A heart attack occurs when an artery supplying your heart with blood and oxygen becomes blocked. This loss of blood flow injures your heart muscle. A heart attack generally causes chest pain for more than 15 minutes, but it can also be "silent" and have no symptoms at all.
Many people who suffer a heart attack have warning symptoms hours, days or weeks in advance. The earliest predictor of an attack may be recurrent chest pain that's triggered by exertion and relieved by rest (angina).
Someone having an attack may experience any or all of the following:
Uncomfortable pressure, fullness or squeezing pain in the center of the chest. The pain might last several minutes or come and go. It may be triggered by exertion and relieved by rest.
Prolonged pain in the upper abdomen.
Discomfort or pain spreading beyond the chest to the shoulders, neck, jaw, teeth, or one or both arms.
Shortness of breath.
Lightheadedness, dizziness, fainting.
Sweating.
Nausea.
If you or someone else may be having a heart attack:
Dial 911 or your local emergency medical assistance number. Don't tough out the symptoms of a heart attack for more than five minutes. If you don't have access to emergency medical services, have a neighbor or a friend drive you to the nearest hospital. Police or fire-rescue units also may be a source of transportation. Drive yourself only as a last resort, if there are absolutely no other options, and realize that it places you and others at risk when you drive under these circumstances.
Chew and swallow an aspirin, unless you're allergic to aspirin or have been told by your doctor never to take aspirin. But seek emergency help first, such as calling 911.
Take nitroglycerin, if prescribed. If you think you're having a heart attack and your doctor has previously prescribed nitroglycerin for you, take it as directed. Do not take anyone else's nitroglycerin, because that could put you in more danger.
Begin CPR. If you're with a person who might be having a heart attack and he or she is unconscious, tell the 911 dispatcher or another emergency medical specialist. You may be advised to begin cardiopulmonary resuscitation (CPR). If you haven't received CPR training, doctors recommend skipping mouth-to-mouth rescue breathing and proceeding directly to chest compression. The dispatcher can instruct you in the proper procedures until help arrives.
source:mayoclinic.com
Monday, December 29, 2008
Tuesday, December 23, 2008
TESTICULAR TORSION
Introduction
Background
Testicular torsion is a true urologic emergency and must be differentiated from other complaints of testicular pain because a delay in diagnosis and management can lead to loss of the testicle. Though testicular torsion can occur at any age, including the prenatal and perinatal periods, it most commonly occurs in adolescent males, and testicular torsion is the most frequent cause of testicle loss in that population.
Pathophysiology
The testicle is typically covered by the tunica vaginalis, a potential space that encompasses the anterior two thirds of the testicle and where fluid from a variety of sources may accumulate. The tunica vaginalis attaches to the posterolateral surface of the testicle and allows for little mobility of the testicle within the scrotum.
In patients who have an inappropriately high attachment of the tunica vaginalis, the testicle can rotate freely on the spermatic cord within the tunica vaginalis (intravaginal testicular torsion). This congenital anomaly, called the bell clapper deformity, results in the long axis of the testicle to become oriented transversely rather than cephalocaudal. This congenital abnormality is present in approximately 12% of males, 40% of which have the abnormality in the contralateral testicle as well.1 The bell clapper deformity allows the testicle to twist spontaneously on the spermatic cord, causing venous occlusion and engorgement, with subsequent arterial ischemia causing infarction of the testicle. Experimental evidence indicates that 720° torsion is required to compromise flow through the testicular artery and result in ischemia.
In the neonatal age group, the testicle frequently has not yet descended into the scrotum, where it becomes attached within the tunica vaginalis. This mobility of the testicle predisposes it to torsion (extravaginal testicular torsion). Inadequate fusion of the testicle to the scrotal wall, moreover, typically occurs within the first 7-10 days of life.
Torsion may be categorized as complete, incomplete, or transient.
Frequency
United States
Incidence of torsion in males younger than 25 years is approximately 1 in 4000.2 Torsion more often involves the left testicle.
Of the cases of testicular torsion that occur in the neonatal population, 70% occur prenatally and 30% occur postnatally.
Mortality/Morbidity
This urologic emergency requires prompt diagnosis, immediate urologic consultation, and rapid definitive operative treatment for salvage of the testicle.
A salvage rate of 90-100% is found in patients who undergo detorsion within 6 hours of pain; the viability rate fell to between 20% and 50% after 12 hours; and 0 to 10% viability if detorsion is delayed greater than 24 hours.3, 2
Sex
Testicular torsion affects males only.
Age
Testicular torsion most often is observed in males younger than 30 years, with most aged 12-18 years. The peak age is 14 years, although a smaller peak also occurs during the first year of life.
Clinical
History
History includes a sudden onset of severe unilateral scrotal pain.
As many as 50% of patients have a history of prior episodes of intermittent testicular pain that has resolved spontaneously (intermittent torsion and detorsion).
Onset of pain can occur more slowly, but this is an uncommon presentation of torsion.
Torsion can occur with activity, be related to trauma in 4-8% of cases2, or develop during sleep.
The historical features suggestive of testicular torsion include the following:
Acute onset of unilateral scrotal pain
Scrotal swelling
Nausea and vomiting: In the pediatric population, nausea and vomiting more commonly accompany acute testicular torsion and have a positive predictive value of greater than 96%.4
Abdominal pain (20-30%)
Fever (16%)
Urinary frequency (4%)
Physical
The physical examination may be difficult to perform, particularly in the case of an ill child.
Involved testicle painful to palpation; frequently elevated in position when compared with the other side
Horizontal lie of the testicle
Enlargement and edema of the testicle; edema involving the entire scrotum
Scrotal erythema
Ipsilateral loss of the cremasteric reflex. The cremasteric reflex is almost always absent in patients with testicular torsion, and its presence may help to distinguish other causes of acute scrotal pain from testicular torsion.5, 6
Usually, no relief of pain upon elevation of scrotum (elevation may improve the pain in epididymitis [Prehn sign])
Fever (uncommon)
Causes
Congenital anomaly; bell clapper deformity
Undescended testicle
Sexual arousal and/or activity
Trauma
Exercise
Active cremasteric reflex
Cold weather
source:emedicine
Background
Testicular torsion is a true urologic emergency and must be differentiated from other complaints of testicular pain because a delay in diagnosis and management can lead to loss of the testicle. Though testicular torsion can occur at any age, including the prenatal and perinatal periods, it most commonly occurs in adolescent males, and testicular torsion is the most frequent cause of testicle loss in that population.
Pathophysiology
The testicle is typically covered by the tunica vaginalis, a potential space that encompasses the anterior two thirds of the testicle and where fluid from a variety of sources may accumulate. The tunica vaginalis attaches to the posterolateral surface of the testicle and allows for little mobility of the testicle within the scrotum.
In patients who have an inappropriately high attachment of the tunica vaginalis, the testicle can rotate freely on the spermatic cord within the tunica vaginalis (intravaginal testicular torsion). This congenital anomaly, called the bell clapper deformity, results in the long axis of the testicle to become oriented transversely rather than cephalocaudal. This congenital abnormality is present in approximately 12% of males, 40% of which have the abnormality in the contralateral testicle as well.1 The bell clapper deformity allows the testicle to twist spontaneously on the spermatic cord, causing venous occlusion and engorgement, with subsequent arterial ischemia causing infarction of the testicle. Experimental evidence indicates that 720° torsion is required to compromise flow through the testicular artery and result in ischemia.
In the neonatal age group, the testicle frequently has not yet descended into the scrotum, where it becomes attached within the tunica vaginalis. This mobility of the testicle predisposes it to torsion (extravaginal testicular torsion). Inadequate fusion of the testicle to the scrotal wall, moreover, typically occurs within the first 7-10 days of life.
Torsion may be categorized as complete, incomplete, or transient.
Frequency
United States
Incidence of torsion in males younger than 25 years is approximately 1 in 4000.2 Torsion more often involves the left testicle.
Of the cases of testicular torsion that occur in the neonatal population, 70% occur prenatally and 30% occur postnatally.
Mortality/Morbidity
This urologic emergency requires prompt diagnosis, immediate urologic consultation, and rapid definitive operative treatment for salvage of the testicle.
A salvage rate of 90-100% is found in patients who undergo detorsion within 6 hours of pain; the viability rate fell to between 20% and 50% after 12 hours; and 0 to 10% viability if detorsion is delayed greater than 24 hours.3, 2
Sex
Testicular torsion affects males only.
Age
Testicular torsion most often is observed in males younger than 30 years, with most aged 12-18 years. The peak age is 14 years, although a smaller peak also occurs during the first year of life.
Clinical
History
History includes a sudden onset of severe unilateral scrotal pain.
As many as 50% of patients have a history of prior episodes of intermittent testicular pain that has resolved spontaneously (intermittent torsion and detorsion).
Onset of pain can occur more slowly, but this is an uncommon presentation of torsion.
Torsion can occur with activity, be related to trauma in 4-8% of cases2, or develop during sleep.
The historical features suggestive of testicular torsion include the following:
Acute onset of unilateral scrotal pain
Scrotal swelling
Nausea and vomiting: In the pediatric population, nausea and vomiting more commonly accompany acute testicular torsion and have a positive predictive value of greater than 96%.4
Abdominal pain (20-30%)
Fever (16%)
Urinary frequency (4%)
Physical
The physical examination may be difficult to perform, particularly in the case of an ill child.
Involved testicle painful to palpation; frequently elevated in position when compared with the other side
Horizontal lie of the testicle
Enlargement and edema of the testicle; edema involving the entire scrotum
Scrotal erythema
Ipsilateral loss of the cremasteric reflex. The cremasteric reflex is almost always absent in patients with testicular torsion, and its presence may help to distinguish other causes of acute scrotal pain from testicular torsion.5, 6
Usually, no relief of pain upon elevation of scrotum (elevation may improve the pain in epididymitis [Prehn sign])
Fever (uncommon)
Causes
Congenital anomaly; bell clapper deformity
Undescended testicle
Sexual arousal and/or activity
Trauma
Exercise
Active cremasteric reflex
Cold weather
source:emedicine
Monday, December 22, 2008
DYSMENORRHEA
What is dysmenorrhea?
Dysmenorrhea is a menstrual condition characterized by severe and frequent menstrual cramps and pain associated with menstruation. Dysmenorrhea may be classified as primary or secondary.
primary dysmenorrhea - from the beginning and usually lifelong; severe and frequent menstrual cramping caused by severe and abnormal uterine contractions.
secondary dysmenorrhea - due to some physical cause and usually of later onset; painful menstrual periods caused by another medical condition present in the body (i.e., pelvic inflammatory disease, endometriosis).
What causes dysmenorrhea?
The cause of dysmenorrhea depends on whether the condition is primary or secondary. In general, females with primary dysmenorrhea experience abnormal uterine contractions as a result of a chemical imbalance in the body (particularly prostaglandin and arachidonic acid - both chemicals which control the contractions of the uterus). Secondary dysmenorrhea is caused by other medical conditions, most often endometriosis (a condition in which tissue that looks and acts like endometrial tissue becomes implanted outside the uterus, usually on other reproductive organs inside the pelvis or in the abdominal cavity - often resulting in internal bleeding, infection, and pelvic pain). Other possible causes of secondary dysmenorrhea include the following:
pelvic inflammatory disease (PID)
uterine fibroids
abnormal pregnancy (i.e., miscarriage, ectopic)
infection, tumors, or polyps in the pelvic cavity
Who is at risk for dysmenorrhea?
While any female can develop dysmenorrhea, the following females may be at an increased risk for the condition:
females who smoke
females who drink alcohol during menses (alcohol tends to prolong menstrual pain)
females who are overweight
females who started menstruating before the age of 11
Consult your physician for more information.
What are the symptoms of dysmenorrhea?
The following are the most common symptoms ofdysmenorrhea. However, each adolescent may experience symptoms differently. Symptoms may include:
cramping in the lower abdomen
pain in the lower abdomen
low back pain
pain radiating down the legs
nausea
vomiting
diarrhea
fatigue
weakness
fainting
headaches
The symptoms of dysmenorrhea may resemble other conditions or medical problems. Always consult your physician for a diagnosis.
How is dysmenorrhea diagnosed?
Diagnosis begins with a gynecologist evaluating a female's medical history and a complete physical examination including a pelvic examination. A diagnosis of dysmenorrhea can only be certain when the physician rules out other menstrual disorders, medical conditions, or medications that may be causing or aggravating the condition. In addition, diagnostic procedures for dysmenorrhea may include:
ultrasound (Also called sonography.) - a diagnostic imaging technique which uses high-frequency sound waves and a computer to create images of blood vessels, tissues, and organs. Ultrasounds are used to view internal organs as they function, and to assess blood flow through various vessels.
magnetic resonance imaging (MRI) - a diagnostic procedure that uses a combination of large magnets, radiofrequencies, and a computer to produce detailed images of organs and structures within the body.
laparoscopy - a minor surgical procedure in which a laparoscope, a thin tube with a lens and a light, is inserted into an incision in the abdominal wall. Using the laparoscope to see into the pelvic and abdomen area, the physician can often detect abnormal growths.
hysteroscopy - a visual examination of the canal of the cervix and the interior of the uterus using a viewing instrument (hysteroscope) inserted through the vagina.
Treatment for dysmenorrhea:
Specific treatment for dysmenorrhea will be determined by your physician based on:
your age, overall health, and medical history
extent of the condition
cause of the condition (primary or secondary)
your tolerance for specific medications, procedures, or therapies
expectations for the course of the condition
your opinion or preference
Counseling with your physician regarding symptoms may increase understanding and lead to activities for stress management. Other possible treatment protocols for managing dysmenorrhea symptoms in young women may include the following:
prostaglandin inhibitors (i.e., nonsteroidal anti-inflammatory medications, or NSAIDs, such as aspirin, ibuprofen) - to reduce pain
acetaminophen
oral contraceptives (ovulation inhibitors)
progesterone (hormone treatment)
dietary modifications (to increase protein and decrease sugar and caffeine intake)
vitamin supplements
regular exercise
heating pad across the abdomen
hot bath or shower
abdominal massage
source:healthsystem.viginia.edu
Dysmenorrhea is a menstrual condition characterized by severe and frequent menstrual cramps and pain associated with menstruation. Dysmenorrhea may be classified as primary or secondary.
primary dysmenorrhea - from the beginning and usually lifelong; severe and frequent menstrual cramping caused by severe and abnormal uterine contractions.
secondary dysmenorrhea - due to some physical cause and usually of later onset; painful menstrual periods caused by another medical condition present in the body (i.e., pelvic inflammatory disease, endometriosis).
What causes dysmenorrhea?
The cause of dysmenorrhea depends on whether the condition is primary or secondary. In general, females with primary dysmenorrhea experience abnormal uterine contractions as a result of a chemical imbalance in the body (particularly prostaglandin and arachidonic acid - both chemicals which control the contractions of the uterus). Secondary dysmenorrhea is caused by other medical conditions, most often endometriosis (a condition in which tissue that looks and acts like endometrial tissue becomes implanted outside the uterus, usually on other reproductive organs inside the pelvis or in the abdominal cavity - often resulting in internal bleeding, infection, and pelvic pain). Other possible causes of secondary dysmenorrhea include the following:
pelvic inflammatory disease (PID)
uterine fibroids
abnormal pregnancy (i.e., miscarriage, ectopic)
infection, tumors, or polyps in the pelvic cavity
Who is at risk for dysmenorrhea?
While any female can develop dysmenorrhea, the following females may be at an increased risk for the condition:
females who smoke
females who drink alcohol during menses (alcohol tends to prolong menstrual pain)
females who are overweight
females who started menstruating before the age of 11
Consult your physician for more information.
What are the symptoms of dysmenorrhea?
The following are the most common symptoms ofdysmenorrhea. However, each adolescent may experience symptoms differently. Symptoms may include:
cramping in the lower abdomen
pain in the lower abdomen
low back pain
pain radiating down the legs
nausea
vomiting
diarrhea
fatigue
weakness
fainting
headaches
The symptoms of dysmenorrhea may resemble other conditions or medical problems. Always consult your physician for a diagnosis.
How is dysmenorrhea diagnosed?
Diagnosis begins with a gynecologist evaluating a female's medical history and a complete physical examination including a pelvic examination. A diagnosis of dysmenorrhea can only be certain when the physician rules out other menstrual disorders, medical conditions, or medications that may be causing or aggravating the condition. In addition, diagnostic procedures for dysmenorrhea may include:
ultrasound (Also called sonography.) - a diagnostic imaging technique which uses high-frequency sound waves and a computer to create images of blood vessels, tissues, and organs. Ultrasounds are used to view internal organs as they function, and to assess blood flow through various vessels.
magnetic resonance imaging (MRI) - a diagnostic procedure that uses a combination of large magnets, radiofrequencies, and a computer to produce detailed images of organs and structures within the body.
laparoscopy - a minor surgical procedure in which a laparoscope, a thin tube with a lens and a light, is inserted into an incision in the abdominal wall. Using the laparoscope to see into the pelvic and abdomen area, the physician can often detect abnormal growths.
hysteroscopy - a visual examination of the canal of the cervix and the interior of the uterus using a viewing instrument (hysteroscope) inserted through the vagina.
