First Aid

Even if it will hopefully be the less of the cases, accidents happen -abroad and at home-. Because we believe that being prepared is the best of the ways of getting over it as fast and successfully as possible, in this section we try to cover two areas of the subject health that we consider are really crucial in case of having a problem. First, everything concerning first aid to help you to treat the problem as soon as it appears. Second, the different health systems of countries to know which hospitals you can go to or what kind of health card you can use.

First Aid Kit

What should be a content of Your first Aid Kit

1. First-aid book.
2. Triangular Bandages X 3 to 5.
3. Conforming Bandages, 10cm and 15cm X 2 each.
4. Crepe Bandage 7.5cm X 2.
5. Tape 2.5cm X 1 Roll.
6. Tape 2.5cm X 1 Roll.
7. Absorbent Gauze (Small Roll).
8. Band-aids (Plasters) X 1 Box
9. Sterile Dressings (Selection)..
10. Cotton Wool (50gr.).
11. Antihistamine, (for Bee Stings.
12. Antiseptic Solution 50ml.
13. Antiseptic Wipes X 4.
14. Scissors.
15. Safety Pins X 12.
16. Tongue Depressor X 4.
17. Latex Gloves, Pair X 2.
18. Clinical Thermometer.
19. Pen Torch.

Band aids or sticky plasters are great for dressing small wounds. They come in all shapes and sizes for fingers, legs and anywhere else you might get little nicks and cuts. Some come with cartoons and fancy colors on them for kids. Make sure the Band aid is big enough to cover the wound, if not you should use a dressing instead. Be sure the sterile seal on the Band aid is intact before you use it.

Sterile dressings are cloth pads that are placed directly on a wound to protect and control bleeding They too come in all shapes and sizes and should be used when a wound is too large for a band aid. In an emergency a clean tea cloth, hand towel, clean tee-shirt can be used to cover the wound.

Bandages used to cover and secure wound dressings to the body (e.g. conforming or roller bandages). Triangular bandages are used as above if you have no roller bandages. They are also used to immobilize an injured limb (e.g. arm sling). Crepe bandages which are normally used to provide compression for injuries such as a sprained ankle, wrist etc.

Latex gloves are always a good idea, especially if you are dealing with body fluids from a stranger. You will notice all EMS personnel wear gloves. The possibility of disease transmission from the victim's blood should be in the forefront of your mind. (If I have cuts on my hand, I wear two pairs of gloves). Last but not lest, remember to wash your hands before and after treatment.

Antihistamine cream is used for bee stings and bug bites. Follow the manufactures instructions. If the victim is allergic to bee venom they may develop anaphylactic shock. If this happens they need to be seen by a Doctor. Now!

Asthma

Asthma is a condition in which the muscles of the air passages go into spasm, making breathing difficult and resulting in a wheeze. Attacks may be triggered off by an allergy to dust, pollen, many other common substances, by over exercise or by nervous tension. Regular asthma sufferers usually carry their own medication in case of attack.

Treatment

1. Reassure and calm the casualty.
2. Advise the casualty to sit down, lean slightly forward, resting on elbows on a support such as a table.
3. Ensure a good supply of fresh air.
4. Allow the casualty to take their own medication as prescribed by a doctor.
5. If the symptoms persist, seek medical aid, i.e.. Call an Ambulance.

Bites & Scratches

Animal bites and scratches, even minor ones, can become infected and spread bacteria to other parts of the body. Whether the animal is a family pet or a creature from the "wild," scratches and bites can carry disease. For example, cat scratch disease, a bacterial infection, can be transmitted by a cat scratch (usually from a kitten) even if the site of the scratch doesn't look infected. In addition, certain animals can transmit rabies and tetanus. Human bites that break the skin are even more likely to become infected.

Treatment

1. If the bite or scratch wound is bleeding, apply pressure to the area with a clean bandage or towel until the bleeding stops. If available, use clean latex or rubber gloves to protect yourself from exposure to blood.
2. Clean the wound with soap and water, and hold it under running water for at least 5 minutes. Do not apply an antiseptic or anything else to the wound.
3. Dry the wound and cover it with sterile gauze or a clean cloth.
4. Phone your child's doctor. Your child may need antibiotics, a tetanus booster, or a rabies vaccination. A bite or scratch on a child's hand or face is particularly prone to infection and should be evaluated by your doctor.
5. If possible, locate the animal that inflicted the wound. Some animals may have to be captured, confined, and observed for rabies. Do not try to capture the animal yourself. Look in your phone book for the number of an animal control office or animal warden in your area.
6. Go to the nearest hospital emergency department if:
   1. the wound won't stop bleeding after 10 minutes of direct pressure.
   2. the wound is more than 1/2 inch long or appears to be deep.
   3. the attacking animal was wild (not tame) or behaving strangely.
   4. a body part is severed. Wrap the severed part in sterile gauze or a clean cloth and take it with you to the emergency department.

