articles addressing various symptoms and their first aid treatments. If you would like more information on related resuscitation and first aid training, please get in touch.

 

You might also be interested in our blog. One of our most recent articles explores if you should call an ambulance.

 

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First Response. Training for life. Training to save a life.

Published in First Aid
Wednesday, 20 June 2012

Heat Stroke

Heat Stroke:

Description:

If someone with HEAT EXHAUSTION continues to be exposed to high temperatures then HEAT STROKE may develop.

 

The body becomes dangerously dehydrated in Heat Stroke. It's cooling mechanism malfunction and are no longer able to help the body to lose heat, so the body temperature starts to rise and the core temperature can reach high levels (40°c) within a short space of time.

 

Signs & Symptoms:

Include the symptoms of heat exhaustion as follows:

  • Excessive sweating.
  • Headache, dizziness.
  • Feeling lightheaded/faint.
  • Muscle cramping.
  • Hot flushed dry skin.
  • Rapid deterioration id level of consciousness (AVPU) Score.
  • Nausea & Vomiting.

 

Plus additional symptoms of:

  • Confusion.
  • Disorientation.
  • Rapid shallow breathing.
  • Fits (seizures).

 

Treatment:

HEAT STROKE IS A MEDICAL EMERGENCY. If left untreated the patient could slip into a coma, develop heart or kidney failure or brain damage. In extreme the patient may die.

  • Try and move patient to a cool area.
  • Dial 999.
  • Cool patient rapidly.
  • Remove clothing and wrap the patient in a cold, wet sheet.
  • Keep sheet wet and cold until temperature falls to normal level. Change wet sheet for a dry sheet.
  • Sponging with cold water-use the garden hose pipe to spray with water.

 

Caution:

  • Be aware of the use of "Recreational Drugs such as Ecstasy".
  • Patient may dance for longer periods and sweat excessively and become hot and dehydrated.

 

 

We hope you find this article useful. This is one in an alphabetical series of articles addressing various symptoms and their first aid treatments. If you would like more information on related resuscitation and first aid training, please get in touch.

 

You might also be interested in our blog. One of our more popular articles is about quality or quantity when it comes to first aid training.

 

 

First Response. Training for life. Training to save a life.

Published in First Aid
Wednesday, 20 June 2012

Heat Exhaustion

Heat Exhaustion:

Description:

In hot weather older people, babies and young children are at greater risk of heat exhaustion, which left untreated, can result in heatstroke. This can be brought about by the working or exercising in hot conditions. Heat exhaustion will normally occur when the body’s temperature rises above 38c. If not recognized and treated this can lead to Heat Stroke (see under heat stroke).

 

Heat exhaustion is a collection of symptoms brought on as the body struggles to control its temperature. The body uses several mechanisms to cool itself down including sending more blood to the skin and by sweating. Salts and water are lost during sweating; if too much is lost then the symptoms of heat exhaustion develop.


Signs & Symptoms:

  • Excessive sweating.
  • Headache, dizziness.
  • Nausea & vomiting .
  • Tiredness.
  • Muscle cramps.
  • Patient may say they feel cold, BUT are hot to touch.


Treatment:

Heat Stroke is a medical emergency so it is important to prevent HEAT EXHAUSTION developing to heat stroke:

  • Take patient to a cool area (an air conditioned room is ideal).
  • Remove thier clothing and lie them down.
  • But them in a cool shower or bath, soak feet in bucket of water.
  • Give them plenty of water. Oral rehydration or isotonic drinks (sports drinks) are best as they also replace salt.
  • If patient level of response changes or symptoms deteriorate (AVPU) place them in the recovery position.
  • Dial 999.

 

Caution:

  • Remember certain recreational drugs such as Ecstasy create more physical activity in people and therefore generates more heat.

 


We hope you find this article useful. This is one in an alphabetical series of articles addressing various symptoms and their first aid treatments. If you would like more information on related resuscitation and first aid training, please get in touch.

 

You might also be interested in our blog. One of our more popular articles is about quality or quantity when it comes to first aid training.

 

 

First Response. Training for life. Training to save a life.

Published in First Aid
Tuesday, 19 June 2012

Heart Attack

Heart Attack

 

Description:

 

Most Heart Attacks are caused by coronary heart disease where the coronary arteries narrow due to build up of fatty material (atheroma) within the walls. If part of this atheroma breaks off it can lead to a blood clot forming, which can block the artery starving the heart of blood and oxygen.

 

The death of the heart muscle is irreversible, if not treated promptly in hospital, serious complications can occur, not excluding death. Remember "time is important" your assistance can save a life.