Treatment for dysmenorrhea:
Specific treatment for dysmenorrhea will be determined by your physician based on:
your age, overall health, and medical history
extent of the condition
cause of the condition (primary or secondary)
your tolerance for specific medications, procedures, or therapies
expectations for the course of the condition
your opinion or preference
Counseling with your physician regarding symptoms may increase understanding and lead to activities for stress management. Other possible treatment protocols for managing dysmenorrhea symptoms in young women may include the following:
prostaglandin inhibitors (i.e., nonsteroidal anti-inflammatory medications, or NSAIDs, such as aspirin, ibuprofen) - to reduce pain
acetaminophen
oral contraceptives (ovulation inhibitors)
progesterone (hormone treatment)
dietary modifications (to increase protein and decrease sugar and caffeine intake)
vitamin supplements
regular exercise
heating pad across the abdomen
hot bath or shower
abdominal massage
source:healthsystem.viginia.edu
Friday, December 19, 2008
GSTROINTESTINAL BLEEDING SYMPTOMS
(continued)
Acute gastrointestinal bleeding first will appear as vomiting of blood, bloody bowel movements, or black, tarry stools. Blood may look like "coffee grounds." Symptoms associated with blood loss can include the following:
Fatigue
Weakness
Shortness of breath
Abdominal pain
Pale appearance
Vomiting of blood usually originates from an upper GI source. Bright red or maroon stool can be from either a lower GI source or from brisk bleeding at an upper GI source.
Long-term GI bleeding may go unnoticed or may cause fatigue, anemia, black stools, or a positive test for microscopic blood.
When to Seek Medical Care
Any presence of blood in the stool or the upper gastrointestinal tract is significant and needs medical investigation. Black or dark stools may represent slow bleeding into the GI tract and should be investigated by a physician.
Any significant bleeding into the GI tract, either vomited blood or blood through the rectum, should be evaluated in the emergency department.
Exams and Tests
A doctor will perform a complete history and physical exam to evaluate your problem. The physical will include a digital rectal exam, to test for visible or microscopic blood from your rectum.
The doctor may need to insert a tube through your nose into your stomach to help identify the source of the bleeding. The procedure is called endoscopy. An endoscope is a long tube with a tiny camera on the end. It may be passed through the nose into the stomach, or through the rectum into the colon, to directly see the source of bleeding. Endoscopy can be both diagnostic, finding the source of bleeding, and therapeutic, stopping it.
Lab tests also can be helpful to determine the rate or severity of bleeding and to determine factors that may contribute to the problem.
Gastrointestinal Bleeding Treatment
Self-Care at Home
There is no home care for heavy gastrointestinal bleeding. Go to a hospital's emergency department. For hemorrhoids or anal fissures, eat a diet high in fiber and fluids to keep stools soft.
Medical Treatment
Serious gastrointestinal bleeding can destabilize your vital signs. For instance, your blood pressure may fall sharply and your heart rate will increase.
The physician may need to resuscitate you with IV fluids and possibly a blood transfusion.
In some cases, you may need surgery.
Next Steps Follow-up
Maintain a proper diet and take the medications prescribed to you as your doctor directs.
Follow up with your physician on a regular basis to monitor progress, so that your doctor can prevent further progression and complications of your gastrointestinal bleeding.
Prevention
You can prevent some causes of gastrointestinal bleeding.
Avoid foods and factors, such as alcohol and smoking, that increase gastric secretions.
Eat a high-fiber diet to increase the bulk of the stool, which helps prevent diverticulosis and hemorrhoids.
source:webmd.com
Acute gastrointestinal bleeding first will appear as vomiting of blood, bloody bowel movements, or black, tarry stools. Blood may look like "coffee grounds." Symptoms associated with blood loss can include the following:
Fatigue
Weakness
Shortness of breath
Abdominal pain
Pale appearance
Vomiting of blood usually originates from an upper GI source. Bright red or maroon stool can be from either a lower GI source or from brisk bleeding at an upper GI source.
Long-term GI bleeding may go unnoticed or may cause fatigue, anemia, black stools, or a positive test for microscopic blood.
When to Seek Medical Care
Any presence of blood in the stool or the upper gastrointestinal tract is significant and needs medical investigation. Black or dark stools may represent slow bleeding into the GI tract and should be investigated by a physician.
Any significant bleeding into the GI tract, either vomited blood or blood through the rectum, should be evaluated in the emergency department.
Exams and Tests
A doctor will perform a complete history and physical exam to evaluate your problem. The physical will include a digital rectal exam, to test for visible or microscopic blood from your rectum.
The doctor may need to insert a tube through your nose into your stomach to help identify the source of the bleeding. The procedure is called endoscopy. An endoscope is a long tube with a tiny camera on the end. It may be passed through the nose into the stomach, or through the rectum into the colon, to directly see the source of bleeding. Endoscopy can be both diagnostic, finding the source of bleeding, and therapeutic, stopping it.
Lab tests also can be helpful to determine the rate or severity of bleeding and to determine factors that may contribute to the problem.
Gastrointestinal Bleeding Treatment
Self-Care at Home
There is no home care for heavy gastrointestinal bleeding. Go to a hospital's emergency department. For hemorrhoids or anal fissures, eat a diet high in fiber and fluids to keep stools soft.
Medical Treatment
Serious gastrointestinal bleeding can destabilize your vital signs. For instance, your blood pressure may fall sharply and your heart rate will increase.
The physician may need to resuscitate you with IV fluids and possibly a blood transfusion.
In some cases, you may need surgery.
Next Steps Follow-up
Maintain a proper diet and take the medications prescribed to you as your doctor directs.
Follow up with your physician on a regular basis to monitor progress, so that your doctor can prevent further progression and complications of your gastrointestinal bleeding.
Prevention
You can prevent some causes of gastrointestinal bleeding.
Avoid foods and factors, such as alcohol and smoking, that increase gastric secretions.
Eat a high-fiber diet to increase the bulk of the stool, which helps prevent diverticulosis and hemorrhoids.
source:webmd.com
Thursday, December 18, 2008
GASTROINTESTINAL BLEEDING OVERVIEW
The many causes of gastrointestinal (GI) bleeding are classified into upper or lower, depending on their location in the GI tract.
Upper gastrointestinal bleeding: Upper GI bleeding originates in the first part of the GI tract-the esophagus, stomach, or duodenum (first part of the intestine). Bleeding can come from ingestion of caustic poisons or stomach cancer. Most often, upper GI bleeding is caused by one of the following:
Peptic ulcers
Gastritis
Esophageal varices
Mallory-Weiss tears
Lower gastrointestinal bleeding: Lower GI bleeding originates in the portions of the GI tract farther down the digestive system-the segment of the small intestine farther from the stomach, large intestine, rectum, and anus. Diverticular disease, angiodysplasia, polyps, hemorrhoids, and anal fissures most commonly cause the bleeding. Blood in the stool can result from cancers, inflammatory bowel disease, and infectious diarrhea.
Gastrointestinal Bleeding Causes
The many causes of gastrointestinal bleeding are classified into upper or lower, depending on their location in the GI tract.
Upper GI bleeding
Peptic ulcer disease: Peptic ulcers are localized erosions of the wall of the digestive tract. Ulcers usually occur in the stomach or duodenum. Breakdown of the walls results in damage to blood vessels, causing bleeding. When the mucous membranes break down, they are unable to counteract the harsh effects of stomach acid. Nonsteroidal anti-inflammatory drugs (NSAIDs), aspirin, alcohol, and cigarette smoking promote gastric ulcer formation. Helicobacter pylori are a type of bacteria that also promote formation of ulcers.
Gastritis: General inflammation of the stomach wall, which can result in bleeding. Gastritis also results from an inability of the gastric lining to protect itself from the acid it produces. NSAIDs, steroids, alcohol, burns, and trauma can cause gastritis.
Esophageal varices: Swellings in veins of your esophagus or stomach usually result from liver disease. Varices most commonly result from alcoholic liver cirrhosis. When varices bleed, the bleeding can be massive and catastrophic and occur without warning.
Mallory-Weiss tear: A tear in the esophageal or stomach wall, often as a result of vomiting or retching. Tears also can occur after seizures, forceful coughing or laughing, lifting, straining, or childbirth. Physicians often find tears in people who have recently binged on alcohol.
Lower GI bleeding
Diverticulosis: One of the most common causes of lower GI bleeding. Small out-pockets, or diverticula, form on part of the wall of your colon (large intestine), usually in a weakened area of the bowel wall. You may develop several pockets, which are more common in people who have constipation and strain at stool.
Angiodysplasia: Along with diverticulosis, this is one of the most common causes of lower GI bleeding. Angiodysplasia is a malformation in the blood vessels in the wall of the GI tract. The sores are most common in the large intestine and often bleed. The elderly and people with chronic kidney failure develop the disease most often.
Polyps: Intestinal polyps are noncancerous tumors of the GI tract, occurring mostly in people older than 40 years. A small proportion of these polyps may transform into cancer. Colonic polyps may bleed rapidly, or they may bleed slowly and go undetected.
Hemorrhoids and fissures: Hemorrhoids are swellings of veins in and around your rectum. Repeated stretching from straining at stool causes them to bleed. Bleeding from hemorrhoids is usually mild, intermittent, and bright red. Massive bleeding is rare. Anal fissures, or tears in the anal wall, also may trigger small amounts of bright red bleeding from the anus. Forceful straining during passage of hard stool usually causes such tears, which can be very painful.
source:webmd.com
Upper gastrointestinal bleeding: Upper GI bleeding originates in the first part of the GI tract-the esophagus, stomach, or duodenum (first part of the intestine). Bleeding can come from ingestion of caustic poisons or stomach cancer. Most often, upper GI bleeding is caused by one of the following:
Peptic ulcers
Gastritis
Esophageal varices
Mallory-Weiss tears
Lower gastrointestinal bleeding: Lower GI bleeding originates in the portions of the GI tract farther down the digestive system-the segment of the small intestine farther from the stomach, large intestine, rectum, and anus. Diverticular disease, angiodysplasia, polyps, hemorrhoids, and anal fissures most commonly cause the bleeding. Blood in the stool can result from cancers, inflammatory bowel disease, and infectious diarrhea.
Gastrointestinal Bleeding Causes
The many causes of gastrointestinal bleeding are classified into upper or lower, depending on their location in the GI tract.
Upper GI bleeding
Peptic ulcer disease: Peptic ulcers are localized erosions of the wall of the digestive tract. Ulcers usually occur in the stomach or duodenum. Breakdown of the walls results in damage to blood vessels, causing bleeding. When the mucous membranes break down, they are unable to counteract the harsh effects of stomach acid. Nonsteroidal anti-inflammatory drugs (NSAIDs), aspirin, alcohol, and cigarette smoking promote gastric ulcer formation. Helicobacter pylori are a type of bacteria that also promote formation of ulcers.
Gastritis: General inflammation of the stomach wall, which can result in bleeding. Gastritis also results from an inability of the gastric lining to protect itself from the acid it produces. NSAIDs, steroids, alcohol, burns, and trauma can cause gastritis.
Esophageal varices: Swellings in veins of your esophagus or stomach usually result from liver disease. Varices most commonly result from alcoholic liver cirrhosis. When varices bleed, the bleeding can be massive and catastrophic and occur without warning.
Mallory-Weiss tear: A tear in the esophageal or stomach wall, often as a result of vomiting or retching. Tears also can occur after seizures, forceful coughing or laughing, lifting, straining, or childbirth. Physicians often find tears in people who have recently binged on alcohol.
Lower GI bleeding
Diverticulosis: One of the most common causes of lower GI bleeding. Small out-pockets, or diverticula, form on part of the wall of your colon (large intestine), usually in a weakened area of the bowel wall. You may develop several pockets, which are more common in people who have constipation and strain at stool.
Angiodysplasia: Along with diverticulosis, this is one of the most common causes of lower GI bleeding. Angiodysplasia is a malformation in the blood vessels in the wall of the GI tract. The sores are most common in the large intestine and often bleed. The elderly and people with chronic kidney failure develop the disease most often.
Polyps: Intestinal polyps are noncancerous tumors of the GI tract, occurring mostly in people older than 40 years. A small proportion of these polyps may transform into cancer. Colonic polyps may bleed rapidly, or they may bleed slowly and go undetected.
Hemorrhoids and fissures: Hemorrhoids are swellings of veins in and around your rectum. Repeated stretching from straining at stool causes them to bleed. Bleeding from hemorrhoids is usually mild, intermittent, and bright red. Massive bleeding is rare. Anal fissures, or tears in the anal wall, also may trigger small amounts of bright red bleeding from the anus. Forceful straining during passage of hard stool usually causes such tears, which can be very painful.
source:webmd.com
Wednesday, December 17, 2008
FIRST AID TIPS
Section 1: How to react responsibly
KEEP CALM. Remaining calm while helping the victim will help him/her to keep calm and cooperate with the rescuer. It will also help prevent any further injury.
PLAN QUICKLY WHAT YOU NEED TO DO. Learn basic procedures, or have your first aid manual available, so you can care for the victim.
SEND FOR PROFESSIONAL HELP. Reaching help quickly could save a life. Know your local emergency telephone numbers.
BE AN ENCOURAGEMENT TO THE INJURED PERSON. Let the victim know that help is on the way and try to make them as comfortable as possible. Showing care and concern for the victim can give them hope during their circumstances.
Section 2: Assessing the Situation
When arriving at a scene, assess the situation immediately. Be aware of any situation which may put your life at risk. Avoid all dangerous situations and do not put yourself into a situation where you may also become a victim. If the scene is dangerous, wait for professional help to arrive at which time you may be asked to assist.
When you are faced with multiple casualties and you are the only rescuer follow these rules:
DO NOT MOVE A VICTIM UNLESS HE/SHE IS IN IMMEDIATE DANGER (e.g. An unsafe building, burning car, etc.)
CALL THE EMERGENCY MEDICAL SERVICES IMMEDIATELY. Ask an onlooker to call Emergency Medical Services. If you are alone, asses the situation, attend to life threatening situations and then call the Emergency Medical Services.
Assess all victims:
a. Check to see if the victim is breathing.
b. Check to see if the victim has a pulse.
c. Check to see whether the victim is bleeding.
Attend the victims in the following priority:
a. Those who are not breathing and do not have a pulse. BEGIN CPR IMMEDIATELY
b. Those who are not breathing and have profound bleeding. CHECK AIRWAY and try to resume breathing. Start artificial respiration if necessary. Be aware that the victim may go into cardiac arrest if you do not stop the bleeding.
c. Those who are breathing and have profound bleeding. Remember that the victim may go into cardiac arrest if you do not stop the bleeding.
Reassess the situation frequently.
Once you have attended to a victim and restored cardiac functions, breathing and stopped bleeding MOVE ON to the next victim. Remember to always reassess the situation.
KEEP CALM. Remaining calm while helping the victim will help him/her to keep calm and cooperate with the rescuer. It will also help prevent any further injury.
PLAN QUICKLY WHAT YOU NEED TO DO. Learn basic procedures, or have your first aid manual available, so you can care for the victim.
SEND FOR PROFESSIONAL HELP. Reaching help quickly could save a life. Know your local emergency telephone numbers.
BE AN ENCOURAGEMENT TO THE INJURED PERSON. Let the victim know that help is on the way and try to make them as comfortable as possible. Showing care and concern for the victim can give them hope during their circumstances.
Section 2: Assessing the Situation
When arriving at a scene, assess the situation immediately. Be aware of any situation which may put your life at risk. Avoid all dangerous situations and do not put yourself into a situation where you may also become a victim. If the scene is dangerous, wait for professional help to arrive at which time you may be asked to assist.
When you are faced with multiple casualties and you are the only rescuer follow these rules:
DO NOT MOVE A VICTIM UNLESS HE/SHE IS IN IMMEDIATE DANGER (e.g. An unsafe building, burning car, etc.)
CALL THE EMERGENCY MEDICAL SERVICES IMMEDIATELY. Ask an onlooker to call Emergency Medical Services. If you are alone, asses the situation, attend to life threatening situations and then call the Emergency Medical Services.
Assess all victims:
a. Check to see if the victim is breathing.
b. Check to see if the victim has a pulse.
c. Check to see whether the victim is bleeding.
