#circulation bleeding /TOUR OF PRACTICAL 1ST AID, Bleeding When using sharp implements, such as cooks' knives, it's important to always direct cutting action away from the body. Many accidents occur in the kitchen preparing food with a sharp knife; fingers, hands & arms can be sliced deeply; similarly, the legs & abdomen. Sometimes, even the abdomen or the chest can be penetrated. A butcher's injury is severance of the {femoral artery}. When involved with a patient it is important to differentiate between types of {bleeding}. These are: $1 arterial venous $1 {Arterial bleeding} is characterized by bright red blood because it is carrying {oxygen}. It spurts from the wound in time with {pulse}. $2 {Venous bleeding} is darker in color because it has passed on {oxygen} to tissues of body. Blood oozes from wound. The most important act is to stop the {bleeding}. {Venous bleeding} is relatively easy to control by applying direct pressure over site of wound & closing it with a firm {dressing}. A clean towel or handkerchief may be used to strap over wound if adhesive tape is not available. Transfer patient to hospital urgently. {Arterial bleeding} is more difficult to control & often catastrophic, leading to a condition called {hypovolemia} or {shock}. The {bleeding} may be external, or internal which is not visible. 1st try & control bleeding - apply direct pressure over wound, elevate limb and then apply pressure to {pressure point} above {artery} which is severed. Transfer patient to hospital urgently. #pressure points /animated 4 f/s /sound effects circulation (water) Notice that {pressure points} are related to position of {artery} as it crosses or becomes adjacent to a bone. Sometimes, a relatively small artery can be sealed off by: $1 applying direct pressure to the bleeding point (cover wound with clean material). elevating the limb applying pressure to the {pressure point} $1 Whilst applying pressure ask someone to call for an ambulance ensuring they stress the urgency. #chest wound Chest wounds are more drastic. If {lung} punctured, patient may have sucking wound. This is easily diagnosed - air can be heard whistling in & out, & there may be air bubbles in wound. A !i! life-saving !n! procedure is to cover with plastic sheeting then seal it on all 4 sides with plastic tape, preventing further collapse of {lung}. Call for medical assistance urgently. {Internal bleeding} can be caused by a puncture wound of abdomen or chest. Or by a fall causing {spleen} or {liver} to rupture & bleed. There may be no signs of {external bleeding}. However, the patient will be in {shock}, complain of abdominal pain & have a raised pulse rate. Call for medical assistance urgently. #casualty shock If you think the patient is in {shock}, look for these signs: $1 pale or ashen color face shallow sighing breathing rapid, thready {pulse} cold extremities (feel nose or ear lobes) unconsciousness blue or {cyanosed} lips thirst restlessness & anxiety $1 There are 3 important actions: $1 call for medical assistance urgently cover with blanket $2 $1 !b! DO NOT GIVE ANYTHING BY MOUTH. #Home accidents /animated 6 f/s /accidents in the garden or countryside !n! Accidents occur in the garden & any cuts or abrasions should be thoroughly washed with running water & then cleaned with a mild {antiseptic}. Go to the nearest medical center & having explained the situation, ask for a {tetanus} injection (rose thorns can pass on spores of tetanus). You should use the same procedure if you tread on a nail or pierce your foot with a garden fork. {Tetanus} injections ought to be kept up to date. A full course should be effective for 10yrs. However, it does no harm to have a booster dose every 5yrs if at risk. #general burns /burns & scalds {Burns} & {scalding} are common accidents in the home. If extensive, they cause permanent skin damage & even become life-threatening, especially to children. $2 !b! It is important to keep kettles, teapots, & cooking utensils out of reach of children. #dry burns !n! {Burns} are usually caused by flame or hot objects (e.g. domestic iron, heating radiator, hot water bottle, frying pan). Burns can also be caused by electricity, chemical agents & over exposure to sunlight. {Scalds} are caused by steam. All {burns} can be classified as follows: $1 1st degree - redness of skin 2nd degree - blistering of skin 3rd degree - full skin thickness burn with involvement of deeper tissues $1 The !i! amount !n! of skin involved & !i! type !n! of {burn} will dictate condition of patient. Destruction of skin allows loss of fluid & may lead to {shock}. Because natural protection of skin is lost, infection nearly always develops. The rule applied is known as the 'Rule of 9's', where '9' represents % area of skin: $1 head - 9% each arm - 9% upper chest - 9% upper back - 9% abdomen - 9% lower back - 9% upper thigh - 9% lower leg - 9% {perineum} - 1% $1 For example, with a fire patient, there may be '18% burns' (i.e. 18% of total skin area has been burnt) - anything above 30% is life-threatening. However, burns of the face are considered life threatening even though they may not exceed 9%. #burns treatment /The 1st Aid treatment of burns 1st put out fire. If patient's clothes are on fire, put out with water. If water is not available, wrap in a blanket to smother flames & lie patient on floor. Cool affected part with cold water as soon as possible. Cover burnt areas with sterile dressing. Do not remove adherent material. Transfer patient to hospital urgently. If burnt area is small: Cool as rapidly as possible for at least 5mins. Remove all clothing near damaged area. DO NOT apply ointment or lotions. Cover with clean non-stick {dressing} (do not use band-aid to secure). Call for medical assistance if in doubt. Use same method for {scalds}. If {burns} or {scalds} are severe, the patient may become unconscious. Cool burnt surfaces with running water. Do not remove charred material. Cover with clean non-stick {dressing}. DO NOT apply ointment or other lotions. Call for medical assistance urgently. #Chemical burns /Chemical burns Usually associated with caustic & acidic chemicals, often found in the home (keep these out of reach of children). Wash affected part with running water (this also applies to eyes). Cover with clean non-stick {dressing}. Transfer patient to hospital urgently. #Electric shock /Electric shock Usually associated with faulty wiring of electrical appliances, or handling of non-grounded equipment on damp or wet floors. A shock from electric mains may cause {cardiac arrest} & severe {burns}. Immediate action is imperative but don't touch until patient is removed from electrical source. This is vital as contact will certainly give you an electric shock. The problem is how to turn off the power without personal risk. Find the mains switch & turn off all electricity. If this is not possible, stand on a rubber mat or put on rubber boots & with a broom handle, switch off the local power point. Feel for {pulse} (the {carotid pulse} is most convenient) and check {breathing}. Cover burnt area of skin with clean non-stick {dressing}. Call for medical assistance urgently & maintain {airway} until help arrives. #home falls /animated 4 f/s /Falls in the home, Garden & on the street Falls in the home are a common accident & can result in serious damage, particularly to the elderly. The skeletal bones can be divided into: $1 long bones flat bones small bones #long bones $1 Long bones consist of: $1 {tibia} & {fibula} in legs {femur} (thigh bones) in upper leg {radius}, {ulna} & {humerus} in arms #flat bones $1 Flat bones consist of: $1 pelvic bones ribs {scapulae} (shoulder) breast bones skull #SMALL BONES $1 The small bones consist of {spinal} or {vertebral}, bones of the hands & feet. #FRACTURE TYPES Treatment of a {fracture} should be administered by trained medical personnel & involves immobilizing the limb & treating shock (if diagnosed). $2 !b! ALL FRACTURES SHOULD BE TREATED IN HOSPITAL & SHOULD BE SEEN BY AN ORTHOPEDIC CONSULTANT. !n! {Fractures} are categorized into 3 groups: $1 {SIMPLE FRACTURE}: includes {greenstick fractures} in children, or {closed fractures} {COMPOUND FRACTURE} or {open fracture}, so called because of bone penetration through skin {COMMINUTED FRACTURE} so called because bone is shattered into numerous fragments; this may be !i! compound !n! or !i! closed $1 !n! When diagnosing a {fracture} look for: $1 pain, deformity, bruising or swelling sometimes patient complains of a grating sensation ({crepitus}); do not try to induce this sign!! {shock} bone ends may