Bleeding

Most small cuts do not present any danger. Larger wounds, particularly those where an artery has been damaged, can cause severe bleeding and result in falling blood pressure and shock. Depending on the type of wound and its location, there can be damage to tendons and nerves. Bleeding from large cuts may require immediate medical treatment.

Treatment

For Minor Bleeding From a Small Cut or Abrasion

1. Rinse the wound thoroughly with water to clean out dirt and debris.
2. Wash the wound with a mild soap and rinse thoroughly. Avoid antiseptic solutions, which don't provide any additional protection.
3. Cover the wound with a sterile adhesive bandage or sterile gauze and adhesive tape.
4. Examine the wound daily. If the bandage gets wet, remove it and apply a new one. After the wound forms a scab, a bandage is no longer necessary.
5. Call your doctor if the wound is red, swollen, tender, warm, or beginning to drain.

For Bleeding From a Large Cut or Laceration

1. Wash the wound thoroughly with water. This will allow you to see the wound clearly and assess its size.
2. Place a piece of sterile gauze or a clean cloth over the entire wound. If available, use clean latex or rubber gloves to protect yourself from exposure to blood. If you can, raise the bleeding body part above the level of your child's heart. Do not apply a tourniquet.
3. Using the palm of your hand on the gauze or cloth, apply direct pressure to the wound for 5 minutes. (During the 5 minutes, do not stop to check the wound or disturb any blood clots that may form on the gauze.)
4. If blood soaks through the gauze, do not remove it. Apply another gauze pad on top and continue applying pressure.
5. Call your doctor for all large cuts or lacerations, or if:
   1. you are unable to stop the bleeding after 5 minutes of pressure, or if the wound begins bleeding again. (Continue applying pressure.)
   2. you are unable to clean out dirt and debris thoroughly.
   3. the wound is near a face or a neck.
   4. there is something stuck in the wound.
   5. the cut is more than 1/2 inch long or appears to be deep. Large or deep wounds can result in nerve damage. If you have any doubt about whether stitches are needed, phone your doctor.

Broken bone

A broken (fractured) bone requires emergency care. Suspect a possible broken bone if you heard or felt a bone snap, if you have difficulty moving the injured part, or if the injured part moves in an unnatural way or is very painful to the touch.

A sprain occurs when the ligaments, which hold bones together, are overstretched and partially torn. Simply overstretching any part of the musculature is called a strain. Sprains and strains generally cause swelling and pain, and there may be bruises around the injured area. Most sprains, after proper medical evaluation, can be treated at home.

Treatment

For a Suspected Broken Bone

1. If the injury involves your neck or back, do not move unless you are in imminent danger. Movement can cause serious nerve damage. Phone for emergency medical help. If you must move, the neck and back must be completely immobilized first.
2. If you have an open break (bone protrudes through the skin) and there is severe bleeding, apply pressure on the bleeding area with a gauze pad or a clean piece of clothing or other material. Do not wash the wound or try to push back any part of the bone that may be sticking out.
3. If you must be moved, apply splints around the injured limb to prevent further injury. Leave the limb in the position you find it. The splints should be applied in that position. Splints can be made by using boards, brooms, a stack of newspapers, cardboard, or anything firm, and can be padded with pillows, shirts, towels, or anything soft. Splints must be long enough to extend beyond the joints above and below the fracture.
4. Place cold packs or a bag of ice wrapped in cloth on the injured area.
5. Keep lying down until medical help arrives.

For a Suspected Sprain or Strain

1. If the injury involves your neck or back, do not move unless you are in imminent danger. Movement can cause serious nerve damage. Phone for emergency medical help. If you must move, the neck and back must be completely immobilized first.
2. It may be difficult to tell the difference between a sprain and a break. If there is any doubt whatsoever, phone your doctor or go to the nearest hospital emergency department. An X-ray can determine whether a bone is broken.
3. First aid for sprains and strains includes rest, ice, compression, and elevation (known as RICE).
   1. Rest the injured part of the body.
   2. Apply ice packs or cold compresses for up to 10 or 15 minutes at a time every few hours for the first 2 days to prevent swelling.
   3. Wearing an elastic compression bandage (such as an ACE bandage) for at least 2 days will reduce swelling.
   4. Keep the injured part elevated above the level of the heart as much as possible to reduce swelling.
4. Do not apply heat in any form for at least 24 hours. Heat increases swelling and pain.
5. Your doctor may recommend an over-the-counter pain relievers.