Attend the victims in the following priority:
a. Those who are not breathing and do not have a pulse. BEGIN CPR IMMEDIATELY
b. Those who are not breathing and have profound bleeding. CHECK AIRWAY and try to resume breathing. Start artificial respiration if necessary. Be aware that the victim may go into cardiac arrest if you do not stop the bleeding.
c. Those who are breathing and have profound bleeding. Remember that the victim may go into cardiac arrest if you do not stop the bleeding.
Reassess the situation frequently.
Once you have attended to a victim and restored cardiac functions, breathing and stopped bleeding MOVE ON to the next victim. Remember to always reassess the situation.
Saturday, December 13, 2008
NEAR DROWNING
Near-drowning is when a person is in danger of drowning. Each year, almost 8,000 people die from drowning. Seventy percent of all near-drowning victims recover; 25% die, and 5% have brain damage.
A toddler can drown in as little as 2 inches of water in a bathtub, sink, etc. Toilet bowls are unsafe, too, if a small child falls into one head-first.
Signs & Symptoms
A person is in the water with signs of distress. He or she can't stay above water, swims unevenly, signals for help, etc.
Blue lips or ears. The skin is cold and pale.
Bloated abdomen. Vomiting. Choking.
Confusion. Lethargy.
The person does not respond or can't breathe.
Causes
Not being able to swim. Being in water too deep and too rough for one's ability to swim.
Water sport and other accidents. Not following water safety rules. Not wearing a life preserver, etc. Unsupervised swimming.
Falling through ice while fishing, skating, etc.
Injury or problems that occur while swimming, boating, etc. Examples are leg or stomach cramps, fatigue, and alcohol or drug use. A heart attack, stroke, seizure, and a marine animal bite or sting may have occurred.
Treatment
Immediate medical care is needed for near-drowning.
source:healthy.net
A toddler can drown in as little as 2 inches of water in a bathtub, sink, etc. Toilet bowls are unsafe, too, if a small child falls into one head-first.
Signs & Symptoms
A person is in the water with signs of distress. He or she can't stay above water, swims unevenly, signals for help, etc.
Blue lips or ears. The skin is cold and pale.
Bloated abdomen. Vomiting. Choking.
Confusion. Lethargy.
The person does not respond or can't breathe.
Causes
Not being able to swim. Being in water too deep and too rough for one's ability to swim.
Water sport and other accidents. Not following water safety rules. Not wearing a life preserver, etc. Unsupervised swimming.
Falling through ice while fishing, skating, etc.
Injury or problems that occur while swimming, boating, etc. Examples are leg or stomach cramps, fatigue, and alcohol or drug use. A heart attack, stroke, seizure, and a marine animal bite or sting may have occurred.
Treatment
Immediate medical care is needed for near-drowning.
source:healthy.net
Friday, December 12, 2008
DISLOCATION FIRST AID
A dislocation is an injury in which the ends of your bones are forced from their normal positions. The cause is usually trauma, such as a blow or fall, but dislocation can be caused by an underlying disease, such as rheumatoid arthritis.
Dislocations are common injuries in contact sports, such as football and hockey, and in sports that may involve falls, such as downhill skiing and volleyball. Dislocations may occur in major joints, such as your shoulder, hip, knee, elbow or ankle or in smaller joints, such as your finger, thumb or toe.
The injury will temporarily deform and immobilize your joint and may result in sudden and severe pain and swelling. A dislocation requires prompt medical attention to return your bones to their proper positions.
If you believe you have dislocated a joint:
Don't delay medical care. Get medical help immediately.
Don't move the joint. Until you receive help, splint the affected joint into its fixed position. Don't try to move a dislocated joint or force it back into place. This can damage the joint and its surrounding muscles, ligaments, nerves or blood vessels.
Put ice on the injured joint. This can help reduce swelling by controlling internal bleeding and the buildup of fluids in and around the injured joint.
Regardless of where the joint dislocation is on the injured person's body, these are the basic steps you should take to provide first aid. The key to providing first aid in any situation is to remain calm while you help the injured person. Take the following steps to give first aid to someone with a dislocated joint.
Step1
Call 911. Do this before you begin any other type of first aid on the joint dislocation. Follow any instructions you are given.
Step2
Make sure to check the injured person's breathing. Make sure nothing is obstructing their airway. Administer CPR or rescue breathing if necessary. Also take any necessary steps to staunch bleeding before beginning first aid for a joint dislocation.
Step3
Keep the injured person still. Don't attempt to move him unless absolutely necessary. If you must move him, grab his clothes, not his body.
Step4
Cover any open wounds to prevent infection. If sterile bandages aren't available, cut up a clean article of clothing.
Step5
Do not try to move the bone and/or joint. Splint it or immobilize it just as it is. If you try to move a dislocated joint, you risk further injury and more pain to the injured person.
Step6
Check that the wounded area is getting enough blood flow. Press near the injury. The skin should turn white, then immediately get its color back.
Step7
Keep the victim calm until emergency help arrives. Cover him with a blanket to keep him warm. Be observant for the signs of shock that may set in several minutes after the injury occurs. Apply an ice bag to the dislocated joint to provide some relief from the pain.
source:Myoclinic.com
Dislocations are common injuries in contact sports, such as football and hockey, and in sports that may involve falls, such as downhill skiing and volleyball. Dislocations may occur in major joints, such as your shoulder, hip, knee, elbow or ankle or in smaller joints, such as your finger, thumb or toe.
The injury will temporarily deform and immobilize your joint and may result in sudden and severe pain and swelling. A dislocation requires prompt medical attention to return your bones to their proper positions.
If you believe you have dislocated a joint:
Don't delay medical care. Get medical help immediately.
Don't move the joint. Until you receive help, splint the affected joint into its fixed position. Don't try to move a dislocated joint or force it back into place. This can damage the joint and its surrounding muscles, ligaments, nerves or blood vessels.
Put ice on the injured joint. This can help reduce swelling by controlling internal bleeding and the buildup of fluids in and around the injured joint.
Regardless of where the joint dislocation is on the injured person's body, these are the basic steps you should take to provide first aid. The key to providing first aid in any situation is to remain calm while you help the injured person. Take the following steps to give first aid to someone with a dislocated joint.
Step1
Call 911. Do this before you begin any other type of first aid on the joint dislocation. Follow any instructions you are given.
Step2
Make sure to check the injured person's breathing. Make sure nothing is obstructing their airway. Administer CPR or rescue breathing if necessary. Also take any necessary steps to staunch bleeding before beginning first aid for a joint dislocation.
Step3
Keep the injured person still. Don't attempt to move him unless absolutely necessary. If you must move him, grab his clothes, not his body.
Step4
Cover any open wounds to prevent infection. If sterile bandages aren't available, cut up a clean article of clothing.
Step5
Do not try to move the bone and/or joint. Splint it or immobilize it just as it is. If you try to move a dislocated joint, you risk further injury and more pain to the injured person.
Step6
Check that the wounded area is getting enough blood flow. Press near the injury. The skin should turn white, then immediately get its color back.
Step7
Keep the victim calm until emergency help arrives. Cover him with a blanket to keep him warm. Be observant for the signs of shock that may set in several minutes after the injury occurs. Apply an ice bag to the dislocated joint to provide some relief from the pain.
source:Myoclinic.com
Thursday, December 11, 2008
MUSCLE CRAMPS
Muscle cramps are common discomforts that everyone has had to deal with at one time or another. Here are some signs of a muscle cramp :
A sharp, sudden, painful spasm, or tightening of a muscle, (especially common in the legs).
Muscle hardness
Twitching of the muscle
Persistent cramping pains in lower abdominal muscles
Sometimes occurring when a muscle contracts with great intensity and stays contracted, refusing to stretch out again.
Causes
Imbalances in certain minerals, body fluids, hormones, and chemicals which allow the lengthening and contracting of our muscles to occur can prompt spasms and cramps. As well as this, malfunctions in the nervous system itself can also cause problems. Excessive physical activity and hormonal imbalances causes us to sweat , which brings about the loss of many essential minerals (such as potassium) our muscles need.
Traditional Treatment
For everyday muscle cramps, there really isn’t any medication specifically for them. Try to stretch the muscle and massage out the cramp it you can.
Muscle cramps can also be caused by a lack of potassium and vitamin E, so eating something like bananas or pineapple can help to replenish the minerals you’ve lost. Calcium is also thought to help prevent muscle cramps, so drink your milk!
If you take vitamin E supplements it will help prevent nighttime muscle cramps, which can be quite an annoyance.
Prevention
Drink 6 to 8 cups of water every day.
Be sure to get enough potassium, vitamin E, and calcium into your system.
Be sure to warm up before exercising.
When to seek further professional advice
If you suffer from frequent or severe cramps, see your doctor. And severe cramps in your chest, shoulders, or arms can be symptoms of a heart attack; call immediately for medical help.
Your muscle cramp lasts more than an hour.
Your cramp is in your chest or arms.
*** Before administering any first aid to anyone outside your family, be aware of your rights and responsibilities: The Good Samaritan Law. ***
source:firstaidguide.net
A sharp, sudden, painful spasm, or tightening of a muscle, (especially common in the legs).
Muscle hardness
Twitching of the muscle
Persistent cramping pains in lower abdominal muscles
Sometimes occurring when a muscle contracts with great intensity and stays contracted, refusing to stretch out again.
Causes
Imbalances in certain minerals, body fluids, hormones, and chemicals which allow the lengthening and contracting of our muscles to occur can prompt spasms and cramps. As well as this, malfunctions in the nervous system itself can also cause problems. Excessive physical activity and hormonal imbalances causes us to sweat , which brings about the loss of many essential minerals (such as potassium) our muscles need.
Traditional Treatment
For everyday muscle cramps, there really isn’t any medication specifically for them. Try to stretch the muscle and massage out the cramp it you can.
Muscle cramps can also be caused by a lack of potassium and vitamin E, so eating something like bananas or pineapple can help to replenish the minerals you’ve lost. Calcium is also thought to help prevent muscle cramps, so drink your milk!
If you take vitamin E supplements it will help prevent nighttime muscle cramps, which can be quite an annoyance.
Prevention
Drink 6 to 8 cups of water every day.
Be sure to get enough potassium, vitamin E, and calcium into your system.
Be sure to warm up before exercising.
When to seek further professional advice
If you suffer from frequent or severe cramps, see your doctor. And severe cramps in your chest, shoulders, or arms can be symptoms of a heart attack; call immediately for medical help.
Your muscle cramp lasts more than an hour.
Your cramp is in your chest or arms.
*** Before administering any first aid to anyone outside your family, be aware of your rights and responsibilities: The Good Samaritan Law. ***
source:firstaidguide.net
Tuesday, December 9, 2008
HEAT CRAMPS
Overview
Heat cramps are involuntary muscle spasms
They are caused by deficiency of water and sodium
Heat cramps are painful, may be severe and prolonged
Heavy exercising in hot weather causes excessive sweating
This causes electrolyte deficiency resulting in muscle cramps
Muscles most affected are the voluntary muscles of-
a. Calves
b. Arms
c. Thighs
d. Back
e. Abdomen
Heat cramps are the least serious of all heat injuries
It is a warning sign for heat exhaustion
Risk factors
Negative sodium balance
Diuretic medications
Absence of acclimatization / adaptation
Causes
Heat
Dehydration
Excessive sweating
Loss of body salts
Muscle stress
Poor body condition
Symptoms
Some of the most common symptoms are:
Dizzy feeling
Fainting
Exhaustion
Nausea
Vomiting
Rapid heartbeat
Hot/sweaty skin
Treatment
Rest briefly and cool down
Manual pressure / massage must be applied to the affected muscle
Drink one quart of water with one teaspoon of salt
Drink some clear juice / electrolyte-containing sports drink
Practice gentle stretching exercise of the affected muscle
Seek medical help if the cramps remain after 1 hour
Prognosis
Heat cramps usually improves with
An electrolyte drink
Cool shade
Rest
Prevention
Adequate fluids must be taken periodically
Fluids must be taken before feeling thirsty
Avoid heavy sweaty exercises in humid conditions
Make sure to drink fluids while exercising
source:Medindia.net
Heat cramps are involuntary muscle spasms
They are caused by deficiency of water and sodium
Heat cramps are painful, may be severe and prolonged
Heavy exercising in hot weather causes excessive sweating
This causes electrolyte deficiency resulting in muscle cramps
Muscles most affected are the voluntary muscles of-
a. Calves
b. Arms
c. Thighs
d. Back
e. Abdomen
Heat cramps are the least serious of all heat injuries
It is a warning sign for heat exhaustion
Risk factors
Negative sodium balance
Diuretic medications
Absence of acclimatization / adaptation
Causes
Heat
Dehydration
Excessive sweating
Loss of body salts
Muscle stress
Poor body condition
Symptoms
Some of the most common symptoms are:
Dizzy feeling
Fainting
Exhaustion
Nausea
Vomiting
Rapid heartbeat
Hot/sweaty skin
Treatment
Rest briefly and cool down
Manual pressure / massage must be applied to the affected muscle
Drink one quart of water with one teaspoon of salt
Drink some clear juice / electrolyte-containing sports drink
Practice gentle stretching exercise of the affected muscle
Seek medical help if the cramps remain after 1 hour
Prognosis
Heat cramps usually improves with
An electrolyte drink
Cool shade
Rest
Prevention
Adequate fluids must be taken periodically
Fluids must be taken before feeling thirsty
Avoid heavy sweaty exercises in humid conditions
Make sure to drink fluids while exercising
source:Medindia.net
Friday, December 5, 2008
CHILD BIRTH GUIDE
Due date is an estimate
What you think of as your due date is actually in medcial terms referred to as EDD--estimated due date. It is better to think of a due month than a due date. Try not to focus too much on your "due" date coming and going. Only 5% of babies are born on their due dates.
How do I know I´m in labor?
Signs that indicate that this is likely "real" labor:
*contractions become progressively more regular, intense and last longer.
*intensified by walking.
*don´t stop when lying down or changing activity.
*contractions are accompanied by a "show" of blood-tinged mucus.
*accompanied by effacement and/or dilation.
Remember that labor may start and stop before finally continuing all the way to birth...don´t be discouraged. Any work done at this time is work that doesn´t have to be done later!
Prelabor signs
Some signs that labor may begin in the next few days or weeks include:
*baby drops lower into the pelvis.
*low backache, different from the normal late-pregnancy tiredness.
*increased urination and bowel movements, perhaps accompanied by abdominal cramps and diarrhea.
*sudden burst of energy (nesting instinct).
*increased vaginal discharge of egg-white consistency.
Changing Positions During Labor
Changing positions during labor is very important. Even if you are confined to the bed - moving around - changing sides you lay on - or sitting up will help to dilate and efface the cervix. Gravity will also aid in bringing the birth about quicker. If you can walk around or sit in a chair this will greatly help. If not, moving around in the bed - even if you have to use a bed-pan can help to bring about the birth quicker.
Sleep on your side
During the last half of pregnancy, side-lying is the most comfortable for mom and healthiest for baby. Use pillows behind your back and under your stomach to help balance comfortably.
Labor Inductions
There are several methods of labor inductions both medically and naturally. Medically speaking there are the application of prostaglandin gel to the cervix, Pitocin IV drip, stripping of the membranes and breaking of the bag of waters. Naturally speaking there are herbs to help bring labor on, nipple stimulation, intercourse and exercise. If labor needs to be augmented (induced) find out all you can about the above mentioned methods.
Due Date
Technically speaking, the due date is calculated by subtracting 3 months from the 1st day of your last period and then adding 7 days.
Let people know how you are doing
Don´t just assume that all pain in childbirth is unavoidable. Be sure to let your caregivers know what is going on with you. They may well have suggestions for you that can ease your discomforts without medication. If you let them know you are having pain in your back, for example, they can help you change positions so as to minimize that. It might also give them clues as to baby´s position that will be helpful to know to allow you to work with your body most efficiently.
True Contractions
True contractions will grow stronger and closer together. They will increase in intensity when changing positions. Braxton Hicks contractions will go away when changing positions and will not be regular. True contractions may be accompanied by lower back pain that radiates to the lower abdomen and possibly down the legs. Diarrhea may accompany the contractions as well as bloody show.
Signs of True Labor
True labor usually begins with contractions that intensify rather than ease up - more than 4 an hour. When you change positions or move around and the contraction gets stronger - it is the real thing. Pain, if any, starts in the lower back and can radiate down the groin and into the legs and feels like you need to have a bowel movement. The contractions will become more frequent and will increase in duration, though they may not be "text" book - i.e. - every 5 minutes. They may be 5 minutes, 8 minutes, 10 minutes, 4 minutes, etc. Bloody show or blood-tinged mucus will start during true labor. Membranes may rupture, though this only happens in about 15% of labors. The rupture may be a gush or a trickle.
