First Aid in Certain Cases

a) First Aid of Burns and Scalds

A burn is an injury caused by fire, heat, hot liquids, very hot steam, radiation, chemical action, electricity or friction, resulting in redness and blistering of the skin and often causing damage to underlying tissues. On the basis of the damage and harm due to burns, it is classified into three groups:

• ·        First-degree or mild burn: A burn marked by pain and reddening of the skin but without blistering or charring of tissues. 
• ·        Second-degree burn or the burn that causes blistering : A burn that causes blistering on the skin, but does not damage the deeper layers of the skin.
• ·        Third-degree burn or severest burn: A burn of the most serious kind, in which the skin and the tissues beneath it are severely damaged.

First aid for burns and scalds:

• ·        If there is fire on any body parts, cover it immediately with wet pieces of cloth sacs. It prohibits supply of oxygen and helps to extinguish the fire.
• ·        Immerse the burnt part immediately in cold water for about 10 minutes. It reduces the extent of damage to the tissues.
• ·        Do not burst the blisters (water-filled projections) . It causes further damage of tissues and assists in infection.
• ·        Cover the burnt part with sterile dressing to make it safe from bacterial infections.
• ·        Do not use random applications and ointments. Consult for medical aid immediately.

Preventive measures for burns and scalds

• ·        Handle stoves and gases safely.
• ·        Keep inflammable materials away from children.
• ·        Switch off the electrical appliances after use.
• ·        Make your family members aware about the safety measures and first aid in the case of burns and scalds.
• ·        Avoid nylon clothes as far as possible. If it is worn, do not go near fire.
• ·        Handle hot water, irons, and chemicals carefully. Keep them away from children.

Snakebite

Snakebite are dangerous. Some of them are poisonous and poison is very strong. Most of the snakes are not poisonous, but a few of them have very strong poison in their poison glands.

Snakebite takes many lives every year during  the hot season. Snakes are the inactive during the cold season.

In winter they hibernate with no active life. Common poisonous snakes found in Nepal are cobra and Karat.

Symptoms of snakebite

• ·        The poisonous snakes have two fangs (sharp incisors). There is distinct mark of the fangs with incisions
• ·        The affected part becomes red with pain and swelling
• ·        Discoloration of skin
• ·        Rapid pulse
• ·        Fatigue
• ·        Burning sensation in tissues
• ·        Blurred vision
• ·        Loss of sensation
• ·        Unconsciousness

First aid for snakebite

If there is snakebite, we should provide first aid as quickly as possible. WHO (World Health Organization ), Regional Office for South-East Asia published the "Guidelines for the management of snake bites" in 2010. The report states, " Unfortunately, most of the traditional, popular, available and affordable first aid methods have proved to be useless or even frankly dangerous. These methods include : making local incisions or pricks/punctures ("tattooing") at the site of the bite or in the bitten limb, attempts to suck the venom out of the wound, use of snake stones, tying tight bands (tourniquets) around the limb, electric shock, topical instillation or application of chemicals , herbs or ice packs. Local people may have great confidence in traditional (herbal) treatments, but they must not  be allowed to delay medical treatment or to do harm. "In light of such findings, the best method for providing first aid for snakebite described below:

• ·        First, make note of the snake so that the information could be provided to the doctor. Identify the mark of the fangs to know whether the snake is poisonous or not.
• ·        Give consolation to the victim so that s/he develops hope for life.
• ·        Advise the patient to remain calm and minimize movements.
• ·        Keep the stung part below the level of the heart if possible.
• ·        Do not let the victim move the bitten part. Apply a splint and tie it with a tourniquet or bandage to prevent motion.
• ·        Do not waste any time in cutting the bitten area, sucking the poison, flushing with water or adopting any other unscientific traditional method instead of taking the victim for medical treatment as soon as possible.
• ·        Manage an ambulance or any other appropriate means to take the victim to a hospital or health center. Apply full effort to take a victim to the snakebite treatment center.

