Clive Haddrell Cert Ed MSET

Clive Haddrell Cert Ed MSET

NHS Paramedic Tutor, NHS Ambulance Emergency Driving Tutor, FAETC 1&2, Cert/Ed, D32, D33. Manual Handling Tutor (RoSPA) and Member of the Society for Education and Training. I have over thirty years experience with the former Avon Ambulance Service NHS Trust, and recently with Great Western Ambulance Service NHS Trust. My experience includes the role of paramedic tutor, rapid response motorcycle paramedic. For the last 25years paramedic advisor to the well-known BBC television program "Casualty".

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.

 

Tuesday, 8 May 2012

Epilepsy

Epilepsy:

Description:

Epileptic Seizures are caused by a sudden burst of excess electrical activity in the brain. This results in a temporary disruption to the normal message being passed between brain calls. The message is either halted or gets mixed-up, so depending where the brain the epileptic activity begins determines how widely and rapidly it is spread.

 

For this reason there are many types of seizures and each person will experience epilepsy in a way unique to them. Seizures can often be sudden and dramatic, though some epileptic patients may experience a brief warning period (aura) for example a strange feeling, smell or taste.

 

Epilepsy is due to an underlying cause, which can be categorized into 3 main groups:

 

1: Symptomatic Epilepsy:

This is where there is a known cause as a head injury, an infection such as meningitis, a stroke or tumour and sometimes where the brain has not developed properly.

 

2: Idoepathic Epilepsy:

This is likely due to a genetic tendency that may have been inherited, or resulting from a change that happens in a person's genes before they are born.

 

3: Cryptogenic Epilepsy

This is where no cause has been despite investigations.

 

Part of the genetic tendency is called the seizure threshold: we all have a seizure threshold so any one of us has the potential to have a seizure but less so if the threshold is high. This threshold therefore plays a key role in whether someone will develop epilepsy.

 

Types of Seizures:

 

Minor: Some patients experience a mild form of epilepsy, with small seizures during which they appear distant from and unaware of their surroundings. We refer to these seizures as "absences" and patients are unlikely to have any convulsive movements.

 

Signs & Symptoms:

  • Sudden switching off.
  • Patient may stare blankly.
  • Slight occasional twitching or jerking of the lips, eyelids, head or limbs.
  • Bizarre "automatic" movements, such as lip-smacking, chewing or making noises.

 

Treatment:

  • Remove sources of danger.
  • Help guide and reassure patient.
  • Stay with them until fully alert.
  • If this has not happened to them before advise to see their GP.

 

Major Seizure: This type of seizure can happen suddenly as a result from major disturbances within the brain. This may cause the patient to fit aggressively involving the whole body

 

Signs & symptoms:

  • Aura: Patient may recognise they are about to have a seizure.
  • Tonic phase: Muscles become suddenly rigid.
  • Clonic Phase: Limbs start to make sudden, jerking, violent movements.
  • Recovery Phase: The patient's body begins to relax although patient is not fully responsive.
  • After the siezure the patient may fell tired and fall asleep.

 

Treatment:

  • Move any dangerous objects away from the patient.
  • Assist patient to floor.
  • If there are any concerns about patients airway, place them in the recovery position.
  • Record start time of seizure.
  • Call 999 if seizure last more than 3 minutes.
  • Call 999 if it is the patients first fit.

 

CAUTION:

  • Never place anything in the patients mouth.
  • Never try and restrain the patient.
  • Never try and move patient unless in extreme danger.

 

 

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.

 

 

 

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.

 

 

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

 

 

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

 

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.
 

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

 

 

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

Monday, 5 March 2012

Amputation

Amputation: 

Description:

A limb that has been partially or completely severed.

 

Signs & Symptoms:

• History of trauma (injury) from external pressure.

• Limb may be completely detached or remain partially attached by tissue.

• Patient may be suffering from shock. Shock can be psychological (mental) which can 

   give symptoms such as palpitations and feeling faint but doesn't usually lead to physical collapse.

   However shock can be also be physiological (circulatory) resulting from blood loss which can

   lead to collapse or even death.

 

Treatment:

• Wear protective gloves.

• Lay the patient down if they feel faint.

• Control any bleeding with pressure dressings.

• Place the amputated limb in a plastic bag or cling film.

• Place bag in or around a package of ice.

• Dial 999.

 

CAUTION:

• Do not wash the severed part.

• Do not allow the severed part to come into direct contact with ice or water.

 

 

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.

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