CHOKING

By Nurse Diane

Two hillbillies walk into a restaurant. While having a bite to eat, they talk about their moonshine operation.

Suddenly, a woman at a nearby table, who is eating a sandwich, begins to cough. After a minute or so, it becomes apparent that she is in real distress.

One of the hillbillies looks at her and says, 'Kin ya swallar?'

The woman shakes her head no. Then he asks, 'Kin ya breathe?'

The woman begins to turn blue and shakes her head no.

The hillbilly walks over to the woman, lifts up her dress, yanks down her drawers and quickly gives her right butt cheek a lick with his tongue.

The woman is so shocked that she has a violent spasm and the obstruction flies out of her mouth. As she begins to breathe again, the Hillbilly walks slowly back to his table.

His partner says, 'Ya know, I'd heerd of that there 'Hind Lick Maneuver' but I ain't niver seed nobody do it!'

I was watching a movie recently, Groundhog Day, and there was a scene where Bill Murray goes to a restaurant and someone is choking, and he performs the Heimlich Maneuver, and out pops the food that was blocking the person's airway and the person quickly recovers.

Choking can happen at any time. Choking prevents breathing, and can be partial or complete, with partial choking allowing some, although inadequate, flow of air into the lungs. Prolonged or complete choking results in asphyxia, which leads to anoxia and is potentially fatal. Oxygen stored in the blood and lungs keep the victim alive for several minutes after breathing is stopped completely.  One of the most common causes of choking is a foreign object blocking the airway, such as food or small toys.

If you see a person start to choke, they will typically use the universal sign of choking, which are the hands across the throat.  If a person is coughing forcefully, there is no need to take any action.  Encourage coughing, or even slapping them on the back.  Sometimes when I drink water it will go "down the wrong way" and my mother will tell me to raise my arms.  This has never helped me, but it may help you.  Keep watching closely, and if they stop coughing, that is the time to go into action.  Ask if they are ok – then follow these steps:

From behind, wrap your arms around the victim's waist.

Make a fist and place the thumb side of your fist against the victim's upper abdomen, below the ribcage and above the navel.

Grasp your fist with your other hand and press into their upper abdomen with a quick upward thrust. Do not squeeze the ribcage; confine the force of the thrust to your hands.

Repeat until object is expelled.

If choking occurs with a small child or infant, there are other procedures to take to prevent causing injury to them.  With a baby you will want to place them on your lap so that their head is lower than their body, have them on their stomach, so that you will be able to slap their backs.  This is the proper technique, however, in most actual cases the rescuer will become excited, and hang the child upside down and shake.  Caution must be taken to prevent injury to the child.

If you find yourself alone and become choked, a person may also perform abdominal thrusts on themselves by using a fixed object such as a railing or the back of a chair to apply pressure where a rescuer's hands would normally do so. As with other forms of the procedure, it is possible that internal injuries may result.

Taking time to chew your food properly, or keeping small objects away from children is the key for prevention of choking.  Taking small bites and proper chewing will help what you swallow to go down efficiently.  Make sure to review the Heimlich Maneuver, and ask those around you if they know the procedure. 

It’s never too later to learn, and you could save a life.

[Photos from Google) 

Pet’s First Aid

By Terry Orr

Keep your family pet safe and healthy.

So how many of our wonderful readers have ever heard of Pet First Aid Awareness Month? It is news to me – as a pet owner for decades – wonder how I missed the boat?  One of my wife’s friends is over; she’s a Professional Dog Walker. One requirement of a professional dog walker is to be Pet First Aid certified. Learn something new every day!

The American Red Cross provides a wealth of good information regarding Pet First Aid and I highly recommend visiting and learning what they are providing. After all, most pets are like having children in our homes – please take the time to learn how to help then in need.  Thank you!

References and Links:

http://www.redcross.org/news/article/April-Is-Pet-First-Aid-Awareness-Month

(All images from Google) 

Dog Bites

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By Nurse Diane

This past weekend I had to babysit my 4-legged grandkids.  My son and his wife came for a visit, and they have 3 dogs.  Two of them stayed with me, while the third went to stay with my parents.  They are very good dogs, but two of them are rescue dogs, and had been abused.  This concerns me, because you never know what they have lived through, and when they may snap at you for no reason.  I have always been a little leery of large dogs, having been bitten when I was younger.  I try to keep my distance, especially if I do not know the animal.

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Dog bites are very common, and are one of the many things that are brought to court on Judge Judy.  The primary message that Judge Judy discusses is to always keep a leash on your dog, and keep them under you control.  This is why the leash laws were established, to prevent injury and any other property damage.

