Firs Aid Basics

Safe Use Of Home Medicines

Your medicine cabinet contains many powerful poisons; relatively safe if taken properly, but very dangerous if taken by a young child. Painkillers are potentially lethal, and undiluted disinfectants can cause severe internal burning if taken by mouth. Many prescribed drugs are even more dangerous. Commonsense tells you to keep all medicines high up, out of reach.

Commonsense also extends to following the instructions with all medicines, whether bought at the chemists, or prescribed by the doctor. Take particular care that you take the right number of doses each day, at the times specified, and never stop taking prescribed medicine before the doctor tells you it is safe to do so; this is particularly important with antibiotics. If you have any doubts about this, ask the doctor for a precise set of dose instructions. Never save any prescribed medicines you have left over after completing a course of treatment. Misuse of drugs can be highly dangerous and some of them actually ‘go off within a short time after mixing. The safest way of disposing of left-over medicines and tablets is to take them back to the chemist.

Elderly people often have to take several different medicines each day, and they easily become confused. This can be dangerous, and if you think there could be a problem, draw up a medicine chart, showing when to take each drug, and how much to take (e.g., Breakfast — 1 red tablet, 1 teaspoon of medicine).

FIRST AID

First aid should never be thought of as a substitute for professional medical advice, and valuable though it is when performed properly, over-zealous first aid treatment can be worse than no treatment at all. If in doubt, don’t treat; call a doctor. Remember that such thoughtless acts as helping an injured person to sit up could kill them, and be very cautious if there seems the slightest possibility of serious injury. An unconscious person should be placed in the recovery’ position.

The ‘entries that follow are in alphabetical order.

ARTIFICIAL RESPIRATION AND CARDIAC MASSAGE These two measures need to be learned by everyone, as they can both save lives by keeping a badly injured or sick person breathing, and their heart pumping, until they reach hospital for more thorough treatment. Artificial respiration is essential whenever breathing has stopped, due to any reason. Accidents such as head injury, drowning, electrocution, poisoning, or inhalation of vomit can cause breathing to cease. For anyone other than a trained first-aider, mouth to mouth artificial respiration is best, as other types involving pressure on the ribs can cause injury if done incorrectly.

Roll the casualty on his back, and using the finger, remove any obstructions from the mouth, including false teeth, vomit, or bits of food. Make sure the tongue has not doubled back down throat. If it has, pull the tongue forward.

Tilt the head back, holding the jaws forward to keep the tongue off the back of the throat. Pull open the clothing around the neck.

Pinch the casualty’s nostrils shut, then, taking a deep breath, seal your lips around his open mouth and exhale into him. Watch to see if the casualty’s chest rises. If not, there is an obstruction in the windpipe, which means checking the mouth again to make sure you have not missed any object blocking the flow of air. Otherwise, press the casualty’s chest to try and dislodge the obstruction.

When the chest is seen to rise, remove your mouth while air is expelled once more and repeat the process, at a rate of about 20 times per minute.

In babies and small children, it is usually better to cover both nose and mouth together as you breathe into them. Especially with small children, never blow forcibly into them, but use only the small amount of air which is contained in your puffed-out cheeks.

Check periodically to see if the casualty has started to breathe naturally. Make absolutely certain that they are breathing strongly before ceasing artificial respiration. Never give up if the patient shows no sign of responding; continue until medical assistance can be obtained.

Cardiac arrest sometimes follows asphyxiation, or can occur due to other causes, such as a heart attack or electric shock. When the heart stops, the casualty very quickly becomes bluish or grey in colour, and the pupils of the eye become widely dilated. Breathing stops, consciousness is lost and no pulse can be felt. Keep the patient breathing as the first priority.

If cardiac massage is to be attempted, roll the casualty on his back. Now thump the casualty sharply on the lower part of the breastbone. In babies, a sharp tap is all that is necessary. If the heart does not start immediately, external heart massage is needed.

Place the heel of one hand over the lower part of the breast bone, and heel of the other hand on top of this. Keep the arms stiff and straight, and rock forward so that the breast bone is pushed in by about 1 ½ inches (4 cm). Repeat the movement once per second for adults; 80-90 times per minute for children. Use firm, regular pressure, and don’t push harder than you need. (Keep up the mouth to mouth respiration.) Continue treatment until the heart re-starts, when the colour will improve, pupils return to normal, and a pulse can be felt. Then get medical aid immediately.

BANDAGES AND DRESSINGS

Dressings are probably more often used than bandages for household first aid.

The purposes of a dressing are to keep out infection and prevent further injury. Because it is in close contact with an open wound, a dressing must be sterile. It must also be porous to absorb blood, and be of material which will not adhere to the wound as it dries.