Things To Pack In The Hospital Bag
Giving birth in a hospital requires at least a one night stay. Items needed are: gown (if you prefer to wear your own), underwear, pads, nursing bra and pads, slippers, socks, outfit to wear home (keeping in mind that you´ll still have a lot of that pregnancy weight on), baby´s going home outfit, at least 2 receiving blankets, diapers, wipes, toiletries, camera and film, clothes for the coach, snacks for you and coach, change for vending machines, money for coach to eat with, lollipops for laboring, lotion for massaging away labor pains, pillow (hospial pillows are uncomfortable) and any item you feel you cannot live without during labor and birth. Most hospitals do provide enough diapers, wipes and gowns for you and baby, pads and pants for you after birth and some toiletry items. Check with your hospital to find out what they provide and pack accordingly.
Epidural Block
Epidurals are used for pain relief in laboring moms. A needle is placed in the lower back in the epidural space between the spinal cord and the outer membrane. The epidural numbs the pelvic area and most of the times the legs too. The medication can be given and stopped easily - to allow the laboring mom to push more effectively. Blood pressure has to be monitored and IV fluids given in conjunction with the epidural. It takes about 2 hours after the epidural has been removed to regain all feeling in the lower half of the body.
When to go to the hospital
For most women the best bet is to stay at home for as long as possible. Early arrival at the hospital may cause labor to slow, opening the door for questionable interventions.
Ask your doctor at a prenatal visit when he or she would like you to go in, but for most women a good rule of thumb for first-time mothers is to go when contractions are 5 minutes or less apart, last at least one minute, and are strong enough that you need to focus solely on them.
Touch your baby
The skin is the largest organ of the human body! Stroking stimulates the newborn to regulate his breathing.
Are you a candidate for home birth?
Home birth is something you should consider if:
*You truly believe that you should birth at home.
*You have no known complications that make your delivery high risk.
*You feel prepared to handle the work of labor through natural means, and your history supports this.
*You live no more than 10-15 minutes from a hospital.
Choosing A Birthing Position
There are several birthing positions. What you choose is entirely up to you and your care provider and whether or not you are giving birth in a hospital, birthing center or at home. The choices consist of back lying (most hospitals use this), side-lying, all fours (crawling position), sitting, squatting, and standing. Whatever position you choose, you may have to practice - such as squatting - because it requires the use of strong arms and legs. Also, depending upon your health and the health of the baby, you may be limited with your choices. If you have a strong preference - talk with your doctor or midwife well in advance of your due date.
Be Prepared EARLY
Yes, I believe it is very necessary to have everything in order before baby arrives. Speaking from experience - I had preterm labor at 30 weeks and was on bedrest and panicked because I didn´t have things in order. Try to have all that you think baby will need - ready at the beginning of the third trimester. Have the crib, bassinet, clothes, carseat, blankets, etc. all set up and ready for the birth. Even though it may sit out for 3 months - at the very least should something happen earlier than anticipated - you´ll have everything in order and ready for your little one.
Methods of Childbirth Classes
There are 4 main childbirth classes. Bradley Method, Lamaze, Grantly Dick-Read and "prepared" childbirth classes. The methods vary in breathing and relaxation excercises. Choosing a class depends upon your preferences and expectations of your childbirth experience and the availability of an instructor in your area.
Midwife and Doctor
If you are planning a home birth - it is a good idea to have a midwife - be it certified or direct-entry. It´s also a good idea to have a doctor that you have seen for emergencies. This is part of your emergency back up plan.
Pain Relief During Childbirth
There are varying degrees of pain relief management for childbirth. Medically there is the epidural, spinal, intrathecal injection of narcotics, narcotics given through an IV and the pudendal block. Naturally there are childbirth classes that teach methods of breathing exercises, relaxation techniques and focusing to alleviate the pain during labor and birth.
Circumcision Debate
Circumcision is a decision that should be made prior to the baby´s birth. Be sure to weigh all the options, if you are unsure of which way to go. There are benefits either way to circumcise or to not circumcise.
Choosing a childbirth class
To best prepare yourself, you should take a private childbirth education class--one not affiliated with a hospital. These type of classes have the advantage of describing all your choices to you; the hospital will only tell you what they are willing to offer. The more complete information allows you to be a better consumer.
Childbirth Classes
I think every woman should take a childbirth class. These classes help to answer questions, educate and prepare you for the best possible experience in childbirth. There are a number of childbirth classes offered from prepared childbirth classes - which teach about hospital procedures - to specialized classes that teach different labor coping means. All teach the mechanics about the birth process and the choices you may have to make. Ask your physican or midwife about the classes offered in your area. Be sure to call soon, most classes fill up fairly quick.
Education Makes The Best Birth Experience Possible
Preparing for childbirth should be number one once you find out you are pregnant. Knowledge melts away fear - ignorance only leads to fear. Read all you can about childbirth and speak with your doctor or midwife in depth about any concerns or questions you may have. Take childbirth classes, subscribe to pregnancy magazines - many are free, and read through quality websites. You may even want to join with a pregnancy discussion board - as I´ve had very positive and educational experiences with these. All in all, education about pregnancy and birth is the best possible plan for a woman facing a pregnancy and the end result - birth. Especially for first-time moms, there is no substitute for what educating yourself can do for a positive experience from conception to birth.
Dehydration
Dehydration is the number one reason preterm labor starts. It is possible to naturally induce labor by withholding water - however it is strongly advisable not to do this without the care of your doctor.
Home Vs. Hospital Birth
Whether you choose to give birth at home or in a hospital depends upon a few things. If your pregnancy has progressed normally, if the baby is doing good and if you have quick access to a hospital in an emergency are good canidates for homebirth. If you desire pain relief during labor and delivery, the hospital may be a better choice. Utlimately it depends upon your preferences. Most doctors will not delivery a home birth - however midwives will. And in some states, having a home birth is against the law.
Active Birth: The New Approach to Giving Birth Naturally
"Active Birth: The New Approach to Giving Birth Naturally" by Janet Balaskas. This book teaches mothers to follow their insticts and use their bodies actively in labor. My personal favorite for practical advice on coping with labor.
Coping With Pre-Term Labor
Pre-term labor is labor that occurs before the 37th week of pregnancy. Most of the time bedrest and plenty of fluids will help to halt pre-term labor. If labor starts to dilate and efface the cervix - drugs are given to relax the uterus. The main thing is to keep stress at bay - and relax. The number one goal in dealing with pre-term labor is keeping that baby inside for as long as possible. Follow doctor´s orders and accept all the help you can with taking care of your household.
Relaxation Methods
Relaxation and breathing techniques can help a laboring mom to better cope with the pain of childbirth. Breathing exercises learned from natural childbirth classes helps to calm and relax the laboring mom - helping her to focus without the use of medications. Usually a coach (husband) plays a big role in helping mom to relax as taught in the natural childbirth classes.
Back Lying
Back lying has long been the favorite position of hospital births in the United States in the 20th century. Lying on your back - feet in stir-ups has been a favorite of physicans because of the ease at which they can assist the delivery. This position is still used in a lot of hospitals if an epidural or spinal anesthesia has been administered or if there is concern for uterine rupture.
What you think of as your due date is actually in medcial terms referred to as EDD--estimated due date. It is better to think of a due month than a due date. Try not to focus too much on your "due" date coming and going. Only 5% of babies are born on their due dates.
How do I know I´m in labor?
Signs that indicate that this is likely "real" labor:
*contractions become progressively more regular, intense and last longer.
*intensified by walking.
*don´t stop when lying down or changing activity.
*contractions are accompanied by a "show" of blood-tinged mucus.
*accompanied by effacement and/or dilation.
Remember that labor may start and stop before finally continuing all the way to birth...don´t be discouraged. Any work done at this time is work that doesn´t have to be done later!
Prelabor signs
Some signs that labor may begin in the next few days or weeks include:
*baby drops lower into the pelvis.
*low backache, different from the normal late-pregnancy tiredness.
*increased urination and bowel movements, perhaps accompanied by abdominal cramps and diarrhea.
*sudden burst of energy (nesting instinct).
*increased vaginal discharge of egg-white consistency.
Changing Positions During Labor
Changing positions during labor is very important. Even if you are confined to the bed - moving around - changing sides you lay on - or sitting up will help to dilate and efface the cervix. Gravity will also aid in bringing the birth about quicker. If you can walk around or sit in a chair this will greatly help. If not, moving around in the bed - even if you have to use a bed-pan can help to bring about the birth quicker.
Sleep on your side
During the last half of pregnancy, side-lying is the most comfortable for mom and healthiest for baby. Use pillows behind your back and under your stomach to help balance comfortably.
Labor Inductions
There are several methods of labor inductions both medically and naturally. Medically speaking there are the application of prostaglandin gel to the cervix, Pitocin IV drip, stripping of the membranes and breaking of the bag of waters. Naturally speaking there are herbs to help bring labor on, nipple stimulation, intercourse and exercise. If labor needs to be augmented (induced) find out all you can about the above mentioned methods.
Due Date
Technically speaking, the due date is calculated by subtracting 3 months from the 1st day of your last period and then adding 7 days.
Let people know how you are doing
Don´t just assume that all pain in childbirth is unavoidable. Be sure to let your caregivers know what is going on with you. They may well have suggestions for you that can ease your discomforts without medication. If you let them know you are having pain in your back, for example, they can help you change positions so as to minimize that. It might also give them clues as to baby´s position that will be helpful to know to allow you to work with your body most efficiently.
True Contractions
True contractions will grow stronger and closer together. They will increase in intensity when changing positions. Braxton Hicks contractions will go away when changing positions and will not be regular. True contractions may be accompanied by lower back pain that radiates to the lower abdomen and possibly down the legs. Diarrhea may accompany the contractions as well as bloody show.
Signs of True Labor
True labor usually begins with contractions that intensify rather than ease up - more than 4 an hour. When you change positions or move around and the contraction gets stronger - it is the real thing. Pain, if any, starts in the lower back and can radiate down the groin and into the legs and feels like you need to have a bowel movement. The contractions will become more frequent and will increase in duration, though they may not be "text" book - i.e. - every 5 minutes. They may be 5 minutes, 8 minutes, 10 minutes, 4 minutes, etc. Bloody show or blood-tinged mucus will start during true labor. Membranes may rupture, though this only happens in about 15% of labors. The rupture may be a gush or a trickle.
Things To Pack In The Hospital Bag
Giving birth in a hospital requires at least a one night stay. Items needed are: gown (if you prefer to wear your own), underwear, pads, nursing bra and pads, slippers, socks, outfit to wear home (keeping in mind that you´ll still have a lot of that pregnancy weight on), baby´s going home outfit, at least 2 receiving blankets, diapers, wipes, toiletries, camera and film, clothes for the coach, snacks for you and coach, change for vending machines, money for coach to eat with, lollipops for laboring, lotion for massaging away labor pains, pillow (hospial pillows are uncomfortable) and any item you feel you cannot live without during labor and birth. Most hospitals do provide enough diapers, wipes and gowns for you and baby, pads and pants for you after birth and some toiletry items. Check with your hospital to find out what they provide and pack accordingly.
Epidural Block
Epidurals are used for pain relief in laboring moms. A needle is placed in the lower back in the epidural space between the spinal cord and the outer membrane. The epidural numbs the pelvic area and most of the times the legs too. The medication can be given and stopped easily - to allow the laboring mom to push more effectively. Blood pressure has to be monitored and IV fluids given in conjunction with the epidural. It takes about 2 hours after the epidural has been removed to regain all feeling in the lower half of the body.
When to go to the hospital
For most women the best bet is to stay at home for as long as possible. Early arrival at the hospital may cause labor to slow, opening the door for questionable interventions.
Ask your doctor at a prenatal visit when he or she would like you to go in, but for most women a good rule of thumb for first-time mothers is to go when contractions are 5 minutes or less apart, last at least one minute, and are strong enough that you need to focus solely on them.
Touch your baby
The skin is the largest organ of the human body! Stroking stimulates the newborn to regulate his breathing.
Are you a candidate for home birth?
Home birth is something you should consider if:
*You truly believe that you should birth at home.
*You have no known complications that make your delivery high risk.
*You feel prepared to handle the work of labor through natural means, and your history supports this.
*You live no more than 10-15 minutes from a hospital.
Choosing A Birthing Position
There are several birthing positions. What you choose is entirely up to you and your care provider and whether or not you are giving birth in a hospital, birthing center or at home. The choices consist of back lying (most hospitals use this), side-lying, all fours (crawling position), sitting, squatting, and standing. Whatever position you choose, you may have to practice - such as squatting - because it requires the use of strong arms and legs. Also, depending upon your health and the health of the baby, you may be limited with your choices. If you have a strong preference - talk with your doctor or midwife well in advance of your due date.
Be Prepared EARLY
Yes, I believe it is very necessary to have everything in order before baby arrives. Speaking from experience - I had preterm labor at 30 weeks and was on bedrest and panicked because I didn´t have things in order. Try to have all that you think baby will need - ready at the beginning of the third trimester. Have the crib, bassinet, clothes, carseat, blankets, etc. all set up and ready for the birth. Even though it may sit out for 3 months - at the very least should something happen earlier than anticipated - you´ll have everything in order and ready for your little one.
Methods of Childbirth Classes
There are 4 main childbirth classes. Bradley Method, Lamaze, Grantly Dick-Read and "prepared" childbirth classes. The methods vary in breathing and relaxation excercises. Choosing a class depends upon your preferences and expectations of your childbirth experience and the availability of an instructor in your area.
Midwife and Doctor
If you are planning a home birth - it is a good idea to have a midwife - be it certified or direct-entry. It´s also a good idea to have a doctor that you have seen for emergencies. This is part of your emergency back up plan.
Pain Relief During Childbirth
There are varying degrees of pain relief management for childbirth. Medically there is the epidural, spinal, intrathecal injection of narcotics, narcotics given through an IV and the pudendal block. Naturally there are childbirth classes that teach methods of breathing exercises, relaxation techniques and focusing to alleviate the pain during labor and birth.
Circumcision Debate
Circumcision is a decision that should be made prior to the baby´s birth. Be sure to weigh all the options, if you are unsure of which way to go. There are benefits either way to circumcise or to not circumcise.
Choosing a childbirth class
To best prepare yourself, you should take a private childbirth education class--one not affiliated with a hospital. These type of classes have the advantage of describing all your choices to you; the hospital will only tell you what they are willing to offer. The more complete information allows you to be a better consumer.
Childbirth Classes
I think every woman should take a childbirth class. These classes help to answer questions, educate and prepare you for the best possible experience in childbirth. There are a number of childbirth classes offered from prepared childbirth classes - which teach about hospital procedures - to specialized classes that teach different labor coping means. All teach the mechanics about the birth process and the choices you may have to make. Ask your physican or midwife about the classes offered in your area. Be sure to call soon, most classes fill up fairly quick.
Education Makes The Best Birth Experience Possible
Preparing for childbirth should be number one once you find out you are pregnant. Knowledge melts away fear - ignorance only leads to fear. Read all you can about childbirth and speak with your doctor or midwife in depth about any concerns or questions you may have. Take childbirth classes, subscribe to pregnancy magazines - many are free, and read through quality websites. You may even want to join with a pregnancy discussion board - as I´ve had very positive and educational experiences with these. All in all, education about pregnancy and birth is the best possible plan for a woman facing a pregnancy and the end result - birth. Especially for first-time moms, there is no substitute for what educating yourself can do for a positive experience from conception to birth.
Dehydration
Dehydration is the number one reason preterm labor starts. It is possible to naturally induce labor by withholding water - however it is strongly advisable not to do this without the care of your doctor.
Home Vs. Hospital Birth
Whether you choose to give birth at home or in a hospital depends upon a few things. If your pregnancy has progressed normally, if the baby is doing good and if you have quick access to a hospital in an emergency are good canidates for homebirth. If you desire pain relief during labor and delivery, the hospital may be a better choice. Utlimately it depends upon your preferences. Most doctors will not delivery a home birth - however midwives will. And in some states, having a home birth is against the law.
Active Birth: The New Approach to Giving Birth Naturally
"Active Birth: The New Approach to Giving Birth Naturally" by Janet Balaskas. This book teaches mothers to follow their insticts and use their bodies actively in labor. My personal favorite for practical advice on coping with labor.
Coping With Pre-Term Labor
Pre-term labor is labor that occurs before the 37th week of pregnancy. Most of the time bedrest and plenty of fluids will help to halt pre-term labor. If labor starts to dilate and efface the cervix - drugs are given to relax the uterus. The main thing is to keep stress at bay - and relax. The number one goal in dealing with pre-term labor is keeping that baby inside for as long as possible. Follow doctor´s orders and accept all the help you can with taking care of your household.