Some tips to follow when bitten by a dog include:

Stay Safe. Secure the dog or the victim. Move one away from the other. If the dog's owner is around, instruct him or her to secure the dog. If not, move the victim to a safe location. Dogs may bite because their territory is threatened. Don't start any treatment until there is a reasonable expectation that the dog won't attack again.

If you are not the victim, practice universal precautions and wear personal protective equipment if available.

Control any bleeding by following the appropriate steps. Avoid using a tourniquet unless there is severe bleeding that cannot be controlled any other way.

Once the bleeding is controlled, clean the wound with soap and warm water. Do not be afraid to clean inside the wound. Be sure to rinse all the soap away, or it will cause irritation later.

Cover the wound with a clean, dry dressing. You can put antibiotic ointment on the wound before covering. Watch for signs of infection:

• Redness
• Swelling
• Heat
• Weeping pus

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Always call a physician to determine if you should be seen. Some dog bites need antibiotics, particularly if they are deep puncture wounds. Additionally, many municipalities have regulations for reporting dog bites and monitoring the dogs, and that is often initiated by contact with a doctor.

Any unidentified dog runs the risk of carrying rabies. If the dog cannot be identified and the owner cannot show proof of rabies vaccination, the victim must seek medical attention. Rabies is always fatal to humans if not treated.

The wound may need stitches. If the edges of a laceration are unable to touch, or if there are any avulsions, the wound will need emergency medical attention. Wounds on the face or hands should be seen by a physician because of the likelihood of scarring and loss of function.

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FIRST AID FOR CHILDREN

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By Diane Forrest, RN

When I think back over the past 25 years, I am amazed that my son made it through with only a few bumps and bruises along the way.  The first major incident he had was on his first birthday.  I had baked him a cake in the shape of a clown, I used strawberry cake, because it was more "skin toned” After I cut him a piece, and allowed him to play in it I took him to the bathroom to clean him up.  The trouble was, the "cake" wasn't coming off. I kept washing his face, but the more I washed, the redder it became.  I finally realized, that it wasn't cake on his face that made him so red, he had broken out in hives from an allergy to the strawberries.  Hives are simple to treat, just a little calamine lotion dabbed on the spots and in a few days they have disappeared.  But that experience taught me to be more diligent in the care of my baby.

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From the time they come home from the hospital children depend on you for their care and survival.  It is the responsibility of the parents and other adults to protect the child from illness or accidents.  From the time they come home from the hospital when they are buckled up in a car seat, until they begin to crawl and walk, and when they begin to drive.  Children are quick; they can get into trouble in the blink of an eye.  When my son was 2 years old, he pulled off his shoes, ran out the door and stood right in the center of a fire ant bed.  His feet were covered with bites, and he had to be carried around for a week.

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The first step in first aid for your child is prevention.  You need to child proof your home and area where the child spends his or her time.  There are several products available to keep children safe from danger.  You can install simple devices that will keep doors and cabinets locked, and outlet plugs blocked. There are barriers to prevent children from falling down stairs, and from entering rooms they don't need to be in.

Once kids become mobile you need to have a first aid kit on hand.  Items necessary for a kit include:

• First-aid manual
• Sterile gauze pads of different sizes
• Adhesive tape
• Adhesive bandages in several sizes
• Elastic bandage
• A splint
• Antiseptic wipes
• Soap
• Antibiotic ointment
• Antiseptic solution (like hydrogen peroxide)
• Hydro-cortisone cream (1%)
• Acetaminophen and ibuprofen
• Extra prescription medications (if the family is going on vacation)
• Tweezers
• Sharp scissors
• Safety pins
• Disposable instant cold packs
• Calamine lotion
• Alcohol wipes or ethyl alcohol
• Thermometer
• Tooth preservation kit
• Plastic non-latex gloves (at least 2 pairs)
• Flashlight and extra batteries
• A blanket
• Mouthpiece for administering CPR (can be obtained from your local Red Cross) your list of emergency phone numbers
• Blanket (stored nearby)  

Make sure you are familiar with the manual and measures to take for a simple injury.  For more serious injuries, you may want to take a first aid course at your local Red Cross office.  This is particularly beneficial if your family has a pool or access to one or any body of water.   Learn to perform CPR and how to perform the Heimlich maneuver in case of choking. A few hours in the class will provide you with a life time of life saving techniques that will benefit not only your family but others as well.

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Kids are fast, they will eventually have cuts and scrapes, bumps and bruises.  Most can be fixed with a hug or a band aid.  For the more serious accidents, learn the proper techniques and be sure to have some telephone numbers to the poison hotline, hospital, and pediatrician close at hand.