Adhesive dressings, or plasters, are most useful, being pre-sterilized, and available in a range of sizes. They will not adhere to damp skin. Use the porous type which allow skin to ‘breathe’.

BRUISING

Bruises are caused by bleeding from the tiny blood vessels beneath the skin. Once a bruise has formed, there is little that can be done to remove it. The body clears up the leaked blood gradually, and the discolouration fades. If you catch it in time, however, a cold compress may stop the bruise forming, or at least stop it getting too big.

BURNS

Burns require rapid treatment, especially serious burning. Burns caused by contact with fire, boiling water, steam or corrosive chemicals must be treated by plunging the affected part under cold flowing water.

Never coat the burned area with creams or ointments. If the burns are extensive, deep, or if severe blistering has occurred, hospital treatment is needed without delay. Shock, infection, and scarring can occur without proper treatment. Burns are especially dangerous in the very young or the very old. For chemical burns, remove affected clothing as soon as possible. For other burns, don’t remove clothing or damaged skin — leave it to the doctor.

Mild burns need no treatment. Just clean them, and cover with a dressing or bandage.

Mild sunburn is best treated with calamine, or with antihistamine cream if it is painful. Blisters need medical treatment, and if the sunburned person is shivering or vomiting, treat as a fever and get medical help immediately, as they may have sunstroke.

CHOKING

Blockage of the windpipe causes choking. Treat by thumping firmly between the shoulder blades, two or three times. A small child can be held up by the feet, and a larger child laid over the knee face down, before thumping the back. Hook out any obstruction in the mouth with the fingers. If choking continues, and the casualty turns bluish, give mouth to mouth respiration and rush them to hospital immediately. Choking with a bone in the throat is painful, but less of an emergency. If you can’t hook it out with a finger, seek medical help.

CONVULSIONS

In infants, convulsions usually occur because of a high temperature during infecious illness. These are called febrile convulsions, where there is usually a brief loss of consciousness as the temperature soars. Get the temperature down quickly. Bathing the body with tepid water is probably fastest. Call the doctor meanwhile, and watch the baby carefully until the doctor arrives.

Adult convulsions are usually due to the disease epilepsy, although there are several other possible causes. Some epilepsy sufferers wear a bracelet or medallion warning of their condition. In such a convulsion, the person falls down and jerks all over. Don’t try to stop this, as you will cause them more harm. Just loosen clothing to prevent breathing difficulties, and try to stop them injuring themselves. In particular, epileptics may bite their tongues, and it is sometimes possible to force a rolled up handkerchief between their jaws to prevent this.

After the convulsion they will be sleepy and confused, and may not realize what has happened. Reassure them, and then get them to a doctor for a check up.

CUTS AND GRAZES

Clean the wound by washing under cold running water. Obvious dirt can be wiped off carefully, wiping away from the wound. Mild antiseptic can be used, especially in grazes which are particularly likely to be dirty, and become infected. Never use at full strength. Use as in the directions.

Bleeding will normally stop naturally after a few minutes. Don’t try to wipe off clotted blood or the wound will bleed again. Cover the wound with an adhesive dressing, or non-adhesive dressing and bandage. Once bleeding has stopped, petroleum jelly can be applied to stop the dressing sticking.

ELECTRIC SHOCK

First switch off the electrical supply, or get the person away from the source of shock. If you cannot switch it off, pull out the plug, or pull the cable free. Make sure that you do not come into contact with any exposed electrical part or conductor of electricity. This means not touching the casualty until you are sure the electricity has been disconnected. If you can’t be sure of this, stand on dry wood, cardboard, or a mat to insulate yourself, or try to roll them away with a length of wood. Always seek medical advice after an electric shock, as there may be severe internal damage, which is not always apparent. Use artificial respiration if breathing has ceased, and cardiac massage if the heart has stopped.

FAINTING

Faints are caused by a partial interruption of the blood supply to the brain. There is usually some warning, such as a feeling of giddiness or ‘cold sweats’. If the affected person lies down, or puts their head down between their knees, the distance the heart has to pump blood to the brain is reduced, and the blood supply improves. Get the casualty to breathe deeply, and loosen clothing around the neck.

Faints are not usually serious, and can happen if a person has a developing illness, or has been standing for a long while in crowded or hot conditions.

FOREIGN BODIES

If a child swallows a coin or other small object, place him face-down over the knee to see if he will vomit it up. If not, check with the doctor to see if hospital treatment is necessary. Most objects pass through the system within a few days, without causing any harm. Sharp objects are potentially dangerous, so advise the doctor immediately.

Small objects pushed up the nose or into ears require special treatment. Never try to get them out, as they may be accidentally pushed further in. Take the casualty to the doctor or hospital for treatment.