Relaxation Methods
Relaxation and breathing techniques can help a laboring mom to better cope with the pain of childbirth. Breathing exercises learned from natural childbirth classes helps to calm and relax the laboring mom - helping her to focus without the use of medications. Usually a coach (husband) plays a big role in helping mom to relax as taught in the natural childbirth classes.
Back Lying
Back lying has long been the favorite position of hospital births in the United States in the 20th century. Lying on your back - feet in stir-ups has been a favorite of physicans because of the ease at which they can assist the delivery. This position is still used in a lot of hospitals if an epidural or spinal anesthesia has been administered or if there is concern for uterine rupture.
Tuesday, December 2, 2008
CHOKING FIRST AID
Maneuvers to relieve choking are frequently life saving. Adults most often choke on a piece of food, such as a large piece of meat. Infants do not have well-developed swallowing reflexes and may choke if given small, rounded foods such as peanuts or hard candies. Children, especially toddlers, also may choke on balloons, toys, coins, other inedible objects that they place in their mouth, and foods (particularly rounded, smooth foods, such as hot dogs, round candies, nuts, and grapes).
Coughing may be the first symptom and is often so severe that the person cannot ask for help. The person may grasp both hands near the throat. Breathing and speaking can become weak or stop. There can be high-pitched or snoring sounds. The person can turn blue, have a seizure, or faint.
First-Aid Treatment
Treatment for a person who is choking takes precedence over calling for emergency medical care.
Performing Abdominal Thrusts
The rescuer stands behind the person and encircles the person's abdomen with the arms. With one hand, the rescuer forms a fist and clasps the other hand around the fist. The rescuer places the hands halfway between the breastbone and navel and thrusts the hands inward and upward.
A strong cough often expels the object from the airway. A person with a strong cough should be allowed to continue coughing. A person who can speak normally usually still has a strong cough. If a person who is choking cannot cough, the rescuer delivers abdominal thrusts (Heimlich maneuver). The abdominal thrusts increase pressure in the abdomen and chest, which expels the object.
If the person is conscious, the rescuer approaches from behind, using the arms to encircle the person's abdomen. The rescuer forms a fist, with the thumb pointing inward, and places it between the breastbone and navel, toward the person. The other hand is placed firmly over the fisted hand. The hands are then thrust inward and upward forcefully, 5 times in succession. Less force should be used if the person is a child. Series of thrusts should be repeated until the object is expelled. If the person loses consciousness, the rescuer should stop the thrusts.
If the person loses consciousness, steps are taken to open the airway and provide artificial respiration (see First Aid: First-Aid Treatment). Failure of the chest to rise indicates that the airway is still blocked. The rescuer checks the airway for, and removes, visible objects. Artificial respiration is then resumed.
Clearing a Blocked Airway in an Infant
The infant is held face down with the chest resting on the rescuer's forearm. Then, the rescuer strikes the infant's back between the shoulder blades.
The infant is turned face up with the head lower than the body. Then, the rescuer places the second and third fingers on the infant's breastbone and thrusts inward and upward.
For an infant, abdominal thrusts are not performed. Instead, the infant is turned face down, the chest resting on the rescuer's forearm, with the head lower than the body. The rescuer then strikes the infant between the shoulder blades 5 times using the heel of the hand (back blows). The strikes should be firm but not hard enough to cause injury. The rescuer then checks the mouth, removing any visible objects. If the airway remains blocked, the rescuer turns the infant face up with the head down, and using the second and third fingers, thrusts inward and upward on the infant's breastbone 5 times (chest thrusts). The rescuer then checks the mouth again.
source:Merck.com
Coughing may be the first symptom and is often so severe that the person cannot ask for help. The person may grasp both hands near the throat. Breathing and speaking can become weak or stop. There can be high-pitched or snoring sounds. The person can turn blue, have a seizure, or faint.
First-Aid Treatment
Treatment for a person who is choking takes precedence over calling for emergency medical care.
Performing Abdominal Thrusts
The rescuer stands behind the person and encircles the person's abdomen with the arms. With one hand, the rescuer forms a fist and clasps the other hand around the fist. The rescuer places the hands halfway between the breastbone and navel and thrusts the hands inward and upward.
A strong cough often expels the object from the airway. A person with a strong cough should be allowed to continue coughing. A person who can speak normally usually still has a strong cough. If a person who is choking cannot cough, the rescuer delivers abdominal thrusts (Heimlich maneuver). The abdominal thrusts increase pressure in the abdomen and chest, which expels the object.
If the person is conscious, the rescuer approaches from behind, using the arms to encircle the person's abdomen. The rescuer forms a fist, with the thumb pointing inward, and places it between the breastbone and navel, toward the person. The other hand is placed firmly over the fisted hand. The hands are then thrust inward and upward forcefully, 5 times in succession. Less force should be used if the person is a child. Series of thrusts should be repeated until the object is expelled. If the person loses consciousness, the rescuer should stop the thrusts.
If the person loses consciousness, steps are taken to open the airway and provide artificial respiration (see First Aid: First-Aid Treatment). Failure of the chest to rise indicates that the airway is still blocked. The rescuer checks the airway for, and removes, visible objects. Artificial respiration is then resumed.
Clearing a Blocked Airway in an Infant
The infant is held face down with the chest resting on the rescuer's forearm. Then, the rescuer strikes the infant's back between the shoulder blades.
The infant is turned face up with the head lower than the body. Then, the rescuer places the second and third fingers on the infant's breastbone and thrusts inward and upward.
For an infant, abdominal thrusts are not performed. Instead, the infant is turned face down, the chest resting on the rescuer's forearm, with the head lower than the body. The rescuer then strikes the infant between the shoulder blades 5 times using the heel of the hand (back blows). The strikes should be firm but not hard enough to cause injury. The rescuer then checks the mouth, removing any visible objects. If the airway remains blocked, the rescuer turns the infant face up with the head down, and using the second and third fingers, thrusts inward and upward on the infant's breastbone 5 times (chest thrusts). The rescuer then checks the mouth again.
source:Merck.com
Wednesday, November 26, 2008
BURNS-CHILDREN
Burns
A burn occurs when the skin comes in contact with anything hot.
Sources of Burns:
Sun
Fire
Matches
Heaters—electric, kerosene, radiators
Curling rods or rollers
Hot plates
Chemicals
Should My Child See A Doctor?
A burn can also occur on the lining of the nose and the air passages of the lungs when the child breathes in hot smoke or fumes. These are called inhalation burns and need immediate attention by a doctor.
What Do I Do?
Skin burns can be cared for at home if the skin is pink or reddened with no blisters (bubbles). For this type of skin burn:
Immediately put the area in cold water to stop further burning.
Keep the area clean and dry to prevent infection.
Watch the area for blistering (bubbling).
Skin burns that form blisters (bubbles) or cause the skin to be open and blackened need to be seen by a doctor immediately.
If the area of the burn is small:
Cover the area with a clean cloth.
Take the child to the emergency department.
If the area of the burn is large:
Immediately call "911" for help.
Cover the child with a clean sheet or cloth.
Do not move the child unless there is further danger.
Give acetaminophen (Infants' or Children's Tylenol®) for pain.
What Shouldn't I Do?
Do not use butter or oil on burns.
Do not break the blisters on the burn.
Do not treat burns with blisters at home.
Could It Be Prevented?
Keep matches in a high, safe place.
Turn pot handles toward the center of the stove.
Keep children away from kerosene heaters, radiators and open fires.
Do not leave young children alone in your home.
Use a cool mist vaporizer rather than a steam vaporizer.
Teach your child the word "hot" and what things are hot.
Important: If your child is setting fires, seek your doctor's help.
A burn occurs when the skin comes in contact with anything hot.
Sources of Burns:
Sun
Fire
Matches
Heaters—electric, kerosene, radiators
Curling rods or rollers
Hot plates
Chemicals
Should My Child See A Doctor?
A burn can also occur on the lining of the nose and the air passages of the lungs when the child breathes in hot smoke or fumes. These are called inhalation burns and need immediate attention by a doctor.
What Do I Do?
Skin burns can be cared for at home if the skin is pink or reddened with no blisters (bubbles). For this type of skin burn:
Immediately put the area in cold water to stop further burning.
Keep the area clean and dry to prevent infection.
Watch the area for blistering (bubbling).
Skin burns that form blisters (bubbles) or cause the skin to be open and blackened need to be seen by a doctor immediately.
If the area of the burn is small:
Cover the area with a clean cloth.
Take the child to the emergency department.
If the area of the burn is large:
Immediately call "911" for help.
Cover the child with a clean sheet or cloth.
Do not move the child unless there is further danger.
Give acetaminophen (Infants' or Children's Tylenol®) for pain.
What Shouldn't I Do?
Do not use butter or oil on burns.
Do not break the blisters on the burn.
Do not treat burns with blisters at home.
Could It Be Prevented?
Keep matches in a high, safe place.
Turn pot handles toward the center of the stove.
Keep children away from kerosene heaters, radiators and open fires.
Do not leave young children alone in your home.
Use a cool mist vaporizer rather than a steam vaporizer.
Teach your child the word "hot" and what things are hot.
Important: If your child is setting fires, seek your doctor's help.
CHEMICAL BURNS FIRST AID
If a chemical burns the skin, follow these steps:
Remove the cause of the burn by flushing the chemicals off the skin surface with cool, running water for 20 minutes or more. If the burning chemical is a powder-like substance, such as lime, brush it off the skin before flushing.
Remove clothing or jewelry that has been contaminated by the chemical.
Apply a cool, wet cloth or towel to relieve pain.
Wrap the burned area loosely with a dry, sterile dressing or a clean cloth.
Rewash the burned area for several more minutes if the person experiences increased burning after the initial washing.
Minor chemical burns usually heal without further treatment.
Seek emergency medical assistance if:
The victim has signs of shock, such as fainting, pale complexion or breathing in a notably shallow manner.
The chemical burn penetrated through the first layer of skin, and the resulting second-degree burn covers an area more than 3 inches (7.5 centimeters) in diameter.
The chemical burn occurred on the eye, hands, feet, face, groin or buttocks, or over a major joint.
The victim has pain that cannot be controlled with over-the-counter pain relievers such as acetaminophen (Tylenol, others) or ibuprofen (Advil, Motrin, others).
If you're unsure whether a substance is toxic, call the poison control center at 800-222-1222. If you seek emergency assistance, bring the chemical container or a complete description of the substance with you for identification.
Remove the cause of the burn by flushing the chemicals off the skin surface with cool, running water for 20 minutes or more. If the burning chemical is a powder-like substance, such as lime, brush it off the skin before flushing.
Remove clothing or jewelry that has been contaminated by the chemical.
Apply a cool, wet cloth or towel to relieve pain.
Wrap the burned area loosely with a dry, sterile dressing or a clean cloth.
Rewash the burned area for several more minutes if the person experiences increased burning after the initial washing.
Minor chemical burns usually heal without further treatment.
Seek emergency medical assistance if:
The victim has signs of shock, such as fainting, pale complexion or breathing in a notably shallow manner.
The chemical burn penetrated through the first layer of skin, and the resulting second-degree burn covers an area more than 3 inches (7.5 centimeters) in diameter.
The chemical burn occurred on the eye, hands, feet, face, groin or buttocks, or over a major joint.
The victim has pain that cannot be controlled with over-the-counter pain relievers such as acetaminophen (Tylenol, others) or ibuprofen (Advil, Motrin, others).
If you're unsure whether a substance is toxic, call the poison control center at 800-222-1222. If you seek emergency assistance, bring the chemical container or a complete description of the substance with you for identification.
Tuesday, November 25, 2008
BURNS FIRST AID
To distinguish a minor burn from a serious burn, the first step is to determine the degree and the extent of damage to body tissues. The three classifications of first-degree burn, second-degree burn and third-degree burn will help you determine emergency care:
First-degree burn
The least serious burns are those in which only the outer layer of skin is burned. The skin is usually red, with swelling and pain sometimes present. The outer layer of skin hasn't been burned through. Treat a first-degree burn as a minor burn unless it involves substantial portions of the hands, feet, face, groin or buttocks, or a major joint.
Second-degree burn
When the first layer of skin has been burned through and the second layer of skin (dermis) also is burned, the injury is called a second-degree burn. Blisters develop and the skin takes on an intensely reddened, splotchy appearance. Second-degree burns produce severe pain and swelling.
If the second-degree burn is no larger than 3 inches (7.5 centimeters) in diameter, treat it as a minor burn. If the burned area is larger or if the burn is on the hands, feet, face, groin or buttocks, or over a major joint, treat it as a major burn and get medical help immediately.
For minor burns, including first-degree burns and second-degree burns limited to an area no larger than 3 inches (7.5 centimeters) in diameter, take the following action:
Cool the burn. Hold the burned area under cold running water for at least five minutes, or until the pain subsides. If this is impractical, immerse the burn in cold water or cool it with cold compresses. Cooling the burn reduces swelling by conducting heat away from the skin. Don't put ice on the burn.
Cover the burn with a sterile gauze bandage. Don't use fluffy cotton, which may irritate the skin. Wrap the gauze loosely to avoid putting pressure on burned skin. Bandaging keeps air off the burned skin, reduces pain and protects blistered skin.
Take an over-the-counter pain reliever. These include aspirin, ibuprofen (Advil, Motrin, others), naproxen (Aleve) or acetaminophen (Tylenol, others). Never give aspirin to children or teenagers.
Minor burns usually heal without further treatment. They may heal with pigment changes, meaning the healed area may be a different color from the surrounding skin. Watch for signs of infection, such as increased pain, redness, fever, swelling or oozing. If infection develops, seek medical help. Avoid re-injuring or tanning if the burns are less than a year old — doing so may cause more extensive pigmentation changes. Use sunscreen on the area for at least a year.
Caution
Don't use ice. Putting ice directly on a burn can cause frostbite, further damaging your skin.
Don't apply butter or ointments to the burn. This could prevent proper healing.
Don't break blisters. Broken blisters are vulnerable to infection.
Third-degree burn
The most serious burns are painless, involve all layers of the skin and cause permanent tissue damage. Fat, muscle and even bone may be affected. Areas may be charred black or appear dry and white. Difficulty inhaling and exhaling, carbon monoxide poisoning, or other toxic effects may occur if smoke inhalation accompanies the burn.
For major burns, dial 911 or call for emergency medical assistance. Until an emergency unit arrives, follow these steps:
Don't remove burnt clothing. However, do make sure the victim is no longer in contact with smoldering materials or exposed to smoke or heat.
Don't immerse large severe burns in cold water. Doing so could cause shock.
Check for signs of circulation (breathing, coughing or movement). If there is no breathing or other sign of circulation, begin cardiopulmonary resuscitation (CPR).
Elevate the burned body part or parts. Raise above heart level, when possible.
Cover the area of the burn. Use a cool, moist, sterile bandage; clean, moist cloth; or moist towels.
First-degree burn
The least serious burns are those in which only the outer layer of skin is burned. The skin is usually red, with swelling and pain sometimes present. The outer layer of skin hasn't been burned through. Treat a first-degree burn as a minor burn unless it involves substantial portions of the hands, feet, face, groin or buttocks, or a major joint.
Second-degree burn
When the first layer of skin has been burned through and the second layer of skin (dermis) also is burned, the injury is called a second-degree burn. Blisters develop and the skin takes on an intensely reddened, splotchy appearance. Second-degree burns produce severe pain and swelling.
If the second-degree burn is no larger than 3 inches (7.5 centimeters) in diameter, treat it as a minor burn. If the burned area is larger or if the burn is on the hands, feet, face, groin or buttocks, or over a major joint, treat it as a major burn and get medical help immediately.
For minor burns, including first-degree burns and second-degree burns limited to an area no larger than 3 inches (7.5 centimeters) in diameter, take the following action:
Cool the burn. Hold the burned area under cold running water for at least five minutes, or until the pain subsides. If this is impractical, immerse the burn in cold water or cool it with cold compresses. Cooling the burn reduces swelling by conducting heat away from the skin. Don't put ice on the burn.
Cover the burn with a sterile gauze bandage. Don't use fluffy cotton, which may irritate the skin. Wrap the gauze loosely to avoid putting pressure on burned skin. Bandaging keeps air off the burned skin, reduces pain and protects blistered skin.
Take an over-the-counter pain reliever. These include aspirin, ibuprofen (Advil, Motrin, others), naproxen (Aleve) or acetaminophen (Tylenol, others). Never give aspirin to children or teenagers.