 

Please note: A heart attack is NOT the same as a cardiac arrest. A cardiac arrest is where the heart stops pumping blood around the body, however one of the causes of cardiac arrest is a heart attack.

 

Signs & Symptoms:

 

  • Sudden onset can occur whilst resting.
  • Pain often described as 'Vicelike'.
  • Tightness or pain in chest which can spread to either arm, neck, jaw, back, stomach or shoulders.
  • Pain lasting more than 30 minutes.
  • Skin: Pale, grey clammy, sweating profusely.
  • Shortness of breath, nausea, vomiting, feeling of 'Impending Doom'.
  • Not all these signs & symptoms may be present.
  • Diagnosis is by electrocardiogram (ECG).

 

Treatment:

 

  • Stop what they are doing and sit them down.
  • Dial 999 NOT your GP as time is IMPORTANT.
  • See if they have their own medication (GTN spray or tablets).
  • Give aspirin 300mg orally, crushed or chewed. If patient is not allergic, not on Warfarin, and not under 16yrs.
  • Reduce any causes of stress or anxiety.
  • Give oxygen if available to new National Institute for Health and Clinical Excellence (NICE) guidelines i.e. under 94% saturation.

 

Remember:

Time is of the essence to improve outcomes. The faster a patient can be got to the Heart Unit for the insertion of a stent* the greater their chance of survival.

 

(* A stent is a small mesh tube inserted into an artery during a procedure called angioplasty to support w weakened artery).

 


We hope you find this article useful. This is one in an alphabetical series of articles addressing various symptoms and their first aid treatments. If you would like more information on related resuscitation and first aid training, please get in touch.

 

You might also be interested in our blog about seizures and related first aid.

 

You can also sign-up to our newsletter  on the homepage.

 

 

First Response. Training for life. Training to save a life.

 

Published in First Aid
Tuesday, 8 May 2012

Fractures

Fractures:

Description:

A fracture may be defined as a break in the continuity of a bone, however a crack is also known as a fracture. Most human bones can stand up to fairly strong impacts or forces, however if the force is too strong or there is something wrong with the bone it will fracture. The older we get the less the force the bone can withstand. Children's bones are more elastic and have areas at the ends called growth plates which can sometimes be damaged so often their fractures are different to those seen in an adult.

 

A greenstick fracture is a common example of this wear the bone partly breaks but the rest bends because of its flexibility.

 

Causes:

  • Direct force.
  • Indirect force.
  • Twisting.
  • Violent sudden movement.
  • Pathological - an underlying illness or condition that has weakened the bone. EG Osteoporosis, a tumour or perhaps infection.

 

Types of Fracture:

  • Closed –The skin is not broken.
  • Open – The skin has been penetrated and the bone exposed to air.
  • Complicated - Involving trapped nerves or blood vessels.
  • Green Stick – More common in children, the bone is split.

 

Signs & Symptoms:

  • History.
  • Pain.
  • Loss of power.
  • Deformity, swelling, bruising at the site.
  • Difficulty in moving.
  • Shortening, rotation.
  • Irregularity.
  • Crepitus – a cracking or grating felling or sound.
  • Tenderness.

 

Diagnosis is made on circumstances, signs and symptoms and sometimes either an X-Ray, MRI (Magnetic Resonance Imaging) or CT (Computed Tomography) scan.

 

Treatment:

  • Reassurance.
  • Do not move patient (unless in a dangerous situation like the middle of a road) and try to keep them still.
  • Make them comfortable.
  • Do not try to bandage or immobilize, wait for health care professional.

 

CAUTION:

  • Do not let the patient eat or drink in case surgery is required.

 

 

We hope you find this article useful. This is one in an alphabetical series of articles addressing various symptoms and their first aid treatments. If you would like more information on related resuscitation and first aid training, please get in touch.

 

You might also be interested in our blog. Amoungst other things, Clive Haddrell talks about what it is like being the paramedic consultant on the BBC's Casualty dramma.

 

 

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First Response. Training for life. Training to save a life.

 

Published in First Aid
Tuesday, 8 May 2012

Febrile Convulsion

Febrile Convulsion:

Description:

Febrile convulsions or seizures are a relatively common childhood condition and although the cause is unknown they can occur when a child has a temperature 38 degrees C or above. This rise in temperature is partly due to the underdevelopment of the part of their brain which is responsible for temperature regulation. This rise in temperature can result can from infections of the throat, ear, and other infectious disease or overheating.

 

Watching a child or baby having a febrile convulsion can be extremely frightening for the parents. During this convulsion the child may stop breathing and lips may become blue. Most babies have what is called a tonic clonic seizure.

