Friday, May 25, 2007

Firs aid 3

Bleeding



Bleeding from wounds can usually be stopped by direct, firm pressure. Use a handkerchief or towel. Add pads as they become soaked. Don't remove soaked pads. When bleeding stops or eases, apply a pressure bandage and seek medical help as soon as possible.



Fits



Quickly clear the surroundings of any injurious objects. Call for help. Loosen any tight clothing around neck and waist. Most convulsions don't last long. When the jerking movements have stopped, lay the child on a soft bed or couch, cover with a warm blanket if cold, or sponge with cool water if hot. Watch breathing. If breathing stops, begin artificial respiration until help comes.



Drowning



Drowning can occur quickly and quietly in a very small amount of water. Call for help. Drain water from lungs by hanging the baby over your knee for about 10 seconds. Then start heart and lung resuscitation and continue until help comes or you get to the hospital.



Electrocution



Turn off the current. Call for help. Start heart and lung resuscitation at once and continue until help comes. Never attempt" to pull anyone away from a live current as you risk electrocution yourself.



Choking



Call for help. Hold the child's head down and give several firm slaps between the shoulder blades. Repeat in a few seconds if necessary. Remove any obstruction in the mouth but don't put your fingers down the child's throat — you may push the obstruction further down. If he doesn't cough up whatever is obstructing breathing, stand behind the child and place your arms around his middle, hands between his navel and ribs. Grip the fist or one hand with the other and-squeeze upwards firmly three or four times. Repeat if necessary. If this fails, hold him firmly by the feet and swing him round and round. If choking continues, take the child to a doctor or hospital as quickly as possible.



Head Injuries



Head injuries must always be taken seriously. Anyone who loses consciousness, even momentarily, after a blow on the head should be checked by a doctor. If the infant remains conscious, keeps a good colour and stops crying in reasonable time, he'll probably be all right. After any head injury, watch the child carefully for the next few days. If headache, drowsiness, vomiting, eye disturbances or lack of coordination develop, seek medical help without delay.



Fractures



The only first aid required is to minimise motion of the fractured parts to lessen the excruciating pain. Splinting the fractured part does this. A splint can be anything which is stiff. Usually the most common material used is a piece of broad wood. The splint should ideally by supporting the joints before and the joint after the fracture, in addition to the fractured site. For example, in a suspected fracture of the forearm, the splint should extend beyond the wrist (i.e. the joint before) and the elbow (i.e. the joint after the fractured part). Don't try to move them. Instead put the splint parallel to the fractured part and bandage together with clothes. For practical purposes, even three handkerchiefs, one each tied around the two ends and one in the middle will suffice. During transport to the hospital, take care that the fractured part is kept as motionless as possible and not jostled too much.



And finally as a matter of abundant caution, in any case of a trauma, while handling the patient, take great care that you don't extend or flex his neck and the spine, i.e. the backbone, should not undergo any motion (flexion, extension or rotation). In other words, the patient should be lifted by at least 4 persons in the same state that he was lying on the ground, particularly avoiding any motion of the neck or backbone relative to the rest of the body. Otherwise it can lead to an injury of the spinal cord and result in paralysis.



Poisons



Try to estimate how much poison the child has consumed. Take the remains of the poison with you to hospital. It is a good idea to keep syrup of Ipecac (available at your chemist) on hand. This can reduce vomiting. However some poisons make vomiting dangerous as they can burn the gullet and throat. Do not induce vomiting for poisoning which involves petroleum products (paraffin, petrol, liquid furniture and car polish, benzene, lighter fuel, turpentine and dry cleaning fluids), strong acids (nitric, sulphuric, hydrochloric), strong alkalis (bleach, ammonia, washing soda, caustic soda) and oil. based paint or insect sprays. Pesticides such as dog and flea rinses are particularly dangerous. In these cases give the child a drink of milk or water to help dilute the poison.



If the child has swallowed pills from a container and you are unsure how many or how dangerous they may be, induce vomiting. It only takes five quinine pills to kill a 2-year-old. If you cannot get through to the Poisons Information Centre or contact a doctor, take the child to a hospital making sure you take a sample of the poison with you, if possible.



Resuscitation Methods



Expired Air Resuscitation (EAR). Shake or shout at the patient to determine whether she is consious. If unconscious, roll her onto her side and clean out any foreign material from her mouth. Move patient onto back. Tilt head backwards.

Infants' head should not be tilted backwards. To keep the airway of an unconscious infant open, the forehead should be held and the point of the chin supported.

Look for movement from the chest and abdomen. Listen and feel for movement from the mouth and nose of the patient.



If there is no sign of breathing, take a breath and place your mouth completely over the patient's open mouth. Seal the nose with your cheek or fingers. For infants, place your mouth over the mouth and nose to seal it off.

Blow five gentle breaths watching the lower chest rise. With infants give little puffs, keeping the patient's jaw upwards and forwards. Vigorous blowing can damage an infant's lungs so take great care. Listen and feel for air leaving the mouth. Breathing should be about 20 per minute (one breath every 3 seconds).





When breathing restarts, roll the patient onto her side. Should breathing become irregular again recommence artificial respiration.

Cardiopulmonary Resuscitation (CPR) : Compression should be applied to the middle of the sternum of the patient when there is no pulse. The resuscitator should carefully feel around the bottom of the ribs to where they meet at the midline. One index finger should be placed on this point, the other hand should be positioned just touching the index finger.



Place the heel of the hand on the midline of the person's sternum, with the finger pointing across the chest and exerting no pressure on the chest.

The second hand should be placed over the first and held, either by the finger holding the other or the thumb holding the wrist. The compression should be vertical and there must be no pressure exerted on the chest except through the need of the lower hand. The upper end of the sternum should be found by feeling the groove between the collar bone.

One hand should be used to compress the centre of the sternum to a depth of about 2.5 cm. For infants, two fingers should be used to compress the centre of the sternum to about 1.5 cm or to a depth assessed for the individual patient by an experienced resuscitator.



For a single resuscitator, two breaths of EAR followed by one compression should be given within 10 seconds. A minimum of six cycles should be completed each minute. For two resuscitator CPR, the victim should receive 100 uninterrupted compressions each minute, counting with 20 breaths at intervals of 5 compressions.