Burns and Scalds

Burns are injuries to body tissues caused by heat, chemicals or radiation. Scalds are caused by wet heat, such as steam or hot liquids. Burns are classified according to the area and depth of injury. Superficial burns involve only the outer layers of the skin, cause redness, swelling, tenderness and usually heal well. Intermediate burns form blisters, can become infected, and need medical aid. Deep burns involve all layers of the skin, which may be pale and charred, may be pain free if nerves are damaged, and will always require medical attention. To limit tissue damage, the burned area should be cooled down immediately by flooding the area with slow running water for at least 10 to 20 minutes. If no water is available, clothing should be remove immediately from the injured area, (only if it is not stuck to the skin) clothing soaked with hot liquids retains heat (avoid pulling clothing over the face).

Treatment

Severe Burns and Scalds

1. Cool the burn area with water for 10 to 20 minutes. Or use Burn Gel.
2. Lay the casualty down and make him as comfortable as possible, protecting burn area from ground contact.
3. Gently remove any rings, watches, belts or constricting clothing from the injured area before it begins to swell.
4. Cover the injured area loosely with sterile unmediated dressing or similar non fluffy material and bandage.
5. Don't remove anything that is sticking to the burn.
6. Don't apply lotions, ointments, butter or fat to the injury.
7. Don't break blisters or otherwise interfere with the injured area.
8. Don't over-cool the patient and cause shivering.
9. If breathing and heartbeat stop, begin resuscitation immediately,
10. If casualty is unconscious but breathing normally, place in the recovery position.
11. Treat for shock.
12. Send for medical attention.

Minor Burns and Scalds

1. Place the injured part under slowly running water, or soak in cold water for 10 minutes or as long as pain persists.
2. Gently remove any rings, watches, belts, and shoes from the injured area before it starts to swell.
3. Dress with clean, sterile, non fluffy material.
4. Don't use adhesive dressings.
5. Don't apply lotions, ointments or fat to burn/ scald.
6. Don't break blisters or otherwise interfere.
7. If in doubt, seek medical aid.

Chemical Burns

1. Flood the area with slowly running water for at least ten minutes.
2. Gently remove contaminated clothing while flooding injured area, taking care not to contaminate yourself.
3. Continue treatment for SEVERE BURNS
4. Remove to hospital.

Sunburn

1. Remove the casualty to the shade and cool the skin by sponging gently with cold water.
2. Give sips of cold water at frequent intervals.
3. If the burns are mild, gently apply an after sun cream.
4. For extensive blistering, seek medical help.

Chocking

Choking occurs when the airway is partially or totally blocked by a swallowed object, i.e. when something goes down the windpipe rather than the food passage.The aim of treatment is to clear the blocked passage.

Treatment

Conscious Adult

1. Ask, "Are you choking?" If the victim can speak, cough or breathe, DO NOT INTERFERE - he is not choking.
2. If the victim cannot speak, cough or breathe, give upward abdominal thrusts.

To do this, stand behind victim and wrap your arms round the waist. Grasp one fist with your other hand and place thumb side of your fist in the mid-line between waist and rib cage. Press fist into abdomen with 4 quick upward and inward thrusts.

1. Do not use abdominal thrust when dealing with a pregnant woman or over-weight victim. In these cases use chest thrusts - press on breastbone as in CPR.
2. Stand behind victim and place your arms under her armpits to encircle body.
3. Grasp one fist with the other hand, and place thumb side on the middle of the breastbone.Press with quick backward thrusts.
4. Repeat above sequence.Be persistent.
5. Send for medical aid, call an Ambulance and continue treatment until help arrives.

Self Help The above technique can be used successfully. If a person is choking and alone, lean over a chair or railing as you act to help release obstruction.

Unconscious Adult

1. Establish unconsciousness.
2. "Call for Help". Get them to get an Ambulance, Now !
3. Dial your local emergency telephone number.
4. Open Airway and begin A of resuscitation procedure.
5. If unsuccessful deliver five abdominal thrusts.
6. Use finger probe in mouth to remove the dislodged foreign body.
7. If unsuccessful repeat these sequences. Be persistent.
8. Continue treatment until help arrives.

Child (as for adults)

If a child ('1-8 years) is choking, proceed as for adult, depending on whether victim is conscious or unconscious.

Infant (up to 1 year)

If an infant is choking, turn infant face downwards supporting the body along your arm with hand supporting head and neck.

1. Ensure airway is open.
2. Deliver five back blows between the shoulders, then turn over and give five chest thrusts.
3. Remove object if visible.
4. Do not perform blind finger sweeps in infants and children. When obstruction is removed and infant is still not breathing and has no pulse start CPR.
5. Call help fast see section on Resuscitation for Children.