Minor burns usually heal without further treatment. They may heal with pigment changes, meaning the healed area may be a different color from the surrounding skin. Watch for signs of infection, such as increased pain, redness, fever, swelling or oozing. If infection develops, seek medical help. Avoid re-injuring or tanning if the burns are less than a year old — doing so may cause more extensive pigmentation changes. Use sunscreen on the area for at least a year.
Caution
Don't use ice. Putting ice directly on a burn can cause frostbite, further damaging your skin.
Don't apply butter or ointments to the burn. This could prevent proper healing.
Don't break blisters. Broken blisters are vulnerable to infection.
Third-degree burn
The most serious burns are painless, involve all layers of the skin and cause permanent tissue damage. Fat, muscle and even bone may be affected. Areas may be charred black or appear dry and white. Difficulty inhaling and exhaling, carbon monoxide poisoning, or other toxic effects may occur if smoke inhalation accompanies the burn.
For major burns, dial 911 or call for emergency medical assistance. Until an emergency unit arrives, follow these steps:
Don't remove burnt clothing. However, do make sure the victim is no longer in contact with smoldering materials or exposed to smoke or heat.
Don't immerse large severe burns in cold water. Doing so could cause shock.
Check for signs of circulation (breathing, coughing or movement). If there is no breathing or other sign of circulation, begin cardiopulmonary resuscitation (CPR).
Elevate the burned body part or parts. Raise above heart level, when possible.
Cover the area of the burn. Use a cool, moist, sterile bandage; clean, moist cloth; or moist towels.
Monday, November 24, 2008
FRACTURE FACTS
A child's fracture heals more quickly than an adult's because kids' bones are surrounded by a thick membrane called the periosteum, which helps to rapidly remodel and restore the broken bone. This membrane gradually thins with age.
A child's broken thighbone will take four to six weeks to heal, compared with 20 weeks for an adult's and two weeks for a baby's.
Bone fractures in children are most often treated with a fiberglass or plaster cast and rarely require surgery.
You should follow up with your child's orthopedist within one year of a fracture to check that the break has healed and the bone is growing properly, especially if the fracture occurs in the growth plate at either end of the bone. Nearly half of your child's total bone mass is formed by age 10. A diet that includes 500 to 800 milligrams of calcium a day will boost her bone strength.
If you suspect a broken bone :
A broken bone can cause severe pain, swelling, tenderness, and also bruising, making it difficult for your child to use that part of his body.
But even if he's able to move an injured hand or foot, for example, your child may still have a hidden fracture that needs medical attention. If you think the bone is broken, you should:
Call a hospital if your child is unconscious, bleeding uncontrollably, or cannot walk due to a possible break in a leg or ankle bone. Also, NEVER try to move your child yourself in the unlikely event of an open fracture (i.e., the bone has penetrated the skin). Apply pressure to the wound with a clean cloth to stop the bleeding until help arrives. Call your doctor immediately.
Take your child to the hospital yourself if he is able to walk (i.e., if he breaks an arm or wrist). First immobilize the broken bone, since movement can cause further bone injury or damage surrounding blood vessels, nerves and tissues.
To create an arm splint: Place your child's forearm against his chest. If this is too painful, place a pillow or sheet between his arm and chest. Using gauze, a sheet, or a blanket, begin at the elbow and wrap the splint in a diagonal direction around your child's back, coming around his chest and wrapping the upper and lover arm all the way up to the hand. Secure the splint snugly with an ACE bandage or safety pins. Apply ice to the area.
Is it a Sprain or Break ?
Your child has taken a bad fall, and all you know for sure is that she's in pain. Here's how to spot and treat what's wrong.
SPRAIN
What happens: Ligaments, the strong bands of connective tissue that join bones together, stretch or tear - often in a fall. Ankles, knees, and wrists are most vulnerable.
What to expect: Pain, bruising, and inflammation of the limb that your child has twisted or landed upon. He may feel a tear or pop when the sprain occurs.
How is it treated: Most doctors recommend RICE (Rest, Ice, Compression, and Elevation). Moderate sprains may require an bandage for 48 hours after the injury or until swelling subsides. Have a coach tape the area if extra support is needed during vigorous activity.
FRACTURE
What happens: A bone cracks, breaks, or shatters due to external pressure.
What to expect: Severe pain or deformity ( if the bone is bent in an unnatural position), or in rare cases, an open wound.
Some breaks are less obvious: If you're not sure, monitor the injured area for two days. If pain persists or increases, your child may have a greenstick fracture ( only one side of the bone is broken) or a hairline fracture ( the bone is cracked ).
How it's treated: Take your child to the doctor for an X ray right away. Fractures are treated by fitting a cast around the injured limb or by manually resetting the bone before casting. Severely fragmented bones require surgery.
Bone Danger Zones
Falls, the leading cause of injury among children, are responsible for most pediatric bone fractures. In fact, children 10 years and younger suffer injuries from falls twice as often as the rest of the population. Here are the most likely hazards leading to a bone-breaking fall - all what to do to keep your child safe.
HAZARD SAFETY STEP
Bike- Make sure your child wears a helmet and rides only on flat, smooth surfaces.
Furniture and Windows Set chairs, couches, and other large objects that kids may climb on away from windows and in a carpeted area. Install window guards on all of your home's windows.
Playground- Avoid asphalt and concrete play areas; look for soft surfaces, such as mulch, sand, or grass. Make sure the playground has separate areas for swinging, running, and quiet play. Keep preschoolers away from older, more active children.
Baby walker Use a stationary activity center instead of a baby walker with wheels.
Stairs- Install safety gates at the top and bottom of household stairs.
Sports- Field Outfit your child with appropriate protective equipment, such as wrist guards, knee pads, a mouth guard, and a helmet.
Pool- Don't let your child go near a pool without adult supervision; teach him to walk - never run - around the pool area. Build a four-sided fence at least five feet high with self-closing and self-latching gates around your pool.
Shopping Cart- Fasten the safety belt around your child; never allow him to stand up in the cart.
A child's broken thighbone will take four to six weeks to heal, compared with 20 weeks for an adult's and two weeks for a baby's.
Bone fractures in children are most often treated with a fiberglass or plaster cast and rarely require surgery.
You should follow up with your child's orthopedist within one year of a fracture to check that the break has healed and the bone is growing properly, especially if the fracture occurs in the growth plate at either end of the bone. Nearly half of your child's total bone mass is formed by age 10. A diet that includes 500 to 800 milligrams of calcium a day will boost her bone strength.
If you suspect a broken bone :
A broken bone can cause severe pain, swelling, tenderness, and also bruising, making it difficult for your child to use that part of his body.
But even if he's able to move an injured hand or foot, for example, your child may still have a hidden fracture that needs medical attention. If you think the bone is broken, you should:
Call a hospital if your child is unconscious, bleeding uncontrollably, or cannot walk due to a possible break in a leg or ankle bone. Also, NEVER try to move your child yourself in the unlikely event of an open fracture (i.e., the bone has penetrated the skin). Apply pressure to the wound with a clean cloth to stop the bleeding until help arrives. Call your doctor immediately.
Take your child to the hospital yourself if he is able to walk (i.e., if he breaks an arm or wrist). First immobilize the broken bone, since movement can cause further bone injury or damage surrounding blood vessels, nerves and tissues.
To create an arm splint: Place your child's forearm against his chest. If this is too painful, place a pillow or sheet between his arm and chest. Using gauze, a sheet, or a blanket, begin at the elbow and wrap the splint in a diagonal direction around your child's back, coming around his chest and wrapping the upper and lover arm all the way up to the hand. Secure the splint snugly with an ACE bandage or safety pins. Apply ice to the area.
Is it a Sprain or Break ?
Your child has taken a bad fall, and all you know for sure is that she's in pain. Here's how to spot and treat what's wrong.
SPRAIN
What happens: Ligaments, the strong bands of connective tissue that join bones together, stretch or tear - often in a fall. Ankles, knees, and wrists are most vulnerable.
What to expect: Pain, bruising, and inflammation of the limb that your child has twisted or landed upon. He may feel a tear or pop when the sprain occurs.
How is it treated: Most doctors recommend RICE (Rest, Ice, Compression, and Elevation). Moderate sprains may require an bandage for 48 hours after the injury or until swelling subsides. Have a coach tape the area if extra support is needed during vigorous activity.
FRACTURE
What happens: A bone cracks, breaks, or shatters due to external pressure.
What to expect: Severe pain or deformity ( if the bone is bent in an unnatural position), or in rare cases, an open wound.
Some breaks are less obvious: If you're not sure, monitor the injured area for two days. If pain persists or increases, your child may have a greenstick fracture ( only one side of the bone is broken) or a hairline fracture ( the bone is cracked ).
How it's treated: Take your child to the doctor for an X ray right away. Fractures are treated by fitting a cast around the injured limb or by manually resetting the bone before casting. Severely fragmented bones require surgery.
Bone Danger Zones
Falls, the leading cause of injury among children, are responsible for most pediatric bone fractures. In fact, children 10 years and younger suffer injuries from falls twice as often as the rest of the population. Here are the most likely hazards leading to a bone-breaking fall - all what to do to keep your child safe.
HAZARD SAFETY STEP
Bike- Make sure your child wears a helmet and rides only on flat, smooth surfaces.
Furniture and Windows Set chairs, couches, and other large objects that kids may climb on away from windows and in a carpeted area. Install window guards on all of your home's windows.
Playground- Avoid asphalt and concrete play areas; look for soft surfaces, such as mulch, sand, or grass. Make sure the playground has separate areas for swinging, running, and quiet play. Keep preschoolers away from older, more active children.
Baby walker Use a stationary activity center instead of a baby walker with wheels.
Stairs- Install safety gates at the top and bottom of household stairs.
Sports- Field Outfit your child with appropriate protective equipment, such as wrist guards, knee pads, a mouth guard, and a helmet.
Pool- Don't let your child go near a pool without adult supervision; teach him to walk - never run - around the pool area. Build a four-sided fence at least five feet high with self-closing and self-latching gates around your pool.
Shopping Cart- Fasten the safety belt around your child; never allow him to stand up in the cart.
BONE FRACTURE FIRST AID
A fracture is a broken bone. It requires medical attention. If the broken bone is the result of major trauma or injury, call 911 or your local emergency number. Also call for emergency help if:
The person is unresponsive, isn't breathing or isn't moving. Begin cardiopulmonary resuscitation (CPR) if there's no respiration or heartbeat.
There is heavy bleeding.
Even gentle pressure or movement causes pain.
The limb or joint appears deformed.
The bone has pierced the skin.
The extremity of the injured arm or leg, such as a toe or finger, is numb or bluish at the tip.
You suspect a bone is broken in the neck, head or back.
You suspect a bone is broken in the hip, pelvis or upper leg (for example, the leg and foot turn outward abnormally).
Take these actions immediately while waiting for medical help:
Stop any bleeding. Apply pressure to the wound with a sterile bandage, a clean cloth or a clean piece of clothing.
Immobilize the injured area. Don't try to realign the bone, but if you've been trained in how to splint and professional help isn't readily available, apply a splint to the area.
Apply ice packs to limit swelling and help relieve pain until emergency personnel arrive. Don't apply ice directly to the skin — wrap the ice in a towel, piece of cloth or some other material.
Treat for shock. If the person feels faint or is breathing in short, rapid breaths, lay the person down with the head slightly lower than the trunk and, if possible, elevate the legs.
The person is unresponsive, isn't breathing or isn't moving. Begin cardiopulmonary resuscitation (CPR) if there's no respiration or heartbeat.
There is heavy bleeding.
Even gentle pressure or movement causes pain.
The limb or joint appears deformed.
The bone has pierced the skin.
The extremity of the injured arm or leg, such as a toe or finger, is numb or bluish at the tip.
You suspect a bone is broken in the neck, head or back.
You suspect a bone is broken in the hip, pelvis or upper leg (for example, the leg and foot turn outward abnormally).
Take these actions immediately while waiting for medical help:
Stop any bleeding. Apply pressure to the wound with a sterile bandage, a clean cloth or a clean piece of clothing.
Immobilize the injured area. Don't try to realign the bone, but if you've been trained in how to splint and professional help isn't readily available, apply a splint to the area.
Apply ice packs to limit swelling and help relieve pain until emergency personnel arrive. Don't apply ice directly to the skin — wrap the ice in a towel, piece of cloth or some other material.
Treat for shock. If the person feels faint or is breathing in short, rapid breaths, lay the person down with the head slightly lower than the trunk and, if possible, elevate the legs.
Sunday, November 23, 2008
ANAPHYLAXIS: FIRST AID
A severe allergic reaction (anaphylaxis) can produce shock and life-threatening respiratory distress and circulatory collapse.
In sensitive people, anaphylaxis can occur within minutes, but may also occur up to several hours after exposure to a specific allergy-causing substance. A wide range of substances — including insect venom, pollen, latex, and certain foods and drugs — can cause anaphylaxis. Some people have anaphylactic reactions from unknown causes.
If you're extremely sensitive, you might break out in hives and your eyes or lips might swell severely. The inside of your throat might swell as well, even to the point of causing difficulty breathing and shock. Your blood pressure drops, and your internal organs can be affected. Dizziness, mental confusion, abdominal cramping, nausea, vomiting or diarrhea also may accompany anaphylaxis.
How you can be ready:
If you've had an anaphylactic reaction in the past, carry medications with you as an antidote. Epinephrine is the most commonly used drug for severe allergic reactions. It comes only as an injection that must be prescribed by your doctor. You can self-administer epinephrine with an auto-injector, such as the EpiPen. Be sure to read the injection instructions as soon as you receive an auto-injector, and have your household members read them as well.
You should also carry an antihistamine pill, such as diphenhydramine (Benadryl, others), because the effects of epinephrine are only temporary. Seek emergency medical attention immediately after taking these medications.
If you observe someone having an allergic reaction with signs of anaphylaxis:
Call 911 or your local medical emergency number.
Check for special medications that the person might be carrying to treat an allergic attack, such as an auto-injector of epinephrine (for example, EpiPen). Administer the drug as directed — usually by pressing the auto-injector against the person's thigh and holding it in place for several seconds. Massage the injection site for 10 seconds to enhance absorption. After administering epinephrine, have the person take an antihistamine pill if he or she is able to do so without choking. Look for a medical emergency ID bracelet or necklace.
Have the person lie still on his or her back with feet higher than the head.
Loosen tight clothing and cover the person with a blanket. Don't give anything else to drink.
If there's vomiting or bleeding from the mouth, turn the person on his or her side to prevent choking.
If there are no signs of circulation (breathing, coughing or movement), begin CPR.
In sensitive people, anaphylaxis can occur within minutes, but may also occur up to several hours after exposure to a specific allergy-causing substance. A wide range of substances — including insect venom, pollen, latex, and certain foods and drugs — can cause anaphylaxis. Some people have anaphylactic reactions from unknown causes.
If you're extremely sensitive, you might break out in hives and your eyes or lips might swell severely. The inside of your throat might swell as well, even to the point of causing difficulty breathing and shock. Your blood pressure drops, and your internal organs can be affected. Dizziness, mental confusion, abdominal cramping, nausea, vomiting or diarrhea also may accompany anaphylaxis.
How you can be ready:
If you've had an anaphylactic reaction in the past, carry medications with you as an antidote. Epinephrine is the most commonly used drug for severe allergic reactions. It comes only as an injection that must be prescribed by your doctor. You can self-administer epinephrine with an auto-injector, such as the EpiPen. Be sure to read the injection instructions as soon as you receive an auto-injector, and have your household members read them as well.
You should also carry an antihistamine pill, such as diphenhydramine (Benadryl, others), because the effects of epinephrine are only temporary. Seek emergency medical attention immediately after taking these medications.
If you observe someone having an allergic reaction with signs of anaphylaxis:
Call 911 or your local medical emergency number.
Check for special medications that the person might be carrying to treat an allergic attack, such as an auto-injector of epinephrine (for example, EpiPen). Administer the drug as directed — usually by pressing the auto-injector against the person's thigh and holding it in place for several seconds. Massage the injection site for 10 seconds to enhance absorption. After administering epinephrine, have the person take an antihistamine pill if he or she is able to do so without choking. Look for a medical emergency ID bracelet or necklace.
Have the person lie still on his or her back with feet higher than the head.
Loosen tight clothing and cover the person with a blanket. Don't give anything else to drink.
If there's vomiting or bleeding from the mouth, turn the person on his or her side to prevent choking.
If there are no signs of circulation (breathing, coughing or movement), begin CPR.
ALTITUDE SICKNESS
Please call 911 immediately if you are having chest pain, difficulty breathing, severe bleeding, sudden weakness or numbness, or if you think you have a medical emergency.
Altitude Sickness Treatment
To prevent acute mountain sickness, a climber's initial sleep altitude should be lower than 8,000 feet. At altitudes above 10,000 feet, the sleeping elevation should increase no more than 1,000 feet per day.