Electric Shock

A shock is an unexpected, intense and distressing experience that has a sudden and powerful effect on somebody's emotions or physical reactions. If such a shock has resulted electricity, it is called electric shock. Many people die every year due to electric shock. It may be mild or hard on the basis of intensity of its effects to the victim.

Causes of electric shock

·        Negligence and ignorance

·        Lack of knowledge

·        Improper handling of electrical appliances

·        Lack of monitoring of the wiring system at home

·        Contact with electric wires and appliances

·        Leakage of electricity

Safety measures for electric shock

• ·        Be careful while working with electrical devices
• ·        Educate family members about safety measures and first aid in the case of electric shock.
• ·        Handle electrical appliances appropriately
• ·        Check electrical  wiring regularly
• ·        Keep children away from electrical appliances

First aid for electric shock

• ·        Switch off the main supply of electricity
• ·        Unplug the cord
• ·        Pull the victim safely with insulator support (dry wood, plastic)
• ·        Check vital signs, respiration, heartbeat, pulse, sensation, consciousness, etc.
• ·        Provide CPR (Cardiopulmonary Resuscitation) if necessary
• ·        Take the victim for medical treatment immediately

 

d) Altitude Sickness

Altitude sickness is a condition caused by low level of oxygen in the air at high altitudes, resulting in breathlessness, nausea, vomiting, fatigue and unconsciousness. It is also called mountain sickness. Our body is adopted in normal environment where we live in. People living at high altitude have higher lung capacity comparatively to the people living at lower altitude. Due to lack of oxygen at high altitude , there is increase in heart activities to supply the required oxygen  to the body. Due to this reason, the pulse rate, cardiac output and blood pressure increase. If the increase crosses the limit or the level of oxygen is too low, the travelers suffer from altitude sickness.

Symptoms of altitude sickness

• ·        Difficulty in breathing
• ·        Increased pulse rate and blood pressure
• ·        Headache, nausea and vomiting
• ·        Dizziness and vertigo
• ·        Pulmonary and cerebral edema (i.e., swelling )
• ·        Unconsciousness

First aid for altitude sickness

• ·        Supply oxygen as soon as possible
• ·        Bring the victim to lower altitude
• ·        Serve hot drinks.
• ·        Tell the victim to do light  exercises
• ·        Incase of several conditions and unconsciousness, manage cardiopulmonary resuscitation and proper medical care

Drowning

To drown is to be under the surface of water in such a way that there is accumulation of unwanted water in the lungs. Drowning is a common problem near ponds, wells, rivers, lakes and similar other water resources. people, especially children, must be made aware of it for its prevention.

Symptoms of drowning

• ·        Difficulty in breathing
• ·        Cyanosis i.e., presence of blue color in body tissues. It is due to lack of oxygen in the blood
• ·        Unconsciousness
• ·        Vomiting of water

First aid for drowning

• ·        Rescue the victim safely out of the water
• ·        Remove obstruction in the respiratory ways (if any)
• ·        Keep head downward and give gentle compression to the stomach to remove excess water accumulated
• ·        Apply CPR (cardiopulmonary resuscitation) if there is no respiration and heartbeat
• ·        Make medical care available for the victim as soon as possible

f) Heatstroke

Heatstroke is a condition caused by your overheating, usually as a result of prolonged exposure to or physical exertion at high temperatures. There is very high temperature in the hot seasons in the Terai region of Nepal. During the hot weather, when hot wind blows, it can cause rise in the temperature of our body. Heatstroke can occur if the body temperature rises to 104F(40C) or higher.

Heatstroke requires emergency treatment. Untreated heatstroke can quickly damage the brain, heart, kidneys and muscles. The longer the treatment is delayed, more the risks of serious complications or death.