Diabetes

People suffering from diabetes need to control their blood sugar levels by balancing the amount of sugar in their diet with insulin injections. As a result, many carry hypodermic needles, insulin bottles, medication, card or identity bracelet with them, indicating that they have diabetes. If a person with diabetes on treatment has missed a meal or taken too much exercise, the concentration of sugar in the blood falls, and unconsciousness can follow. The aim of first aid in this situation is to restore the sugar/insulin balance as soon as possible.

Treatment

1. If the casualty is conscious and capable of swallowing, immediately give sugar lumps, a sugary drink, chocolate or other sweet food in order to raise the level of sugar in the blood.
2. If the casualty is unconscious but breathing normally, place in the recovery position, and carry out general treatment for unconsciousness.

Electrocution

The passage of electrical current through the body can cause cardiac arrest, burning, and shock. Many injuries result from faulty switches, frayed cables or defects in electrical appliances.

Whatever the cause of an electrical accident, never touch the casualty with bare hands unless you are sure there is no danger to yourself.

Treatment

1. Switch off the electrical supply if possible or remove fuse.
2. Remove the casualty from contact with electrical source, using non-conductive articles such as a dry brush handle, dry rope or piece of clothing.
3. Call for help.
4. If breathing and heartbeat have stopped, begin the A-B-C of resuscitation immediately.
5. If the casualty is breathing, but unconscious, place him in the recovery position.
6. Treat any burns.
7. Treat for shock.

Epilepsy

An epileptic seizure is caused by a disruption in the normal activity of the brain. Some people with epilepsy carry an identification card, or wear a warning bracelet. Very little first aid treatment is required, the main aims being to keep the person safe during a seizure and to provide after-care.

Treatment

Minor Attack

In a minor attack, the person may appear to be in a daydream, stare blankly or behave strangely.

1. Take care of him by protecting him from dangers such as busy roads.
2. Remain with him until you are certain he has recovered.

Major Seizure

In a major epilepsy seizure, the person usually falls to the ground, loses consciousness, followed by jerking. The seizure can last up to five minutes.

1. If the person is falling, try to support or ease the fall and lay down gently.
2. Clear a space around him. If possible, loosen clothing around the neck and place something soft under the head.
3. When convulsions cease, place him in the recovery position.
4. DO NOT move or lift unless in danger.
5. DO NOT forcibly restrain.
6. DO NOT put anything in his mouth or try to open
7. DO NOT try to wake him.
8. Seek medical aid.

Eye Injuries

Generally speaking, first aid for all eye injuries (other than the removal of small foreign bodies) should be followed up by expert examination of the eyes. The surface of the eye is very delicate, easily damaged.

Foreign body in the eye

Small items such as dust and grit can be washed from the eye with gently running water. The eye should then be bathed with Hyperacid and Calendula solution. Larger objects can be dabbed off the eyeball with a clean handkerchief dipped in the same solution; you may have to lift the upper lid to encourage the natural rear fluid to wash the object to the front of the eyeball. If pain persists for more than 12 hours after removal of a foreign body, see a doctor as soon as possible.

Penetration of the eye

If the eye is penetrated by glass or splinters, do not try to remove them. Dial the emergency number, and put a pad of gauze over both eyes to discourage eye movements (if the uninjured eye moves, the injured eye moves with it).

Chemicals in the eye

Chemical accidents involving the eyes call for very swift action indeed. As well as causing excruciating pain, they can lead to permanent blindness.

Turn the head so that the affected eye is lower than the other - this prevents the offending chemical from trickling into the uninjured eye. Hold the person's face and eye under a gently running tap for 10-15 minutes, separating the eyelids with your fingers. Then cover the eye with sterile gauze and a bandage. Take the person to the nearest Accident and Emergency department to have the eye checked.

Snow blindness

This is the result of over-long exposure to snow glare without the benefit of sunglasses or ski goggles. The eyes become puffy, painful, and water profusely.

Head Injuries

These injuries are caused by falls, road accidents, sporting accidents, or working in high risk occupations. They can result in skull fractures, scalp wounds, concussion, brain injury/brain damage, and should always receive urgent medical attention.

Treatment

Skull Fracture

It may be seen or indicated, in some cases by blood or fluid from the ear, or loss of consciousness, or by a wound or sometimes there may be no signs.

1. If breathing and heartbeat stop, begin the A-B-C of resuscitation immediately.
2. If any discharge issues from the ear, incline towards the injured side and cover with a sterile dressing - DO NOT PLUG.
3. If the casualty is unconscious, place him in the recovery position with the injured side down.
4. If the casualty is conscious, place him in a half sitting position, with head and shoulders supported. If you suspect spinal injury, keep the casualty's head and trunk aligned at all times.
5. Check breathing and pulse every ten minutes.
6. Treat for shock.
7. Send for medical assistance and remove to hospital.