be seen penetrating skin $1 The 1st Aid treatment of a {fracture} is essentially to immobilize limb & treat {shock} (if diagnosed). #f radius & ulna /Fracture of radius & ulna In children, as a result of a fall on outstretched arm, a kink in bone can be seen on {x-ray}. Arm can be supported by splint & sling & child taken to hospital where a {plaster cast} is applied. Bone heals within 3 weeks & after 6-12 months, the bone re-models so old fracture site cannot be seen. #f Colles /Colles fracture A {fracture} of lower end of wrist involving {radius & ulna}. It is often seen in elderly who may slip, falling directly onto an outstretched hand. DIAGNOSIS: $1 pain in wrist swelling typical dinner fork deformity bruising inability to move wrist $2 $1 TREATMENT: Splint wrist in comfortable position. Place affected arm in a sling. Transfer to hospital. #f mid radius & ulna /Fracture of the mid-shaft of radius & ulna Wrist & forearm. This can either be {compound fracture} or {simple fracture} & is usually due to a fall, or a direct blow or a twisting force on the forearm. #fracture types CLOSED FRACTURE: A simple splint such as a piece of wood can be placed on either side of forearm with some padding between splint & arm. Splints are then bandaged firmly to forearm & placed in sling. Transfer to hospital. COMPOUND FRACTURE: A simple splint, such as a piece of wood, can be placed either side of forearm with padding between splint & arm. Splints are then bandaged firmly to forearm & placed in sling. Transfer to hospital. With complex fractures around elbow, principles are the same as any fracture. #f humerus /humerus fracture Long bone of upper arm is called {humerus}. A break may occur as a result of direct blow or twisting force. Thus spiral {fractures} may occur or direct horizontal breaks may be found. Apply sling to arm keeping at 90 degree angle, then firmly bandage arm to chest. Transfer to hospital. DIAGNOSIS: $1 pain in shoulder bruising deformity inability to move it $1 #f Scaphoid /Scaphoid fracture Small bone at base of thumb, lying directly beneath midpoint of triangle formed by tendons at base of thumb. Bone is kidney shaped & has poor blood supply. A fall onto an outstretched hand can cause crack through waist of bone. However, this may not show on {X-ray}. Identified by loss of power of grip & pain on pressing over site of bone. Transfer to hospital. #f Clavicle /Clavicle fracture This is the collar bone which is often damaged in sporting injuries. Place arm in sling & firmly bind upper arm to chest. Transfer to hospital. #F ribs /Fractured ribs Look for: $1 pain in chest pain on breathing diminished movement of chest on affected side history of blow or injury $1 The 1st Aid treatment is really nothing. Immobilization of chest invites {pneumonia}. Patient should be sent to hospital for medical examination to see {ribs} have not penetrated the {lung}. #f stoveinchest /animation A more serious injury of the chest, often as a result of a car accident, is multiple {fracture} of the {ribs} or a {flailed chest}. The chest is unable to expand properly often leading to {paradoxical respiration}. In this case the patient is seriously ill. The signs are: $1 {shock} {cyanosis} pain extreme difficulty in breathing $1 TREATMENT: $1 call for medical assistance urgently sit patient up immobilize affected side of chest with thick pad maintain an adequate {airway} & respiration #f potts /Fracture of lower limbs $1 {Fractures} around the ankle are called {Potts fractures}. These are of various degrees & characterized by: $1 pain & swelling deformity & bruising inability to walk $1 TREATMENT: $2 $1 pad ankle immobilize with wooden splints & bandage transfer to hospital $1 Fractures of the lower limb are often {compound} because of proximity of bones to skin. Damage to bones in the lower limb are usually caused by direct blows or by {torsion}. Horizontal breaks in the {tibia} are usually stable & can be treated by plaster splint. {Spiral fractures} are unstable, the signs are similar to other fractures. TREATMENT: $1 cover any open wound with clean well-padded dressing use wooden splints to immobilize leg transfer to hospital $1 #f thigh /Fractures of thigh Damage is usually by a direct blow. The {femur} is the strongest bone in the body & does not