Foreign bodies in the eye can cause damage if not properly treated. Usually tears will dislodge them and carry them into the corner of the eye, where they can be gently removed with the edge of a clean cloth. If not, pull the upper eyelid down over the lower, holding it by the lashes. The lashes on the lower lid will then sometimes brush the object out. Pull the lower eyelid down and remove any visible dirt with a clean cloth. Never touch the eye with any hard object. Seek medical attention without hesitation if you cannot remove the foreign body easily.

HEAD INJURIES

Any head injury which causes even a short loss of consciousness could be serious, and the ill-effects can be delayed. Always report such injuries to the doctor, and watch the casualty for such symptoms as sleepiness, dizziness, persistent headaches or vomiting. Report these conditions to the doctor without delay.

HEART ATTACKS Symptoms of a heart attack are varied, and may not even be felt in the area of the heart. Common warning signs are heaviness and pain in the upper chest, spreading to the shoulders and arms, and even to the jaw.

Feelings of weakness are common, together with sweating and breathlessness. The symptoms may fade and then return. Immediate medical attention is essential, and if the doctor is not available, call an ambulance. If breathing stops, give mouth to mouth respiration. If the heart stops, give cardiac massage.

INSECT BITES AND STINGS

Bites and stings are seldom serious, although they can be painful. Most can be treated with calamine lotion, or with an antihistamine cream which eases the itching. Bee stings break off in the skin, and must be removed with

tweezers. Try not to squeeze the sting, as this will only pump more venom into the wound. Avoid scratching bites, as this leads to infection. Sometimes there is a severe allergic reaction to a bite, which can cause breathing difficulties. This needs immediate medical attention. This condition is fortunately extremely rare. Similarly, although a single bee sting is no cause for alarm, multiple stings can be dangerous, and if a stung casualty collapses, artificial respiration may be necessary while awaiting medical aid.

NOSE BLEEDS

A nose bleed is seldom more than a nuisance. It often follows a cold, where the nasal tissues have been damaged by sneezing violently, or by congestion. Get the casualty to sit, with the head forward, and breathing through the mouth. Hold the soft part of the nose pinched closed for 10 minutes, after which the bleeding will usually have stopped. Stop the casualty from sniffing or blowing the nose as this will disturb the clot and start the bleeding again. If bleeding persists for an hour or more, seek medical aid.

POISONING

Corrosive poisons: disinfectants, petrol, paraffin, cleaning fluids, caustic soda, some insecticides. Try to dilute the poison by getting the casualty to drink water or milk. Don’t try to make them vomit, as this will lead to more burning. Rinse the mouth out and wipe away any deposits of the corrosive material around the lips.

Non-corrosive poisons: medicines, weedkiller, poisonous plants. If you are certain that the poison is not corrosive, try to make the casualty vomit, by placing a finger far back in the throat. Don’t give the casualty a drink, as this could worsen his condition.

In all cases of poisoning, seek medical aid immediately. If the casualty is conscious, try to obtain details of what he has taken, and tell the doctor. Some drugs have a delayed action and if the casualty deteriorates, give artificial respiration and cardiac massage as necessary. Try to save a specimen of the original poison, its container, or any vomited material to send to hospital with the casualty.

ROAD ACCIDENTS AND MAJOR INJURIES

Don’t do anything to make matters worse. Never try to move the casualty or straighten obviously damaged limbs. If the casualty is unconscious put him in the recovery position, but if conscious don’t move him at all. Give artificial respiration and/or cardiac massage if necessary. Never give drinks, as internal damage may have occurred. Call an ambulance immediately.

Severe bleeding needs emergency treatment on the spot, by pressing a pad of cloth over the wound. Add more thicknesses of cloth if this is insufficient, For small wounds, press the sides of the wound together with the fingers to check bleeding. Do not attempt to cut off the blood supply with a tourniquet unless you know exactly what you are doing, as this can worsen the damage. Cover the casualty with a warm blanket or a coat, while waiting for help to arrive.

SHOCK

Shock is a condition in which the circulation begins to fail. It can sometimes be fatal. It can follow severe injury, burns, bleeding, ruptured appendix, fright, or even bad news. The symptoms are rapid, shallow breathing, fainting or dizziness, sweating, and sometimes, blurred vision.

Lay the casualty down, cover him and keep him warm. Do not give hot drinks or anything else by mouth, in case internal injury has oc curred. Get medical help quickly.

UNCONSCIOUSNESS

Check that an unconscious person is breathing. If not, give artificial respiration. Check first that the airway is not blocked by the tongue, and make sure that any vomit is removed from the mouth.

If the casualty is breathing satisfactorily, turn him over into the ‘recovery position’. Loosen clothing around the neck, and keep him warm until medical help can be obtained. Watch him carefully while waiting for assistance, to make sure that breathing is maintained. Use artificial respiration if breathing seems to stop or to be very weak.

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