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.

 

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Published in First Aid
Tuesday, 8 May 2012

Eye injuries

Eye Injuries:

Description:

The structure of the face helps to protect the eyes from injury. Each eyeball is set into a protective socket of bone known as the orbit, and the eyelids can close very quickly to form a protective barrier. However the eye can still be injured as a result of a direct blow, metal, grit, fluids, chemicals or dust particles.

 

Although uncommon, all eye injuries are potentially serious due to the possibility of damaging the patient's vision. Even superficial grazes to the cornea of the eye can lead to infection and subsequently permanent damage. An eye injury is classified as superficial (i.e. affecting only the surface) if it does not penetrate beneath the Bowmans Membrane (a smooth layer located in the cornea).

 

Signs & Symptoms:

  • Intense pain within or near the eyelids.
  • Visible wound (bruising or bloodshot appearance).
  • Partial or total loss of vision.
  • Blood around the eye or within the eye.

 

Treatment:

  • Wash small pieces of dirt, grit or dust out of the eye with cold tap water or sterile eye wash.
  • Encourage the patient to keep still with a soft sterile pad/dressing over the injured eye.
  • Encourage the patient to close their good eye as this will help stop movement in the injured eye.
  • If necessary dress both eyes. Please be aware this could prove distressing for the patient so keep talking to them.
  • In the case of a chemical getting in the eye, wear cloves and wash with lots of clean water ensuring water runs away from the good eye. Firmly open the patients eyelid to irrigate the eye fully.

 

CAUTION

  • DO NOT attempt to remove an embedded foreign object from the patients eye.

 

 

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. Tim Hart talks about dealing with a diabetic hypo when someone might be drunk.

 

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Published in First Aid
Thursday, 19 April 2012

Recovery Position

Recovery Position:

Description:

The biggest danger to the unconscious patient is airway obstruction. This may be caused by the patient lying flat on their back allowing the tongue to fall into a position where it obstructs air entering the air passages or through stomach regurgitation (vomit).

  • Manually immobilising the airway or placing your patient into the recovery position will prevent these two common dangers obstructing the patient airway.
  • Roll the casualty onto their side and gently tilt their head back to open their airway (head tilt, chin lift).

 

Recovery position for babies:

  • If an infant is unconscious but breathing normally, hold them on their side, head tilted, as if you were giving them a cuddle, with their head lower than their tummy.

 

CAUTION:

  • DO NOT place anything in an unconscious patient mouth.
  • DO NOT place anything under the patients head whilst on their back.
  • DO NOT move the patient unnecessarily.
  • DO NOT take for granted the patients airway is always maintain in this 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. One of our more popular articles is about recognising a siezure.

 

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Published in First Aid
Friday, 13 April 2012

Diabetes

Diabetes:

Description: 

Diabetes Mellitus is a group of metabolic diseases in which a person has high blood sugar, either because the body does not produce enough insulin or because cells do not respond to the insulin that is produced.

 

This high blood sugar produces the fowling symptoms:

  • Polyuria (frequent urination).
  • Polydipsia (increased thirst).
  • Polyphagia (Increased hunger).

 

There are 3 main types of Diabetes:

  • TYPE 1. This results from the body's failure to produce insulin and requires the person to inject insulin.
  • TYPE 2. This results from insulin resistance where the cells fail to use insulin properly.
  • GESTATIONAL. This is a pregnant woman, who has never had Diabetes before, but develops a high blood glucose level during pregnancy. This can sometimes precede Type 2.

 

Patients must make sure that eat the right type of food and balance their food intake with the insulin dose they are injecting, imbalance can cause sugar levels to rise (Hyperglycaemia) or fail (Hypoglycaemia).

  

There are three reasons why a patients sugar levels become low:

  • Insulin overdose.
  • Missing meals.
  • Sudden or too much exercise.

 

Signs & Symptoms:

  • Condition starts suddenly.
  • Uncharacteristic changes, uncooperative, violent, appears drunk, confused.
  • Pale, cold skin, sweating profusely.
  • Fast pulse, rapid shallow breathing.
  • Patient may be wearing a medic-alert bracelet or necklace.

 

Treatment:

  • Patient needs a sugary drink, sugar lumps, glucose tablets, or other sweet foods. If they respond well make sure you give them more food or drink.
  • If they do not respond within 10 minutes or they become dangerously unmanageable dial 999 for help.
  • If they become unconscious, place in recovery position.

 

HYPERGLYCAEMIA

 

Signs & Symptoms:

  • Slower onset.
  • Increased thirst.
  • Headaches.
  • Difficulty concentrating.
  • Fatigue.
  • Weight loss.
  • Blurred vision.
  • Frequent urination.