A simple, fundamental rule will help to prevent severe altitude illness in almost every case: If a person experiences any symptoms of altitude sickness, the person should not ascend or increase the sleeping elevation until all symptoms have resolved. Failure to follow this rule can allow simple altitude mountain sickness to progress to potentially fatal high-altitude pulmonary edema or high-altitude cerebral edema.
Treatments for the forms of altitude sickness are as follows:
Altitude mountain sickness (AMS): Stop the ascent and rest. Symptoms typically go away by themselves; however, the person with AMS may need supplemental oxygen. Acetazolamide (a diuretic), if prescribed, will minimize fluid retention, and acetaminophen (Tylenol) or aspirin will relieve headaches.
High-altitude pulmonary edema (HAPE): The climber with HAPE must rest, get supplemental oxygen, and descend immediately. In severe cases, nifedipine (Procardia), if prescribed, may be used as a "rescue agent," but it does not replace the need for descent.
High-altitude cerebral edema (HACE): A person with HACE must receive supplemental oxygen and descend immediately. Use dexamethasone (Dexone) to decrease brain swelling. The person may require a Gamow bag (a bag that increases the air pressure around the climber which simulates descent) or other hyperbaric chamber treatment. However, this does not replace the need for descent.
Altitude Sickness Treatment
To prevent acute mountain sickness, a climber's initial sleep altitude should be lower than 8,000 feet. At altitudes above 10,000 feet, the sleeping elevation should increase no more than 1,000 feet per day.
A simple, fundamental rule will help to prevent severe altitude illness in almost every case: If a person experiences any symptoms of altitude sickness, the person should not ascend or increase the sleeping elevation until all symptoms have resolved. Failure to follow this rule can allow simple altitude mountain sickness to progress to potentially fatal high-altitude pulmonary edema or high-altitude cerebral edema.
Treatments for the forms of altitude sickness are as follows:
Altitude mountain sickness (AMS): Stop the ascent and rest. Symptoms typically go away by themselves; however, the person with AMS may need supplemental oxygen. Acetazolamide (a diuretic), if prescribed, will minimize fluid retention, and acetaminophen (Tylenol) or aspirin will relieve headaches.
High-altitude pulmonary edema (HAPE): The climber with HAPE must rest, get supplemental oxygen, and descend immediately. In severe cases, nifedipine (Procardia), if prescribed, may be used as a "rescue agent," but it does not replace the need for descent.
High-altitude cerebral edema (HACE): A person with HACE must receive supplemental oxygen and descend immediately. Use dexamethasone (Dexone) to decrease brain swelling. The person may require a Gamow bag (a bag that increases the air pressure around the climber which simulates descent) or other hyperbaric chamber treatment. However, this does not replace the need for descent.
Saturday, November 22, 2008
WHAT IS FIRST AID
First aid is the provision of initial care for an illness or injury. It is usually performed by a lay person to a sick or injured patient until definitive medical treatment can be accessed. Certain self-limiting illnesses or minor injuries may not require further medical care past the first aid intervention. It generally consists of a series of simple and, in some cases, potentially life-saving techniques that an individual can be trained to perform with minimal equipment.
While first aid can also be performed on animals, the term generally refers to care of human patients.
Contents
1 History
2 Aims
3 Key skills
3.1 Preserving life
3.2 Promoting recovery
4 Training
4.1 Australia
4.2 Canada
4.3 Ireland
4.4 United Kingdom
5 Specific disciplines
6 Symbols
7 Conditions that often require first aid
History
The earliest instances of recorded first aid were provided by religious knights, such as the Knights Hospitaller, formed in the 11th century, providing care to pilgrims and knights, and training other knights in how to treat common battlefield injuries.[1] The practice of first aid fell largely in to disuse during the Dark Ages, and organised societies were not seen again until in 1859 Henry Dunant organized local villagers to help victims of the Battle of Solferino, including the provision of first aid. Four years later, four nations met in Geneva and formed the organization which has grown into the Red Cross, with a key stated aim of "aid to sick and wounded soldiers in the field".[1] This was followed by the formation of St. John Ambulance in 1877, based on the principles of the Knights Hospitaller, to teach first aid, and numerous other organisation joined them, with the term first aid first coined in 1878 as civilian ambulance services spread as a combination of 'first treatment' and 'national aid'[1] in large railway centres and mining districts as well as with police forces. First aid training began to spread through the empire through organisations such as St John, often starting, as in the UK, with high risk activities such as ports and railways.[2]
Many developments in first aid and many other medical techniques have been driven by wars, such as in the case of the American Civil War, which prompted Clara Barton to organize the American Red Cross.[3] Today, there are several groups that promote first aid, such as the military and the Scouting movement. New techniques and equipment have helped make today’s first aid simple and effective.
Aims
The key aims of first aid can be summarised in three key points-[4]
Preserve life - the overriding aim of all medical care, including first aid, is to save lives
Prevent further harm - also sometimes called preventing the condition worsening, this covers both external factors, such as moving a patient away from a cause of harm, and applying first aid techniques to prevent worsening of the condition, such as applying pressure to stop a bleed becoming dangerous.
Promote recovery - first aid also involves trying to start the recovery process from the illness or injury, and in some cases might involve completing a treatment, such as in the case of applying a plaster to a small wound.
First aid training also involves the prevention of initial injury and responder safety, and the treatment phases.
Key skills
In case of tongue fallen backwards, blocking the airway, it is necessary to hyperextend the head and pull up the chin, so that the tongue lifts and clears the airway.Certain skills are considered essential to the provision of first aid and are taught ubiquitously. Particularly, the "ABC"s of first aid, which focus on critical life-saving intervention, must be rendered before treatment of less serious injuries. ABC stands for Airway, Breathing, and Circulation. The same mnemonic is used by all emergency health professionals. Attention must first be brought to the airway to ensure it is clear. Obstruction (choking) is a life-threatening emergency. Following evaluation of the airway, a first aid attendant would determine adequacy of breathing and provide rescue breathing if necessary. Assessment of circulation is now not usually carried out for patients who are not breathing, with first aiders now trained to go straight to chest compressions (and thus providing artificial circulation) but pulse checks may be done on less serious patients.
Some organizations add a fourth step of "D" for Deadly bleeding or Defibrillation, while others consider this as part of the Circulation step. Variations on techniques to evaluate and maintain the ABCs depend on the skill level of the first aider. Once the ABCs are secured, first aiders can begin additional treatments, as required. Some organizations teach the same order of priority using the "3 Bs": Breathing, Bleeding, and Bones. While the ABCs and 3Bs are taught to be performed sequentially, certain conditions may require the consideration of two steps simultaneously. This includes the provision of both artificial respiration and chest compressions to someone who is not breathing and has no pulse, and the consideration of cervical spine injuries when ensuring an open airway.
Preserving life
As the key skill to first aid is preserving life, the single most important training a first aider can receive is in the primary diagnosis and care of an unconscious or unresponsive patient. The most common mnemonic used to remember the procedure for this is ABC, which stands for Airway, Breathing and Circulation.
In order to preserve life, all persons require to have an open airway - a clear passage where air can move in through the mouth or nose through the pharynx and down in to the lungs, without obstruction. Conscious people will maintain their own airway automatically, but those who are unconscious (with a GCS of less than 8) may be unable to maintain a patent airway, as the part of the brain which autonomously controls in normal situations may not be functioning.
If the patient was breathing, a first aider would normally then place them in the recovery position, with the patient leant over on their side, which also has the effect of clearing the tongue from the pharynx. It also avoids a common cause of death in unconscious patients, which is choking on regurgitated stomach contents.
The airway can also become blocked through a foreign object becoming lodged in the pharynx or larynx, commonly called choking. The first aider will be taught to deal with this through a combination of ‘back slaps’ and ‘abdominal thrusts’.
Once the airway has been opened, the first aider would assess to see if the patient is breathing. If there is no breathing, or the patient is not breathing normally, such as agonal breathing, the first aider would undertake what is probably the most recognized first aid procedure - Cardiopulmonary resuscitation or CPR, which involves breathing for the patient, and manually massaging the heart to promote blood flow around the body.
Promoting recovery
The first aider is also likely to be trained in dealing with injuries such as cuts, grazes or broken bones. They may be able to deal with the situation in its entirety (a small adhesive bandage on a paper cut), or may be required to maintain the condition of something like a broken bone, until the next stage of definitive care (usually an ambulance) arrives.
Training
First aid scenario training in progressMuch of first aid is common sense. Basic principles, such as knowing to use an adhesive bandage or applying direct pressure on a bleed, are often acquired passively through life experiences. However, to provide effective, life-saving first aid interventions requires instruction and practical training. This is especially true where it relates to potentially fatal illnesses and injuries, such as those that require cardiopulmonary resuscitation (CPR); these procedures may be invasive, and carry a risk of further injury to the patient and the provider. As with any training, it is more useful if it occurs before an actual emergency, and in many countries, emergency ambulance dispatchers may give basic first aid instructions over the phone while the ambulance is on the way.
Training is generally provided by attending a course, typically leading to certification. Due to regular changes in procedures and protocols, based on updated clinical knowledge, and to maintain skill, attendance at regular refresher courses or re-certification is often necessary. First aid training is often available through community organizations such as the Red Cross and St. John Ambulance, or through commercial providers, who will train people for a fee. This commercial training is most common for training of employees to perform first aid in their workplace. Many community organizations also provide a commercial service, which complements their community programmes.
Australia
In Australia, Nationally recognized First Aid certificates may only be issued by Registered training organisations who are accredited on the National Training Information System (NTIS). Most First Aid certificates are issued at one of 3 levels:
Level 1 (or “Basic First Aid”, or “Basic Life Support”): is a 1-day course covering primarily life-threatening emergencies: CPR, bleeding, choking and other life-threatening medical emergencies.
Level 2 (“Senior First Aid”) is a 2 day course that covers all the aspects of training in Level 1, as well as specialized training for treatment of burns, bites, stings, electric shock and poisons. Level 2 reaccreditation is a 1 day course which must be taken every 3 years, but CPR reaccrediation may be required more frequently (typically yearly).
Level 3 (“Occupational First Aid”) is a 4-day course covering advanced first aid, use of oxygen and Automated external defibrillators and documentation. It is suitable for workplace First Aiders and those who manage First Aid facilities.
Other courses outside these levels are commonly taught, including CPR-only courses, Advanced Resuscitation, Remote Area or Wilderness First Aid, Administering Medications (such as salbutamol or the Epi-Pen) and specialized courses for parents, school teachers, community first responders or hazardous workplace first aiders. CPR Re-accredidation courses are sometimes required yearly, regardless of the length of the overall certification.
Canada
In Canada, first aid certificates are awarded by one of several organizations including the Red Cross, the Lifesaving Society, St. John Ambulance, the Heart and Stroke Foundation, and Ski Patrol. Workplace safety regulations vary depending on occupation. Many workplaces opt to have their employees trained in Standard First Aid (see below).
Emergency First Aid: is an 8-hour course covering primarily life-threatening emergencies: CPR, bleeding, choking and other life-threatening medical emergencies.
Standard First Aid: is a 16-hour course that covers the same material as Emergency First Aid and will include training for some, but not all, of the following: breaks; burns; poisons, bites and stings; eye injuries; head and neck injuries; chest injuries; wound care; emergency child birth; and multiple casualty management.
Medical First Responder (BTLS - known by different names among different Canadian organizations): is a 40 hour course. It requires Standard First Aid certification as a prerequisite. Candidates are trained in the use of oxygen, Automated external defibrillators, airway management, and the use of additional emergency equipment.
CPR certification in Canada is broken into several levels. Depending on the level, the lay person will learn CPR and choking procedures for adults, children, and infants.
CPR H.C.P. (Health Care Professional) also provides training on artificial respiration, the use of bag valve masks, and suction. This level of qualification is usually not offered to the general public.
Ireland
In Ireland, the workplace qualification is the Occupational First Aid Certificate. The Health and Safety Authority issue the standards for first aid at work and hold a register of qualified instructors, examiners and organisations that can provide the course. A FETAC Level 5 certificate is awarded after passing a three day course and is valid for two years from date of issue. Occupational First Aiders are more qualified than Cardiac First Responders (Cardiac First Response and training on the AED is now part of the OFA course) but less qualified than Emergency First Responders but strangely Occupational First Aid is the only one of the three not certified by PHECC. Organisations offering the certificate include, Ireland's largest first aid organisation, the Order of Malta Ambulance Corps, the St John Ambulance Brigade, and the Irish Red Cross. The Irish Red Cross also provides a Practical First Aid Course aimed at the general public dealing primarily with family members getting injured. Many other (purely commercially run) organisations offer training.
United Kingdom
In the United Kingdom, there are two main types of first aid courses offered. An “Emergency Aid for Appointed Persons” course typically lasts one day, and covers the basics, focusing on critical interventions for conditions such as cardiac arrest and severe bleeding, and is usually not formally assessed. A “First Aid at Work” course is usually a four-day course (two days for a re-qualification) that covers the full spectrum of first aid, and is formally assessed by recognized Health and Safety Executive assessors. Certificates for the “First Aid at Work” course are issued by the training organization and are valid for a period of three years from the date the delegate passes the course. Other courses offered by training organizations such as St. John Ambulance, St. Andrew’s Ambulance Association or the British Red Cross include Baby & Child Courses, manual handling, people moving, and courses geared towards more advanced life support, such as defibrillation and administration of medical gases such as oxygen & entonox).
Specific disciplines
There are several types of first aid (and first aider) which require specific additional training. These are usually undertaken to fulfill the demands of the work or activity undertaken.
Aquatic/Marine first aid - Usually practiced by professionals such as lifeguards or in diver rescue, and covers the specific problems which may be faced after water-based rescue.
Battlefield first aid - This takes in to account the specific needs of treating wounded combatants and non-combatants during armed conflict.
Hyperbaric first aid - Which may be practiced by SCUBA diving professionals, who need to treat conditions such as the bends.
Oxygen first aid - Providing oxygen to casualties who suffer from conditions resulting in hypoxia.
Wilderness first aid is the provision of first aid under conditions where the arrival of emergency responders or the evacuation of an injured person may be delayed due to constraints of terrain, weather, and available persons or equipment. It may be necessary to care for an injured person for several hours or days.
Symbols
For more details on this topic, see Emblems of the Red Cross#Use of the emblems.
Although commonly associated with first aid, the symbol of a red cross is an official protective symbol of the Red Cross. According to the Geneva Conventions and other international law, the use of this and similar symbols is reserved for official agencies of the International Red Cross and Red Crescent, and as a protective emblem for medical personnel and facilities in combat situations. Use by any other person or organization is illegal, and may lead to prosecution.
The internationally accepted symbol for first aid is the white cross on a green background shown at the start of the page.
Some organizations may make use the Star of Life, although this is usually reserved for use by Ambulance services, or symbols such as the Maltese Cross such as the Order of Malta Ambulance Corps and St John Ambulance, or other symbols.
Conditions that often require first aid
Altitude sickness, which can begin in susceptible people at altitudes as low as 5,000 feet, can cause potentially fatal swelling of the brain or lungs.
Anaphylaxis, a life-threatening condition in which the airway can become constricted and the patient may go into shock. The reaction can be caused by a systemic allergic reaction to allergens such as insect bites or peanuts. Anaphylaxis is initially treated with injection of epinephrine.
Battlefield First aid - This protocol refers to treating shrapnel, gunshot wounds, burns, bone fractures, etc. as seen either in the ‘traditional’ battlefield setting or in an area subject to damage by large scale weaponry, such as a bomb blast or other terrorist activity.
Bone fracture, a break in a bone initially treated by stabilizing the fracture with a splint.
Burns, which can result in damage to tissues and loss of body fluids through the burn site.
Choking, blockage of the airway which can quickly result in death due to lack of oxygen if the patient’s trachea is not cleared, for example by the Heimlich Maneuver.
Childbirth.
Cramps in muscles due to lactic acid build up caused either by inadequate oxygenation of muscle or lack of water or salt.
Joint dislocation.
Diving disorders resulting from too much pressure.
Near drowning or asphyxiation.
Gastrointestinal bleeding.
Gender-specific conditions, such as dysmenorrhea and testicular torsion.
Heart attack, or inadequate blood flow to the blood vessels supplying the heart muscle.
Heat stroke, also known as sunstroke or hyperthermia, which tends to occur during heavy exercise in high humidity, or with inadequate water, though it may occur spontaneously in some chronically ill persons. Sunstroke, especially when the victim has been unconscious, often causes major damage to body systems such as brain, kidney, liver, gastric tract. Unconsciousness for more than two hours usually leads to permanent disability. Emergency treatment involves rapid cooling of the patient.
