COMING SOON: New First Response First Aid A-Z section

First Response have been busy compiling a handy A-Z of medical conditions and first aid. We want to share this with you, so each month we will be uploading a letter-full of articles on this website. We're kicking off with:

Published in First Response News
Tuesday, 3 July 2012

Hypoxia

Hypoxia:

Description:

Hypoxia is a pathogical condition in which the body as a whole (generalised) hypoxia) or a region of the body (tissue hypoxia) is deprived of an adequate oxygen supply. Variations in arterial oxygen concentrations can be part of normal physiology such as during strenuous exercise.

 

Generalised hypoxia occurs in healthy people when they ascend to high altitudes causing altitude sickness. It can also occur in healthy people due to breathing a mixture of gases with low oxygen content. For example when diving underwater defined as "Low Oxygen in the blood. This medical condition may arise when insufficient oxygen reaches the bodies tissues.

 

But there are a number of causes to be considered also:

 

External:

  • Drowning.
  • Lack of oxygen in the area, i.e. gas or smoke.
  • Carbon monoxide.
  • Suffocation.

 

Airway:

  • Obstruction by the tongue.
  • Vomit.
  • Anaphylaxis.
  • Burns.
  • Hanging - Strangulation.

 

Breathing:

  • Asthma.
  • Poisoning.
  • Chest Injury.
  • Crush injury.
  • Collapsed Lung.
  • Lung Infections.

 

Circulation:

  • Heart attack.
  • Angina.
  • Anaemia.
  • Cardiac arrest.

 

Control Centre (Brain):

  • Head injury.
  • Strokes.
  • Overdose.
  • Electric shock.
  • Spinal injury

 

Low levels of oxygen can prove to be potentially fatal; it is therefore essential that first aiders can recognise this condition and treat the patient accordingly.

 

Signs & Symptoms:

The symptoms of generalised hypoxia depend on its severity and acceleration of onset. In altitude sickness for example the onset is gradual and as well as the symptoms below the individual may have feelings of euphoria

  • Pale, cold, clammy skin.
  • Increased pulse rate.
  • Increased breathing rate.
  • Grey-blue skin (cyanosis).
  • Anxiety.
  • Restlessness.
  • Headache.
  • Nausea –Vomiting.
  • Because haemoglobin is darker red when not bound to oxygen, when seen through the skin it can reflect blue light back to the eye, so in cases where the oxygen has been displaced by carbon monoxide the skin may appear cherry red rather than cyanotic.

 

Treatment:

  • Remove the patient from the cause.
  • Monitor patient level of consciousness (AVPU).
  • Maintain patients airway.
  • Unconscious patient to be placed in the recovery position.
  • If available use a pulse oximeter on patients finger (a non invasive method of measuring the oxygenation of haemoglobin)
  • Sats below 94% give patient oxygen therapy using a 100% non-rebreathing mask at 15 liters per minute.
  • Monitor sats.

 

Caution:

  • Do not allow your patient to eat, drink or smoke.

 

We hope you find this article useful. This is one in an alphabetical series of articles addressing various symptoms and their first aid treatments. Many of the topics mentioned above are covered in our A-Z.

 

You might also be interested in our blog. In particular our post that talks about how we should control bleedng.

 

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, 3 July 2012

Hypothermia

Hypothermia:

Description:

Hypothermia happens when the body temperature falls below 35°c (95°f). Normal body temperature is around 37 degrees c (98.6 degrees F).

 

Hypothermia can quickly become life threatening and should be treated as a medical emergency.

 

Causes:

Hypothermia is usually caused by being in a cold environment. It can be triggered by a combination of things including being exposed to the cold for a long time. This may be outside in cold conditions or indoors in a poorly heated room or being in cold water.

 

Particularly vulnerable are elderly patients who often do not generate much body heat, due possibly to lack of mobility, poor heating or inadequate or inappropriate clothing. Young children are also vulnerable as their temperature control centre in the brain is under developed. The homeless suffer from lack of protection from the cold weather, poor intake of food, lack of activity and illness. All these can increase the risk of hypothermia

 

Signs & Symptoms:

When your body gets cold it will try to prevent further heat loss by:

  • Shivering.
  • Restricting blood flow to the skin.
  • Releasing hormones to generate heat.

 

However, these responses use up energy and may not be enough to maintain body temperature if you have been exposed to the cold for a long time. When the body runs out of energy it gradually begins t shut down. Shivering stops and your heart beat begins to slow.

  • Shivering.
  • Tiredness.
  • Confusion.

 

The symptoms vary depending on how low the body temperature has dropped. Mild symptoms include:

 

But as the body temperature drops:

  • Shivering becomes violent.
  • A person is likely to become delirious.
  • They may struggle to breath.
  • The may lapse into unconsciousness.
  • Babies may by limp, refuse to feed or be unusually quiet.

 

Treatment:

  • Protect from weather, remove wet clothing.
  • Cover with warm dry clothing.
  • If patient is young and able to climb into bath unaided, bathe them in warm water (40°c/104°f). DO NOT allow the elderly to enter a bath.
  • If bath not possible, wrap them up in warm blankets and try to raise the room temperature to (25°c/77°f).
  • Give patient warm drinks and food.
  • If in any doubt Dial 999.

 

Caution:

  • Do not give patient alcohol.
  • Do not place patient in front of a direct heat source.
  • Do not warm babies or the elderly to quickly.

 

Important:

Handle a hypothermic patient with great care, rough handling can induce cardiac arrest

 

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 particular our post that talks about the difference in recognising hyperglycaemia when drunk.

 

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, 3 July 2012

Levels of Response

Levels of Response AVPU:

Description:

The AVPU scale (Alert, Voice, Pain, Unresponsive) is a system which is taught to healthcare professionals and first aiders on how to measure and record the patient's level of consciousness. It is a simplification of the GCS Scale (Glasgow Coma) which assesses a patient's response using Eyes, Voice and Motor skills as measures.

 

The AVPU has only one of four possible outcomes

 

These four outcomes are:

 

  • Alert - Patient is fully awake (though not necessarily orientated), will have spontaneously open eyes, and will respond to voice (thought may be confused). They will have bodily motor function

 

  • Voice – The patient makes some sort of response when you talk to them. This could be through the eyes which open when you speak to them, or by voice which may only be as little as a grunt. Or, it could be by moving a limb when prompted to do so by the rescuer.

 

  • Pain - A patient may respond by using any of the three components when pain stimulus is used on them (Eyes, Voice, Movement). Recognised methods for causing pain are pinching the ear or pressing into the bed of a fingernail. A fully conscious patient will locate the pain and push it away, whereas a patient who is not alert and not responded to voice may only manifest involuntary flexion or extension of a limb. Performing pain stimulus should be used with caution as in extreme circumstances this could be considered assault.

 

  • Unresponsive - This outcome is noted if the patient does not give any Eye, Voice or Motor response to voice or pain.

 

In first aid, an AVPU score less than A is a good indication of the need to get further help.

 

Treatment:

  • If patient conscious level is below 'A' seek medical help.
  • Monitor patient's level of response until medical help arrives.
  • An unconscious patient is serious and the priority here is the patients airway.
  • Place in recovery position.
  • Dial 999.
  • Treat any bleeding or cover open fractures.
  • If first aiders have oxygen therapy, place pulse oximeter on patients finger and take reading, if below 94% place patient on oxygen therapy.

 

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, Clive talks about when you should or shouldn't call an ambulance.

 

 

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

 

 

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.

 

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
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.

 

 

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

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
Page 2 of 4

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