usually break under {torsion} strains. {Fractures} of this bone are common in road traffic accidents & particularly involving motorcycles. They are often {compound fractures} & {comminuted fractures}. Fractures occur in mid-shaft, lower-end, & at surgical neck in elderly. The diagnosis is made by usual signs, but {shock} may be present. Loss of blood of 3 pints or more may occur at fracture site with considerable tissue damage. It is important to diagnose a fracture of neck of {femur} in the elderly. The signs are: $1 pain over hip swelling may be present inability to bear weight external rotation of foot - possibly most important sign $1 TREATMENT: $1 call for medical assistance urgently immobilize limb with long board splints & triangular bandages if {shock} is present, maintain an {airway}, keep warm cover any wound with non-stick dressing/clean cloth #F Skull /Fractures of the Skull $1 Always caused by direct blow & may be depressed & {compound fracture}. The signs are: $1 unconsciousness bleeding from ear unequal {pupils} clear discharge from nose $1 TREATMENT: $1 call for medical assistance urgently clear & maintain {airways} #F spine /Fractures of spine $1 These can occur from a direct blow, whiplash injury, or diving accident. Diagnosis is relatively easy: $1 pain at site of injury loss of sensation/movement below site of injury breathing difficulty (cervical spine injury) {shock} $1 TREATMENT: $2 $1 call for medical assistance urgently treat {shock} do not move until skilled help is available maintain an {airway} $1 With a road traffic accident, where patient has suspected spine injury, DO NOT MOVE unless fire threatens (movement could cause permanent {paralysis}). Should this arise, get several helpers & keep body as straight as possible & place on a gate or door. 1 person must be responsible for controlling neck at all times. #Dislocations /Dislocations The most common are: $1 dislocation of fingers, shoulder, elbow more rarely, dislocation of hip, knee, & ankle (nearly always associated with fractures around joint) $1 DIAGNOSIS: $1 pain swelling deformity loss of function $1 TREATMENT - for shoulder: $1 place arm in sling bandage upper arm to trunk transfer to hospital do not attempt to reduce dislocation $1 For elbow (elbow is deformed & painful): $1 immobilize to prevent damage to nerves around joint bandage to trunk if possible place in sling (if dislocated in extension this will be impossible & it's best to splint arm) transfer to hospital $1 For fingers or toes: $1 often injury only involves end of finger which may be put back into position easily (this isn't recommended) do not attempt to reduce dislocation transfer to hospital #diabetic tools /Diabetes $1 Disease of {pancreas} where body is unable to fully control the amount of sugar in blood. This can result in 2 conditions: $2 $1 too much sugar in blood - {hyperglycemia} too little sugar in blood - {hypoglycemia} $1 HYPERGLYCEMIA OR DIABETIC COMA - DIAGNOSIS: $1 usually slow onset thirst ({polydipsia}) passes a lot of dilute urine ({polyuria}) dramatic loss of weight possible crops of boils or itchy anus $1 This condition rarely presents an emergency but in advanced disease, there is a characteristic breath odor like acetone or nail varnish. Transfer to hospital as only hospital treatment can be used to control condition. {HYPOGLYCEMIA} - DIAGNOSIS: $1 knowledge of patient's disease feeling of hunger/bizarre behavior before {coma} if unconscious, skin is pale rapid {pulse} breathing becomes shallow possible trembling of limbs $2 $1 TREATMENT: If conscious, encourage patient to drink sweet drinks with plenty of sugar. Recovery is rapid, but if in doubt, seek medical advice. If unconscious, call for medical assistance immediately. Maintain {airway}. #angina 1st aid /Heart attack & Angina {Angina} is pain emanating from heart because of {oxygen} starvation & diagnosed by: $1 central chest pain - feels in grip of vice or as if heavy weight pressing pain may radiate into left shoulder down inner aspect of left arm & into small finger of left hand pain may also radiate into angle of jaw sometimes, pain may start in pit of stomach (often incorrectly diagnosed as {duodenal ulcer} & treated with fatal results) possible irregular {pulse} $1 TREATMENT: $1 ask if similar