For more specific actions to take, visit this site for information that will keep your family safe. http://kidshealth.org/parent/index.jsp?tracking=P_Home

Heat-Related Emergencies

These past several weeks we have been informing you about different subjects relating to the heat and summer.   Emergencies such as dehydration, heat exhaustion, heat strokes, sunburn and other summer related issues.  As I am writing this now the temperature is in the triple digits, and there is no end in sight. 

The heat affects everyone, but is more dangerous to the elderly and infants, and those with certain medical conditions.

People suffer heat-related illness when their bodies are unable to compensate and properly cool themselves. The body normally cools itself by sweating. But under some conditions, sweating just isn't enough. In such cases, a person's body temperature rises rapidly. Very high body temperatures may damage the brain or other vital organs.

Heat-related deaths and illness are preventable yet annually many people succumb to extreme heat.  I was just reading today where a 61 year old man from Jackson, MS passed away from heat exhaustion while working in his garden.

Because heat-related deaths are preventable, people need to be aware of who is at greatest risk and what actions can be taken to prevent a heat-related illness or death. The elderly, the very young, and people with mental illness and chronic diseases are at highest risk. However, even young and healthy individuals can succumb to heat if they participate in strenuous physical activities during hot weather. Air-conditioning is the number one protective factor against heat-related illness and death. If a home is not air-conditioned, people can reduce their risk for heat-related illness by spending time in public facilities that are air-conditioned.

To protect your health when temperatures are extremely high, remember to keep cool and use common sense.  Some things you can do include:

• Drink Plenty of Fluids;
• Replace salt and minerals, check with your doctor before ingesting any additional salt though;
• Wear appropriate clothing and sunscreen;
• Schedule outdoor activities carefully, try to limit yourself in morning and evening activities;
• Pace yourself, take frequent rest periods;
• Stay cool indoors, use air conditioning, fans and limit the use of stoves and ovens to keep the temperature down;
• Use the buddy system; keep in contact with those you know who are sick or elderly to make sure they are keeping cool;
• Never leave children or pets in a parked car; and
• Use Common sense.

Even short periods of high temperatures can cause serious health problems. During hot weather health emergencies, keep informed by listening to local weather and news channels or contact local health departments for health and safety updates. Doing too much on a hot day, spending too much time in the sun or staying too long in an overheated place can cause heat-related illnesses. Know the symptoms of heat disorders and overexposure to the sun, and be ready to give first aid treatment.

First Aid Overview and Quiz

The definition of first aid is "the immediate care of the injured or ill". This could be a stranger, a family member or even yourself. To administer first aide one must know what to do and also just as important one must know what not to do. The whole object of first aide is to aid the injured or ill without ever doing harm.

The first and most important thing in first aide is to always prevent harm to yourself. Do not jump into a automobile without first making sure that there is no danger of fire or of the auto moving and causing you or another rescuer injury.

Remember these "ABCs" of first aid

A) Be sure that the person has an open Airway.

B) Secondly be sure that the person is Breathing. An open airway does not mean that the person is breathing. Everyone from young children to elderly adults should be trained in CPR. This training is given free of charge. Check with your local fire department for a location near you.

C) Check for proper Circulation. Check for signs of bleeding. Check for open wounds and for blood soaked clothes. Most bleeding can be temporarily controlled by applying direct pressure to the area. Once you have applied pressure to the area using a clean cloth or gauze pads or whatever you have at hand, do not remove the cloth or gauze from the wound. If it becomes blood soaked apply another pad over the soaked one and continue to apply pressure. In this day and age I would also advise any first aide person to wear gloves. There are a number of infections that can be transported via body fluids. These include AIDS as well as Hepatitis. Your welfare is to be considered before your patient's.

If you are coming to the aid of a victim of a fall or trauma type accident where the person has a deformity due to a broken bone(s), do not move the appendage that is involved. If you must splint the appendage, do so in the position found. Check for a pulse distal to the injury before splinting and check for a pulse after splinting. Distal is further from the heart than the fracture.

If the fracture is open and bleeding or bone is visible do not apply direct pressure. Cover the area with a clean dressing. Call 911 at once.

Anytime that a person is injured from a fall or a trauma, remember to keep the person still and hold the head in place. Do not allow the head to rotate. This one simple step may save the person’s life. Crouch or lay at the top of the patient and place your hands on both sides of the head. Hold firmly but gently. If the person is awake, talk to him (her) in a soft, even voice. Assure the patient that you are there to help until an ambulance arrives. Assure the patient that you will not leave him (her) alone. Comfort the patient with your voice. Have someone call 911 or yell for assistance. Do not release the head until trained help arrives.