Heat syncope, another stage in the same process as heat stroke, occurs under similar conditions as heat stroke and is not distinguished from the latter by some authorities.
Heavy bleeding, treated by applying pressure (manually and later with a pressure bandage) to the wound site and elevating the limb if possible.
Hyperglycemia, or diabetic coma.
Hypoglycemia, or insulin shock.
Hypothermia, or Exposure, occurs when a person’s core body temperature falls below 33.7°C (92.6°F). First aid for a mildly hypothermic patient includes rewarming, but rewarming a severely hypothermic person could result in a fatal arrhythmia, an irregular heart rhythm.
Insect and animal bites and stings.
Muscle strain.
Poisoning, which can occur by injection, inhalation, absorption, or ingestion.
Seizures, or a malfunction in the electrical activity in the brain. Three types of seizures include a grand mal (which usually features convulsions as well as temporary respiratory abnormalities, change in skin complexion, etc) and petit mal (which usually features twitching, rapid blinking, and/or fidgeting as well as altered consciousness and temporary respiratory abnormalities).
Sprain, a temporary dislocation of a joint that immediately reduces automatically but may result in ligament damage.
Stroke, a temporary loss of blood supply to the brain.
Sucking chest wound, a life threatening hole in the chest which can cause the chest cavity to fill with air and prevent the lung from filling, treated by covering with an occlusive dressing to let air out but not in.
Toothache, which can result in severe pain and loss of the tooth but is rarely life threatening, unless over time the infection spreads into the bone of the jaw and starts osteomyelitis.
Wounds and bleeding, including laceration, incision and abrasion, and avulsion.
While first aid can also be performed on animals, the term generally refers to care of human patients.
Contents
1 History
2 Aims
3 Key skills
3.1 Preserving life
3.2 Promoting recovery
4 Training
4.1 Australia
4.2 Canada
4.3 Ireland
4.4 United Kingdom
5 Specific disciplines
6 Symbols
7 Conditions that often require first aid
History
The earliest instances of recorded first aid were provided by religious knights, such as the Knights Hospitaller, formed in the 11th century, providing care to pilgrims and knights, and training other knights in how to treat common battlefield injuries.[1] The practice of first aid fell largely in to disuse during the Dark Ages, and organised societies were not seen again until in 1859 Henry Dunant organized local villagers to help victims of the Battle of Solferino, including the provision of first aid. Four years later, four nations met in Geneva and formed the organization which has grown into the Red Cross, with a key stated aim of "aid to sick and wounded soldiers in the field".[1] This was followed by the formation of St. John Ambulance in 1877, based on the principles of the Knights Hospitaller, to teach first aid, and numerous other organisation joined them, with the term first aid first coined in 1878 as civilian ambulance services spread as a combination of 'first treatment' and 'national aid'[1] in large railway centres and mining districts as well as with police forces. First aid training began to spread through the empire through organisations such as St John, often starting, as in the UK, with high risk activities such as ports and railways.[2]
Many developments in first aid and many other medical techniques have been driven by wars, such as in the case of the American Civil War, which prompted Clara Barton to organize the American Red Cross.[3] Today, there are several groups that promote first aid, such as the military and the Scouting movement. New techniques and equipment have helped make today’s first aid simple and effective.
Aims
The key aims of first aid can be summarised in three key points-[4]
Preserve life - the overriding aim of all medical care, including first aid, is to save lives
Prevent further harm - also sometimes called preventing the condition worsening, this covers both external factors, such as moving a patient away from a cause of harm, and applying first aid techniques to prevent worsening of the condition, such as applying pressure to stop a bleed becoming dangerous.
Promote recovery - first aid also involves trying to start the recovery process from the illness or injury, and in some cases might involve completing a treatment, such as in the case of applying a plaster to a small wound.
First aid training also involves the prevention of initial injury and responder safety, and the treatment phases.
Key skills
In case of tongue fallen backwards, blocking the airway, it is necessary to hyperextend the head and pull up the chin, so that the tongue lifts and clears the airway.Certain skills are considered essential to the provision of first aid and are taught ubiquitously. Particularly, the "ABC"s of first aid, which focus on critical life-saving intervention, must be rendered before treatment of less serious injuries. ABC stands for Airway, Breathing, and Circulation. The same mnemonic is used by all emergency health professionals. Attention must first be brought to the airway to ensure it is clear. Obstruction (choking) is a life-threatening emergency. Following evaluation of the airway, a first aid attendant would determine adequacy of breathing and provide rescue breathing if necessary. Assessment of circulation is now not usually carried out for patients who are not breathing, with first aiders now trained to go straight to chest compressions (and thus providing artificial circulation) but pulse checks may be done on less serious patients.
Some organizations add a fourth step of "D" for Deadly bleeding or Defibrillation, while others consider this as part of the Circulation step. Variations on techniques to evaluate and maintain the ABCs depend on the skill level of the first aider. Once the ABCs are secured, first aiders can begin additional treatments, as required. Some organizations teach the same order of priority using the "3 Bs": Breathing, Bleeding, and Bones. While the ABCs and 3Bs are taught to be performed sequentially, certain conditions may require the consideration of two steps simultaneously. This includes the provision of both artificial respiration and chest compressions to someone who is not breathing and has no pulse, and the consideration of cervical spine injuries when ensuring an open airway.
Preserving life
As the key skill to first aid is preserving life, the single most important training a first aider can receive is in the primary diagnosis and care of an unconscious or unresponsive patient. The most common mnemonic used to remember the procedure for this is ABC, which stands for Airway, Breathing and Circulation.
In order to preserve life, all persons require to have an open airway - a clear passage where air can move in through the mouth or nose through the pharynx and down in to the lungs, without obstruction. Conscious people will maintain their own airway automatically, but those who are unconscious (with a GCS of less than 8) may be unable to maintain a patent airway, as the part of the brain which autonomously controls in normal situations may not be functioning.
If the patient was breathing, a first aider would normally then place them in the recovery position, with the patient leant over on their side, which also has the effect of clearing the tongue from the pharynx. It also avoids a common cause of death in unconscious patients, which is choking on regurgitated stomach contents.
The airway can also become blocked through a foreign object becoming lodged in the pharynx or larynx, commonly called choking. The first aider will be taught to deal with this through a combination of ‘back slaps’ and ‘abdominal thrusts’.
Once the airway has been opened, the first aider would assess to see if the patient is breathing. If there is no breathing, or the patient is not breathing normally, such as agonal breathing, the first aider would undertake what is probably the most recognized first aid procedure - Cardiopulmonary resuscitation or CPR, which involves breathing for the patient, and manually massaging the heart to promote blood flow around the body.
Promoting recovery
The first aider is also likely to be trained in dealing with injuries such as cuts, grazes or broken bones. They may be able to deal with the situation in its entirety (a small adhesive bandage on a paper cut), or may be required to maintain the condition of something like a broken bone, until the next stage of definitive care (usually an ambulance) arrives.
Training
First aid scenario training in progressMuch of first aid is common sense. Basic principles, such as knowing to use an adhesive bandage or applying direct pressure on a bleed, are often acquired passively through life experiences. However, to provide effective, life-saving first aid interventions requires instruction and practical training. This is especially true where it relates to potentially fatal illnesses and injuries, such as those that require cardiopulmonary resuscitation (CPR); these procedures may be invasive, and carry a risk of further injury to the patient and the provider. As with any training, it is more useful if it occurs before an actual emergency, and in many countries, emergency ambulance dispatchers may give basic first aid instructions over the phone while the ambulance is on the way.
Training is generally provided by attending a course, typically leading to certification. Due to regular changes in procedures and protocols, based on updated clinical knowledge, and to maintain skill, attendance at regular refresher courses or re-certification is often necessary. First aid training is often available through community organizations such as the Red Cross and St. John Ambulance, or through commercial providers, who will train people for a fee. This commercial training is most common for training of employees to perform first aid in their workplace. Many community organizations also provide a commercial service, which complements their community programmes.
Australia
In Australia, Nationally recognized First Aid certificates may only be issued by Registered training organisations who are accredited on the National Training Information System (NTIS). Most First Aid certificates are issued at one of 3 levels:
Level 1 (or “Basic First Aid”, or “Basic Life Support”): is a 1-day course covering primarily life-threatening emergencies: CPR, bleeding, choking and other life-threatening medical emergencies.
Level 2 (“Senior First Aid”) is a 2 day course that covers all the aspects of training in Level 1, as well as specialized training for treatment of burns, bites, stings, electric shock and poisons. Level 2 reaccreditation is a 1 day course which must be taken every 3 years, but CPR reaccrediation may be required more frequently (typically yearly).
Level 3 (“Occupational First Aid”) is a 4-day course covering advanced first aid, use of oxygen and Automated external defibrillators and documentation. It is suitable for workplace First Aiders and those who manage First Aid facilities.
Other courses outside these levels are commonly taught, including CPR-only courses, Advanced Resuscitation, Remote Area or Wilderness First Aid, Administering Medications (such as salbutamol or the Epi-Pen) and specialized courses for parents, school teachers, community first responders or hazardous workplace first aiders. CPR Re-accredidation courses are sometimes required yearly, regardless of the length of the overall certification.
Canada
In Canada, first aid certificates are awarded by one of several organizations including the Red Cross, the Lifesaving Society, St. John Ambulance, the Heart and Stroke Foundation, and Ski Patrol. Workplace safety regulations vary depending on occupation. Many workplaces opt to have their employees trained in Standard First Aid (see below).
Emergency First Aid: is an 8-hour course covering primarily life-threatening emergencies: CPR, bleeding, choking and other life-threatening medical emergencies.
Standard First Aid: is a 16-hour course that covers the same material as Emergency First Aid and will include training for some, but not all, of the following: breaks; burns; poisons, bites and stings; eye injuries; head and neck injuries; chest injuries; wound care; emergency child birth; and multiple casualty management.
Medical First Responder (BTLS - known by different names among different Canadian organizations): is a 40 hour course. It requires Standard First Aid certification as a prerequisite. Candidates are trained in the use of oxygen, Automated external defibrillators, airway management, and the use of additional emergency equipment.
CPR certification in Canada is broken into several levels. Depending on the level, the lay person will learn CPR and choking procedures for adults, children, and infants.
CPR H.C.P. (Health Care Professional) also provides training on artificial respiration, the use of bag valve masks, and suction. This level of qualification is usually not offered to the general public.
Ireland
In Ireland, the workplace qualification is the Occupational First Aid Certificate. The Health and Safety Authority issue the standards for first aid at work and hold a register of qualified instructors, examiners and organisations that can provide the course. A FETAC Level 5 certificate is awarded after passing a three day course and is valid for two years from date of issue. Occupational First Aiders are more qualified than Cardiac First Responders (Cardiac First Response and training on the AED is now part of the OFA course) but less qualified than Emergency First Responders but strangely Occupational First Aid is the only one of the three not certified by PHECC. Organisations offering the certificate include, Ireland's largest first aid organisation, the Order of Malta Ambulance Corps, the St John Ambulance Brigade, and the Irish Red Cross. The Irish Red Cross also provides a Practical First Aid Course aimed at the general public dealing primarily with family members getting injured. Many other (purely commercially run) organisations offer training.
United Kingdom
In the United Kingdom, there are two main types of first aid courses offered. An “Emergency Aid for Appointed Persons” course typically lasts one day, and covers the basics, focusing on critical interventions for conditions such as cardiac arrest and severe bleeding, and is usually not formally assessed. A “First Aid at Work” course is usually a four-day course (two days for a re-qualification) that covers the full spectrum of first aid, and is formally assessed by recognized Health and Safety Executive assessors. Certificates for the “First Aid at Work” course are issued by the training organization and are valid for a period of three years from the date the delegate passes the course. Other courses offered by training organizations such as St. John Ambulance, St. Andrew’s Ambulance Association or the British Red Cross include Baby & Child Courses, manual handling, people moving, and courses geared towards more advanced life support, such as defibrillation and administration of medical gases such as oxygen & entonox).
Specific disciplines
There are several types of first aid (and first aider) which require specific additional training. These are usually undertaken to fulfill the demands of the work or activity undertaken.
Aquatic/Marine first aid - Usually practiced by professionals such as lifeguards or in diver rescue, and covers the specific problems which may be faced after water-based rescue.
Battlefield first aid - This takes in to account the specific needs of treating wounded combatants and non-combatants during armed conflict.
Hyperbaric first aid - Which may be practiced by SCUBA diving professionals, who need to treat conditions such as the bends.
Oxygen first aid - Providing oxygen to casualties who suffer from conditions resulting in hypoxia.
Wilderness first aid is the provision of first aid under conditions where the arrival of emergency responders or the evacuation of an injured person may be delayed due to constraints of terrain, weather, and available persons or equipment. It may be necessary to care for an injured person for several hours or days.
Symbols
For more details on this topic, see Emblems of the Red Cross#Use of the emblems.
Although commonly associated with first aid, the symbol of a red cross is an official protective symbol of the Red Cross. According to the Geneva Conventions and other international law, the use of this and similar symbols is reserved for official agencies of the International Red Cross and Red Crescent, and as a protective emblem for medical personnel and facilities in combat situations. Use by any other person or organization is illegal, and may lead to prosecution.
The internationally accepted symbol for first aid is the white cross on a green background shown at the start of the page.
Some organizations may make use the Star of Life, although this is usually reserved for use by Ambulance services, or symbols such as the Maltese Cross such as the Order of Malta Ambulance Corps and St John Ambulance, or other symbols.
Conditions that often require first aid
Altitude sickness, which can begin in susceptible people at altitudes as low as 5,000 feet, can cause potentially fatal swelling of the brain or lungs.
Anaphylaxis, a life-threatening condition in which the airway can become constricted and the patient may go into shock. The reaction can be caused by a systemic allergic reaction to allergens such as insect bites or peanuts. Anaphylaxis is initially treated with injection of epinephrine.
Battlefield First aid - This protocol refers to treating shrapnel, gunshot wounds, burns, bone fractures, etc. as seen either in the ‘traditional’ battlefield setting or in an area subject to damage by large scale weaponry, such as a bomb blast or other terrorist activity.
Bone fracture, a break in a bone initially treated by stabilizing the fracture with a splint.
Burns, which can result in damage to tissues and loss of body fluids through the burn site.
Choking, blockage of the airway which can quickly result in death due to lack of oxygen if the patient’s trachea is not cleared, for example by the Heimlich Maneuver.
Childbirth.
Cramps in muscles due to lactic acid build up caused either by inadequate oxygenation of muscle or lack of water or salt.
Joint dislocation.
Diving disorders resulting from too much pressure.
Near drowning or asphyxiation.
Gastrointestinal bleeding.
Gender-specific conditions, such as dysmenorrhea and testicular torsion.
Heart attack, or inadequate blood flow to the blood vessels supplying the heart muscle.
Heat stroke, also known as sunstroke or hyperthermia, which tends to occur during heavy exercise in high humidity, or with inadequate water, though it may occur spontaneously in some chronically ill persons. Sunstroke, especially when the victim has been unconscious, often causes major damage to body systems such as brain, kidney, liver, gastric tract. Unconsciousness for more than two hours usually leads to permanent disability. Emergency treatment involves rapid cooling of the patient.
Heat syncope, another stage in the same process as heat stroke, occurs under similar conditions as heat stroke and is not distinguished from the latter by some authorities.
Heavy bleeding, treated by applying pressure (manually and later with a pressure bandage) to the wound site and elevating the limb if possible.
Hyperglycemia, or diabetic coma.
Hypoglycemia, or insulin shock.
Hypothermia, or Exposure, occurs when a person’s core body temperature falls below 33.7°C (92.6°F). First aid for a mildly hypothermic patient includes rewarming, but rewarming a severely hypothermic person could result in a fatal arrhythmia, an irregular heart rhythm.
Insect and animal bites and stings.
Muscle strain.
Poisoning, which can occur by injection, inhalation, absorption, or ingestion.
Seizures, or a malfunction in the electrical activity in the brain. Three types of seizures include a grand mal (which usually features convulsions as well as temporary respiratory abnormalities, change in skin complexion, etc) and petit mal (which usually features twitching, rapid blinking, and/or fidgeting as well as altered consciousness and temporary respiratory abnormalities).
Sprain, a temporary dislocation of a joint that immediately reduces automatically but may result in ligament damage.
Stroke, a temporary loss of blood supply to the brain.
Sucking chest wound, a life threatening hole in the chest which can cause the chest cavity to fill with air and prevent the lung from filling, treated by covering with an occlusive dressing to let air out but not in.
Toothache, which can result in severe pain and loss of the tooth but is rarely life threatening, unless over time the infection spreads into the bone of the jaw and starts osteomyelitis.
Wounds and bleeding, including laceration, incision and abrasion, and avulsion.
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