attack has occurred & if using any drugs assist patient in taking any drugs prescribed by the patient's doctor make patient rest seek medical advice #HEART ATTACK $1 Heart attack, or {myocardial infarction}, may be easy to diagnose if conscious, but difficult if unconscious. $2 If conscious: $1 patient may complain of {palpitations} & {pulse} may be irregular ask about the pain; it is usual to experience central chest pain (described as crushing sensation), radiating to other parts of body, to angles of jaw, both arm pits, typically left arm on inner aspect, left elbow, small finger of left hand; pain in isolation in areas of left arm, without chest pain, must not be confused with a {heart attack} skin color may be pale extremities may be cold may complain of difficulty in {breathing} lips may be blue may feel as though they are about to {faint} $1 TREATMENT: $1 call for medical assistance urgently make comfortable, loosen tie & clothing check {pulse} keep warm & watch {respirations} $1 If unconscious: $1 quickly check {carotid pulse} & breathing check for loss of color of extremities check {pupils}, (if {dilated} in {shock}; if fixed, with no response to light, either dead or suffered {cardiac arrest}) call for medical assistance urgently loosen clothing around neck make sure {airway} is clear try & establish any history of previous heart disease & events leading up to patient's collapse #epileptic man /animated 5 f/s /{EPILEPSY} $1 {EPILEPSY} is a condition found in man & animals. We shall examine 2 main types: $1 major epilepsy, known as {grand mal} minor epilepsy, known as {petit mal} $2 $1 The causes are: $1 birth trauma after a head injury permanent brain damage because of alcohol &/or drug abuse after inflammatory infection of brain coverings, e.g. {encephalitis} & {meningitis} after previous brain surgery rapid withdrawal from {benzodiazepines} & {opiates} withdrawal of alcohol in chronic alcoholics $2 $1 Any of these may lead to abnormal release of electrical impulses in the brain which causes a {fit}. GRAND MAL - DIAGNOSIS: $1 sudden onset of jerking spasmodic movements of upper & lower limbs semi-conscious state, or even unconscious frothing at mouth, blue tinge to lips & face possible involuntarily passing of urine $1 TREATMENT: DON'T STICK YOUR FINGER IN PATIENT'S MOUTH, it may be severed. Seek medical advice. When severity lessens, make comfortable. Providing the {airway} is maintained, victim should make an uneventful recovery. However, there is a condition, post epileptic automatism, which can occur following {grand mal}. The patient can become uncontrollable & run {amok}. Should this occur, call for medical assistance urgently. Try to calm &, if possible, restrain forcibly, !i! always !n! ensuring that you don't put yourself at risk. PETIT MAL - DIAGNOSIS: $1 trance like state, as though momentarily asleep eyelids may close utensils held at time may drop may fall & injure themselves no memory of event no loss of control of bladder or bowels no jerking motions of arms or legs no {respiratory} embarrassment $1 TREATMENT: Very little needs to be done apart from ensuring patient doesn't fall. {Petit mal} only lasts a few seconds & recovery is spontaneous. If, however, victim is slow to recover seek medical advice. #Asphyxia /animated 4 f/s /sound effects breathing Inability to breathe by any cause. {Oxygen} failing to enter {lungs}, is not transferred to arterial system, therefore does not reach the brain. This results in cessation of activity of vital centers of the brain, resulting in death. CAUSES INCLUDE: manual strangulation, hanging, choking, drowning, smothering (e.g. a pillow), {cerebro vascular} accident, smoke inhalation, entrapment of clothing (e.g. necktie in machinery), various medical conditions. #Strangulation /animated 5 f/s, run once, 10 sec delay /Manual Strangulation /sound effects 'ahhhh' from mac This is nearly always fatal, since it is rarely possible to interrupt the individual who is performing the act. Face will be livid with numerous small purple {petechiae}. White part of eye will be dotted with bright red blood & eyes may appear to be bulging from their sockets. TREATMENT: Release all clothing & any restriction around neck. Feel {pulse}. Call for medical assistance urgently. #Hangman /Hanging