Medical emergencies are not in the realm of most first aid rescuers. If you come on to a person that is unconscious or their level of consciousness is low, call 911. Assure that the person has an open airway and is breathing. Check for bleeding (circulation). What may have started out as a medical problem may turn into a trauma situation due to a fall or other accident brought on by a low level of consciousness. Look at the whole picture, not just what is obvious at first glance.

This is a very simple overview of only two types of situations that call for first aid intervention. Many courses can be taken through the Red Cross as well as other agencies. Learn what you can before the incident happens. The life you save maybe your loved one or even yourself. Don't wait. Learn first aid and CPR today.

First Aid Quiz

http://firstaid.about.com/library/quiz/bl_firstaidQuiz1.htm

Emergency Medical Services (EMS) 2011

This week we are honoring the Emergency Medical Services (EMS).   Who are they? What do they do? EMS are a type of emergency service dedicated to providing out-of-hospital acute medical care and/or transport to definitive care, to patients with illnesses and injuries which the patient, or the medical practitioner, believes constitutes a medical emergency.  The term emergency medical service evolved to reflect a change from a simple system of ambulances providing only transportation, to a system in which actual medical care is given on scene and during transport. In some jurisdictions, EMS units may handle technical rescue operations such as extrication, water rescue, and search and rescue.

History

Documentation of the first EMS is found in the Bible with the story of the Good Samaritan.   Luke 10:34 (NIV) - "He went to him and bandaged his wounds, pouring on oil and wine. Then he put the man on his own donkey, took him to an inn and took care of him."  The first known hospital-based ambulance service operated out of Commercial Hospital, Cincinnati, Ohio (now the Cincinnati General) by 1865.  This was soon followed by other services, notably the New York service provided out of Bellevue Hospital which started in 1869 with ambulances carrying medical equipment, such as splints, a stomach pump, morphine, and brandy, reflecting contemporary medicine.

Purpose

Emergency medical services exists to fulfill the basic principles of first aid, which are to Preserve Life, Prevent Further Injury, and Promote Recovery.

This common theme in medicine is demonstrated by the "star of life". The Star of Life , where each of the 'arms' to the star represent one of the 6 points. These 6 points are used to represent the six stages of high quality pre-hospital care, which are:

• Early detection - Members of the public, or another agency, find the incident and understand the problem
• Early response- The first professional (EMS) rescuers arrive on scene as quickly as possible, enabling care to begin
• Early reporting- The first persons on scene make a call to the emergency medical services and provide details to enable a response to be mounted
• Good on-scene care - The emergency medical service provides appropriate and timely interventions to treat the patient at the scene of the incident
• Care in transit- the emergency medical service load the patient in to suitable transport and continue to provide appropriate medical care throughout the journey
• Transfer to definitive care - the patient is handed over to an appropriate care setting, such as the emergency department at a hospital, in to the care of physicians

Members:

• First Responder
• Ambulance Driver
• Ambulance Care Assistant
• Emergency Medical Technician (EMT)
• Emergency Medical Dispatcher
• Paramedic
• Critical Care Paramedic
• Nurse
• Doctor

EMS does more than just provide a taxi service to and from the hospital.  They are usually the first responder to an accident or any emergency situation.  They assess the situation, provide initial care to stabilize the injured or ill person and perform life saving techniques while transporting to a medical facility.  I had several occasions in which I relied on the EMS here to transport my husband to the hospital.  This was not an easy task.  He weighed around 220 pounds, dead weight. It took 2 EMTs and me to transfer him to a stretcher, then they had to maneuver their way out of the house, which was also complicated considering the turns they had to make.  Once they got him into the ambulance they would initiate oxygen and start an I.V. for fluids before racing him to the hospital.  Not only did I call them during emergency situations, but also on special occasions when he wanted to get out of the bed for holiday celebrations.  They would help me transfer him to his wheelchair, then return to put him back in the bed.  Not only did they not charge for this service, but they did it willingly and cheerfully.

Being a part of the EMS team is not an easy job.   They work 12 to 24 hour shifts, all kinds of weather, and any time of the day or night.  The conditions in which they find their victims is not always the best.  And on top of that they are in charge of doing all they can to save lives while also dealing with confused, upset or irrational people.  They all deserve our respect and gratitude for the hard work they do.  So as we honor them this week, reach out to them, give a pat on the back, and let them know how vital they are to your community and how much they are appreciated.