 

The cells in the brain communicate by using electrical impulses. A seizure occurs when these are disrupted causing the brain and body to behave abnormally.

 

Types:

Simple

  • The most common.
  • Is a tonic clonic seizure.
  • Last no longer than 15 minutes.
  • Does not reoccur over the following 24 hr.

 

Complex

  • Only has symptoms in one part of body.
  • Last longer than 15 minutes.
  • Child does not fully recover from seizure within 1 hr.
  • Has more seizures within 24 hrs.

 

Signs & Symptoms:

  • Obvious signs of fever, hot flushed skin.
  • Violent muscle twitching, clench fists, arched back.
  • Twitching of the face, squinting, fixed or upturned eyes
  • Breath-holding, drooling around the mouth.
  • Loss or partial loss of consciousness.

 

Treatment:

  • Position soft padding/pillows around the child .
  • Remove clothing, bedding.
  • Ensure a good supply of cool, fresh air. (be careful not to overcool the child).
  • Sponge child's skin with tepid water to help cooling.
  • If fits persist Dial 999.

 

CAUTION:

  • Never place anything in child's mouth.
  • Do not try and restrain the child.
  • Be careful not to overcool.

 

We hope you find this article useful. This is one in an alphabetical series of articles addressing various symptoms and their first aid treatments. If you would like more information on related resuscitation and first aid training, please get in touch.

 

You might also be interested in our blog. In this post, Linda Hart talks about seizures and related first aid.

 

 

You can also sign-up to our newsletter on our homepage.

 

 

First Response. Training for life. Training to save a life.

 

Published in First Aid
Tuesday, 8 May 2012

Fainting or Syncope

Fainting or Syncope:

Description:

In order for the brain to function properly it relies on oxygen being carried to the blood. If the blood flow is reduced temporarily then the brains defence mechanism kicks in and takes available blood and oxygen from other parts of the body at the expense of other organs.

 

Breathing rate increases (hyperventilation) as does the heart rate as it tries to pump blood around the body. This increased heart rate lowers the blood pressure (hypotension); the combination of both can lead to temporarily loss of consciousness but at the least can make a patient fell cold, sweaty and dizzy. The onset is usually sudden and other symptoms may include blurred vision.

 

Causes:

Postural Syncope:

Occasionally from sitting but usually whilst standing for prolonged periods or when getting up. The blood pools in the big veins in the lower limbs and it is more difficult to get it back to the heart.

 

Vasovagal:

  • Reaction to pain.
  • Emotional stress or fright.
  • Hot stuffy environments.

 

Situational Syncope:

Occurs when a bodily function or activity places a sudden strain on the autonomic nervous system:

  • Coughing
  • Sneezing
  • Swallowing
  • Laughing
  • Passing stools
  • Exercising

 

Carotid Sinus Syndrome:

The carotid sinus as part of the carotid artery is located in the neck and is the main artery to the brain. Physical stimulation can affect the carotid sinus such as:

  • Turning the head to one side.
  • Wearing a tight collar.
  • Sometimes shaving in the area of the carotid sinus.

 

Cardiac Origin:

Transient decreases in the cardiac output as a result of severe bradycardia (slow pulse) which reduces cardiac output or a tachycardia (fast pulse)

 

Signs & Symptoms:

During fainting, one or more of the following signs may be present:

  • Slow pulse increasing with recovery.
  • Cold, clammy skin.
  • Pale in colour.
  • Reduce level of consciousness (AVPU).

 

Treatment:

  • Loosen any tight clothing.
  • Lie the patient down on the floor before they fall.
  • Raise their legs (raises blood pressure by easing the flow of blood from the major vessels in the lower legs to the heart.
  • Patient quick to recover however let the patient stay until they feel they are able to sit up slowly. If they then still feel faint lie them back down.
  • Ask the patient if this is their first faint (fainting is rare) if however they are having repeated episodes of fainting advise visit to GP.

 

CAUTION:

  • If the patient does not regain consciousness quickly, open airway and check for normal breathing. If patient is breathing normally, place them in the recovery position with a good airway. Then dial 999.
  • If the patient is not breathing normally or in doubt dial 999.

 

 

We hope you find this article useful. This is one in an alphabetical series of articles addressing various symptoms and their first aid treatments. If you would like more information on related resuscitation and first aid training, please get in touch.

 

You might also be interested in our blog. One of our more popular articles is about how we should control bleeding.

 

You can also sign-up to our newsletter on the homepage.

 

 

First Response. Training for life. Training to save a life.

 

 

Published in First Aid
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