Usually an attempted suicide. Depending on time body has been hanging, resuscitation may not be effective. TREATMENT: Cut rope & gently lower body to ground. Release clothing/restrictions around neck. Feel for {carotid pulse}. Call for medical assistance urgently. #Choking /Choking This can occur in adults as well as small children. {Choking} is always due to foreign body lodging at entrance of wind pipe, where {pharynx} divides into {oesophagus} & {trachea}. Smothering ({asphyxia}), by intentional or accidental obstruction to air passages (e.g. a pillow), shares similar diagnosis & treatment. CAUSE: In elderly, false teeth may be inhaled. Food can lodge in this area both in young children & adults. Small toys, peanuts & coins can be inhaled by young children. Acute infection of vocal chords & back of {pharynx}, such as {diphtheria}, can also cause obstruction. Acute {epiglottitis} can be fatal if not correctly treated in acute stage. #Abdominal thrust DIAGNOSIS: Patient distressed & makes loud high-pitched sound when trying to inhale. Face ashen & lips blue or {cyanosed}. May be semi-conscious. TREATMENT: Get a suitably qualified person to try to dislodge foreign body with abdominal thrusts (commonly known as the Heimlich maneuver). !b! It's important to practise the abdominal thrust technique under trained supervision. There's no substitute for practical knowledge & experience. !n! If this procedure isn't successful, call for medical aid as death can occur very rapidly unless the obstruction is cleared. Usually with infectious causes of asphyxia, e.g. {polio}, warning of the severe illness is given. With polio, paralysis of limbs occurs before respiratory problems. There is 1 form of {poliomyelitis} which attacks the brain stem at onset & this is often fatal. !b! All individuals should consider vaccination against poliomyelitis to eradicate this disease. !n! Similarly, protection from {diphtheria} by vaccination is the best form of treatment (it obstructs {airways} & prevents air from reaching {lungs}). The disease is due to a bacterial infection. It is often found in developing countries where the victim may be far from hospital & suitable antibiotics may not be available. #Smothering asphyxia /Smothering asphyxia Caused by intentional or accidental obstruction to {airways} (e.g. a pillow). $2 DIAGNOSIS: Patient distressed. Face is ashen & lips become blue or {cyanosed}. May be semi-conscious. TREATMENT: Clear {airways}. Call for medical aid immediately as death can occur very rapidly unless the obstruction is cleared. #Drowning /Drowning May be caused by submersion in water, or by causing the throat to go into a spasm. $2 CAUSES: Bathing accidents, falling overboard a ship or small boat, suicide attempts (e.g. drowning in bath), excessive intake of alcohol, combined with drugs, gunshot wounds of lower jaw & face. DIAGNOSIS: Apart from gunshot wounds, patient is found in water, patient will be unconscious, body is lifeless, no evidence of breathing, color is ashen, lips are blue, often an absence of {pulse}, body is cold. TREATMENT: Remove from water, check {airway} & remove any debris from mouth which may be causing obstruction, quickly feel for {pulse}. Call for medical assistance urgently. #HEAD CASUALTY /Cerebro Vascular accident Caused by bleeding into the brain (mainly into brain stem). This damages the center which controls breathing. $2 DIAGNOSIS: Sudden onset, absence of respiration, {pupils} often pin point & non-reactive to light, pupils may be dilated & non reactive to light, skin color pale, lips blue or {cyanosed}. TREATMENT: Call for medical assistance urgently. Free clothing around neck. #smoke house /Smoke inhalation /animated 5 f/s /sound effects burning noise Caused by inhalation of dense smoke, usually experienced in domestic fires. The smoke is {toxic} because of waste products produced by burning plastic & household furniture. The smoke has a very irritating effect on cells of {lungs} & causes an outpouring of fluid into the {bronchial tree}, effectively causing obstruction & {asphyxia}. TREATMENT: Remove from smoke, check breathing & {pulse}, transfer patient to hospital urgently. #Entrapment man /Entrapment of clothing /sound effect factory noise Common occurrence in machine workshops with inadequate