 

Treatment:

  • Drink more water.
  • Exercise more as this lowers blood glucose.
  • Review diet.
  • Review medication but only with your doctor.

 

Untreated HYPERGLYCAEMIA can develop into an emergency condition called KETOACIDOSIS whereby the body can not use sugar as a fuel source because of the lack of insulin so burns fat instead. The by-product of this is Ketones, which in high levels are poisonous.

 

CAUTION: 

  • DO NOT give any unconscious patient anything to eat or drink.

 

 

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.

 

 

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

 

Published in First Aid
Friday, 13 April 2012

Crush Injury

Crush Injury:

Description:

A crush injury has occurred when a body part has been subjected to a high degree of force or pressure, usually after being squeezed between two heavy objects.

 

Crush injuries mainly occur on building sites, industrial sites, construction areas, storage warehouses and in road accidents. It can affect the blood flow to a limb. When the flow of blood to an area is restricted by a heavy weight, there is the danger of a build-up of toxins within the muscle below the site of the crushing weight.

 

If the blood flow is restricted or impaired for more than 15 minutes, toxins can be released into the rest of the body and cause kidney failure. This process called 'Crush Syndrome' and the patient is at a high risk of death.

 

Treatment:

 

For crushing less than 15 minutes:

  • Release the weight as quickly as you can.
  • Dial 999.
  • Control any bleeding.
  • Treat for shock.

 

For crushing more than 15 minutes:

  • DO NOT release the weight.
  • Dial 999.
  • Monitor patient.

 

REMEMBER:

  • DO NOT release the weight if crushed for more than 15 minutes, wait arrival of paramedics.

 

 

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.

 

 

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

 

Published in First Aid
Friday, 13 April 2012

Chest Injuries

Chest Injuries:

Description:

Any injury to the chest (damage to the area between the neck and the abdomen including the ribs) can cause impairment to breathing leading to hypoxia. Hypoxia is a pathological condition in which the body as a whole (generalised hypoxia), or a region off the body (tissue hypoxia) is deprived of adequate oxygen supply. An undiagnosed chest injury can cause one or both lungs to collapse causing pressure on the heart; and ultimately cardiac arrest.

 

The two types of chest injury are:

  • Closed: The skin has not broken and air does not enter the chest cavity through the chest wall.
  • Open: The chest wall has been penetrated by a foreign object.

 

Causes of Chest Injury:

  • Blunt Trauma.
  • Penetrating objects.
  • Compression (crush injury).

 

Examples of Chest Injury:

  • Fractures ribs.
  • Fail segment.
  • Pneumothorax (Air entering the pleural cavity).
  • Open Pneumothorax (open sucking wound).
  • Haemothorax (Blood entering the pleura cavity).
  • Tension Pneumothorax (Air trapped in the pleura cavity under positive pressure displacing other organs).

 

NB: THE PLEURA CAVITY is the space between 2 pleura (serous membrane) visceral and parietal, which cover the lungs.

 

Signs & Symptoms:

  • Difficulty in breathing.
  • Uneven-unusual chest movement.
  • Panic & anxiety.
  • Pain at site of injury.
  • Blueness around the lips.
  • Pain.
  • Rapid heart beat.
  • Rapid breathing.
  • Poor oxygenation (SATS below 94%).

 

NB: SATS or Oxygen Saturation is a measure of how much oxygen the blood is carrying as a percentage of the maximum it could carry. A healthy individual would have SATS between 94 -100%.

 

Treatment:

  • Place casualty in the most comfortable position, if possible inclined to the injured side.
  • If open sucking chest wound, prevent air entry ASAP. If possible use a credit card, cling film or any air-tight seal to cover the wound. This must be taped on three sides to prevent air getting in, but will allow air to come out.
  • Dial 999.
  • If First Aiders are pulse Oximetery & oxygen therapy trained, then deliver oxygen therapy appropriately.

 

 

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 when to dial 999.

 

 

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

 

Published in First Aid
Tuesday, 6 March 2012

Anaphylaxis

Anaphylaxis:

Description:

Anaphylaxis is defined as a serious allergic reaction that is rapid in onset and may cause death.

 

The most common causes are food such as peanuts, shellfish, insect bites and some medications but there are others. It is due to histamine in large dosages, resulting in the following symptoms in varying degrees:

 

  • Blood vessels dilate (enlarge).
  • Bronchioles in the airway constrict (get smaller).
  • Blood vessels begin to leak, this in turn causes swelling.
  • Skin is itchy.
  • Rash may develop.