safeguards. Usually items such as ties can be caught in a rotating drum or wheel causing strangulation. TREATMENT: Stop machine, release clothing & restriction around neck, feel for {pulse}, ask for medical aid urgently. #child dribble /animated 5 f/s /Epiglottitis Infection of {uvula} & {epiglottis}. Mainly seen in young children. It is characterized by a high temperature, dribbling & a high-pitched coarse noise on breathing in. Partial obstruction is present & if chest is observed spaces between the ribs are sucked in on inspiration. DO NOT UNDER ANY CIRCUMSTANCES ATTEMPT TO PLACE A SPATULA OR EQUIVALENT IN THE PATIENT'S MOUTH. By doing this, the {epiglottis} may close completely. Call for medical assistance urgently. #Poisoning /Poisoning Poisons enter the body in a number of different ways: $1 via mouth - eating/drinking via {lungs} - inhalation via skin - sting, bite, absorption or hypodermic syringe $1 GENERAL TREATMENT: Quickly ask patient what happened (they may lose consciousness any time), try to identify substance ingested or cause of bite/sting, !b! DO NOT ATTEMPT TO INDUCE VOMITING, !n! if lips/mouth show signs of burning, cool by giving water or milk slowly. Transfer to hospital urgently, with samples of vomit & any evidence of poisonous cause (e.g. pill boxes, plant, etc.). See 'General Skills' section for specific examples of poisoning. Natural curiosity puts young children particularly at risk from swallowing household bleaches & cleaning fluids, which are poisons. !b! Keep all such items out of the reach of children !n! - poisoning is not only dangerous, but also very painful. Serious poisoning requires a life-saving technique {stomach pump}, an uncomfortable & grim method of clearing poisonous stomach contents. #Heat Exhaustion /Heat Exhaustion A condition which occurs in hot humid climates caused by excessive profuse sweating, inadequate salt & fluid intake. DIAGNOSIS: Newly arrived persons in a hot humid climate, a feeling of dizziness associated with near collapse or {fainting}, prior excessive alcohol intake, excessive sweating, failure to take preventive measures, such as additional salt. TREATMENT: Place patient in cool shade, give 3-4 pints of water to drink over 1hr. Patient normally makes full recovery within 1hr. If in doubt, seek medical advice. It's important when visiting hot climates to know about hazards & how to avoid them (see 'Travelling Abroad' section). #Heat Stroke /animated 8 f/s /sound effects fan Far more serious condition than {heat exhaustion} & can lead to death if not treated urgently. The body actually becomes cooked & the temperature control center in brain stem is put out of action. To prevent this condition, wear a hat & avoid exposing body during hottest part of day. Work in early morning or late afternoon when temperature is lowest. DIAGNOSIS: Skin dry & hot, temperature 104-107F (40-42C), unconscious, no evidence of sweating, face flushed, {pulse} rapid & thready. TREATMENT: Transfer patient to hospital urgently. If not possible, remove clothing, wrap in wet sheet with electric fan directed on it from distance of 10ft (3m). DO NOT PLUNGE IN COLD BATH. Fan will cause evaporation, thus cooling skin & body's internal temperature. When spontaneous sweating occurs, body's temperature control mechanism will have taken over & internal body temperature will drop to normal. #frozen house /Hypothermia A condition of excessive cooling of body. It's found in elderly & young people where there is inadequate heating & clothing, particularly during winter months. DIAGNOSIS: Patient is cold & may be in semi - {coma}, thought processes & speech are slow, evidence of inadequate heating (e.g. ice inside windows), {pulse} is slow. TREATMENT: Wrap in blankets to promote warming, give warm drinks if conscious. If recovery is slow, transfer to hospital, do not heat up rapidly as this may cause collapse & {shock}. #Frost Bite /Frost Bite, igloo A condition which affects nose, fingers, & toes in extremely cold (i.e. sub-zero, sub-freezing conditions). Tissues become frozen & cells are killed. The result is like an electric burn injury. TREATMENT: Warm up patient slowly, dress affected areas with non-adhesive dressings. Wrap in blankets. This treatment is purposely conservative. Transfer to hospital urgently.