 

Signs & Symptoms:

  • Reaction can take place in seconds.
  • Look for swelling of the face, tongue. Lips, eyes & neck.
  • Difficult wheezy breathing.
  • Tight chest.
  • Fast weak pulse.
  • Stomach cramps, vomiting, nausea.
  • Skin rash.

 

Treatment:

  • The primary treatment would be adrenaline injection and if the patient has their own syringe device i.e. Emerade Auto-injector 500mg, 300mg & 150mg. Epi-Pen 300mg & 150mg
  • Encourage them to use it or give the injection to the patient yourself ASAP.
  • Lay the patient in a comfortable position.
  • If the patient has airway or breathing problems they may prefer to sit (this will help their breathing).
  • If the patient feels faint however – do not sit them up. Lay them down flat and raise their legs.
  • Dial 999.

 

If patient becomes unconscious place in recovery position (semi prone which will prevent tongue from blocking the airway) and ensure that the airway stays clear and that the patient is breathing.

 

CAUTION:

  • Do not sit or stand them up, as this could be potentially fatal.

 

 

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.
 

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

Published in First Aid
Tuesday, 6 March 2012

Burns & Scalds

Burns & Scalds:

Description:

Although burns and scalds causes similar injuries / damage to the skin and underlying tissues, the difference between them is the way they are caused. Burns such as chemical, electrical, and irradiation have special features.

 

Burns to the mouth and throat can cause serious problems with breathing as airways can rapidly swell. If necessary place in recovery position and be prepared to resuscitate.

 

The extent of the burn will indicate whether shock is like to develop, as tissue fluid (serum) leaks from the burnt area and is replaced by fluid from the circulatory system.

 

Causes of Burns:

 

Burns are caused by dry heat:

  • Flame or radiation (thermal)
  • Electricity
  • Friction
  • Corrosive

 

Scalds are caused by wet heat:

  • Water
  • Steam
  • Fat
  • Hot liquid chemicals

 

Treatment:

  • Cool the burn with cold running water for 10 minutes (important).
  • Use any cold fluid that is immediately available until water is.
  • Remove jewellery i.e. rings, watches ASAP as the limb will swell.
  • Carefully remove loose clothing.
  • Boiling water and fat take a long time to cool down, remove wet or fat covered loose clothing as quickly as possible, then treat the burn/scald.
  • Dress the burn with a non-sticky dressing. Cling film is great , provided you have cooled the burn sufficiently (10) minutes, do not wrap tightly around the limb.
  • Use specialist burns dressing (water gel pads) if and when available.

 

Infection:

  • Patients with burns or scalds are at risk from infection. Try and keep the inquiry clean and free of contamination

 

When to seek medical advice:

  • If the burns appears to be larger then a 50p piece.
  • If the patient is a child.
  • If the burn scalds goes all the way around a limb.
  • If any part of the burn appears to be full thickness.
  • If the burn involves hands, feet, genitals or face.
  • If you are not sure, seek medical advice.

 

CAUTION:

  • Do not burst blisters under any circumstances as the fluid inside is usually sterile.
  • Do not apply any lotions, or ointments.
  • Do not touch the injuries unnecessarily.
  • Do not apply any adhesive dressings.
  • Do not remove clothing that has adhered to the burn.

 

 

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.

 

 

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

 

Published in First Aid
Tuesday, 6 March 2012

Body Temperature

Body Temperature:

Description:

Our skin is one of our largest organs and it function is to protect the body from injury, infection and maintain a constant body temperature within its normal range of 36-37°C.

 

Our body temperature is constantly monitored by a thermostat within the brain. If this temperature was to raise or fall various mechanism are activated to either warm or cool the body.

 

How the body keeps of warm:

  • Blood vessels constrict to reduce blood flow to the skin to maintain core temperature.
  • Activity of our sweat glands is reduced.
  • Hairs stand up on end to trap and warm air close to the skin.
  • Body's other systems react by producing more warmth.
  • Rate of metabolism is increased.
  • Heat is also generated by muscle activity.

 

How the body loses Heat:

  • Body activates a number of mechanisms to encourage heat loss.
  • Blood vessels dilate; blood flow to the surface increased and more heat is lost.
  • Sweat glands become more active.
  • Sweat cools the skin as it evaporates.

 

Checking Temperature:

  • Digital thermometer: This can be used to measure temperature under the tongue or armpit.
  • Forehead thermometer: Hold the strip in place against the forehead for about 30 seconds.
  • Ear sensor thermometer: The tip of the thermometer is placed inside the ear and gives a temperature reading within 1 second.

 

Look at sections on:

  • Hypothermia.
  • Heat Exhaustion.

 

 

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.

 

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

 

 

 

Published in First Aid
Tuesday, 6 March 2012

Bleeding

Bleeding:

Description:

Bleeding, technically known as haemorrhaging, is the loss of blood from the circulatory system. Bleeding can occur internally where the blood leaks inside the body or externally (possibly via a opening such as ear, nose, mouth, anus (back passage), vagina or through the skin.

 

Typically a healthy person can endure a loss of up to 10-15% without having a serious medical problem. If you were to be a blood donor a typical donation would take about 8%.

 

Types of bleeding can be either:

  • Arterial (bright red and spurting as it is under pressure).
  • Venous (dark red) and under less pressure, it gushes rather than spurts.
  • Capillary (bluish bruising under the skin). The most common form that occurs in all minor wounds and oozes out.

 

Types of wounds:

  • Incisions or Incised wounds (clean cut caused by a sharp edge such as a knife or piece of glass).
  • Laceration (Irregular, tear like wound, possibly caused by a blunt object).
  • Abrasion (superficial, such as a graze in which the topmost layer of the skin is scraped off).
  • Contusion More commonly known as a bruise (blunt blow rupturing the capillaries).
  • Puncture (an object has penetrated into the skin).
  • Gunshot (bullet or missile under force penetrates the skin).

 

Treatment:

S.E.E.P. will assist you in remembering the treatment procedure (see below).

 

External bleeding:

  • S - Sit or lay: Sit or lay the patient down.
  • E - Examine: Examine wound for any foreign objects.
  • E - Elevate: Elevate the wound if possible above the level of the heart.
  • P - Pressure: Apply direct or indirect pressure.

 

Direct Pressure:

Placing pressure on the wound will constrict the blood vessels manually, helping to stem any blood flow. Keeping the wound above the level of the heart will decrease the pressure at the site of the wound and therefore reduce bleeding (this applies mainly to limbs and head, however if a fracture (break) was suspected in a limb it should not be moved. 

 

  • Wear gloves
  • Apply direct pressure over the wound using patient own hands preferably with a layer of gauze between to minimize infection.
  • Apply a dressing large enough to cover the wound.
  • Apply firm pressure, but not tight enough to stop the flow of blood to the rest of the limb.
  • If an inbreeded object is still in the wound apply pressure to both sides of the wound. Objects should NEVER be removed.

 

Indirect Pressure:

In situations where direct pressure and / or elevation are not possible or proving ineffective then using pressure to constrict the artery which supplies the bleeding point is an option.

 

  • Is the last resort.
  • Apply pressure to the artery supply the limb (for a maximum of 10 minutes).
  • Use two main pressure points.
  • Brachial, by using two fingers in the upper inside part of the arm just below the arm pit and Femoral using three fingers on the upper inside of the thigh bone (femur).

 

Dressings:

  • Should be large enough to cover the wound.
  • Apply the dressing firmly to control the bleeding.
  • Check dressing is not tight as to restrict the flow of blood.
  • If blood seeps through this dressing apply a further dressing.
  • If this does not work remove dressing and start again.

 

Internal Bleeding:

The treatment of internal bleeding is usually beyond the scope of simple first aid so should be considered as LIFE THREATENING. Medical advice should be sought immediately as inevitably surgical intervention will be required.

 

  • Internal bleeding take place within our body.
  • Can be the result of inquires - trauma to the chest or abdomen, spontaneously such as bleeding from an artery (aneurism) or stomach.
  • Bleeding can also take place within the skull i.e. from the brain.
  • Shock may develop rapidly in your patient.

 

Signs & Symptoms:

  • Pain, or history of a (recent blow or fall).
  • Bruising – swelling.
  • Blood may be discharged from various orifices of the body.
  • Rapid weak pulse.
  • Pale clammy skin.
  • Fast, shallow breathing.
  • Deep, sighing breathing (Air hunger).
  • Blue colour to lips.
  • Nausea or vomiting.
  • Decreasing level of consciousness (AVPU) Alert – Voice – Pain – Unresponsive.
  • Confusion.

 

Treatment:

  • Lay patient down flat with their legs raised.
  • Dial 999.
  • Keep patient warm, but do not overheat.
  • Do not allow patient to have food or drinks or smoke.
  • Be prepared for patient to go unconscious (place in recovery position).

 

CAUTION:

  • Embedded objects should not be removed.

 

 

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.

 

 

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 3 of 4

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