Symptoms of heatstroke

• ·        High body temperature
• ·        Altered mental state or behavior, confusion
• ·        Body shaking, agitation.
• ·        Slurred speech, irritability, delirium, seizure and coma
• ·        Sweating.
• ·        Nausea and vomiting
• ·        Flushed skin (Skin may turn red as the body temperature increases)
• ·        Rapid breathing
• ·        Rapid heart rate
• ·        Headache

Choking

Choking is the condition of severe difficulty in breathing because a constricted or obstructed throat. Choking occurs when a foreign object becomes lodged in the throat or windpipe, blocking the flow of air. Young children often swallow small objects. Choking cuts off the oxygen supply to the brain. Therefore, first aid should be administrated as quickly as possible.

Signs and symptoms of choking

• ·        A person tries to give signals to the people around him/her. If the person doesn't give the signal, the following symptoms are seen:
• ·        Inability to talk
• ·        Difficulty in breathing or noisy breathing
• ·        Inability to cough forcefully
• ·        Sudden redness of the face
• ·        Skin, lips and nails turning blue or dusky
• ·        Loss of consciousness

First aid of choking

• Give up to five back blows. Hit them firmly on their back between the shoulder blades. Back blows should not be very hard as it may cause injury to the spinal cord.
• If back blows do not dislodge the object, give up to five abdominal thrusts. Hold the child around the waist and pull inwards and upwards above the waist and pull inwards and upwards above their belly button.
• ·Give CPR, if the condition does not improve.
• ·Provide medical assistance as quickly as possible. The victim should be taken to the medical center or an expert should be called immediately.

h) Poisoning

Poison is  a substance that cause disturbance in organisms, usually by chemical reaction or other activity, when an organism absorbs it through any route. The route may be oral (swallowing or eating poison) or respiratory (inhalation of poisonous gas). Sometimes, it may be dermal (through the skin, snakebite, insect-bite etc.). First aid for poisoning depends on the poison entered into the body. Sometimes, poisoning leaves very severe effects and needs proper first aid for the survival of the victim. Contacting a health center or hospital emergency room is the first step in getting proper treatment.

Signs and symptoms of poisoning

Signs and symptoms of poisoning can mimic other conditions, such as seizure, alcohol intoxication, stroke and insulin reaction. Common signs and symptoms of poisoning may include:

• ·        Burns or redness around the mouth and lips
• ·        Breath that smells like chemicals, such as gasoline or paint thinner
• ·        Vomiting
• ·        Difficulty in breathing
• ·        Drowsiness
• ·        Confusion or other altered mental status

First aid for poisoning

Looking at the signs and symptoms of poisoning, the first aider must try to find out the causative poison substance in the victim's body. According to the nature of poison and its effects, the most appropriate first aid method should be adopted. General first aid measures for poisoning are as follows:

• ·        Identify the cause of poisoning
• ·        If the victim is unconscious, take him/her as fast as possible to the health center or hospital. Do not try to force the victim or administer any other substances into his/her mouth.
• ·        If the victim is conscious and the poisoning is through the oral route, compress the abdomen and put a finger into the mouth to stimulate vomiting. (If petroleum substances, alkali or acid is swallowed, do not urge the victim to vomit).
• ·        If the victim has vomited, the sample should be collected and taken to the hospital along with the person.
• ·        Any empty bottle and pack found near the victim should be taken to the hospital for examination.
• ·        It is better to provide milk or clean water if the victim is conscious.

J) Frostbite

Frostbite is an injury caused by freezing of the skin and underlying tissues. First your skin becomes very cold and red, then numb, hard and pale. Later, the color of the skin turns bluish and black when the effects are aggravated. Frostbite is most common on the fingers, toes, nose, ears, cheeks and chin. Exposed skin is cold, windy weather is most vulnerable to frostbite. Frostbite can occur on the skin covered by gloves or other clothing if they are thin and non -protective.

The first stage of frostbite is called frostnip. It doesn't cause permanent skin damage. We can treat very mild frostbite with first-aid measures, including rewarming the cold skin. Severe frostbite requires medical attention because it can damage skin, tissues, muscle and bones. Possible complications of severe frostbite include infection and nerve damage.

• Common first aid measures to be followed for controlling the adverse effects of frostbite are;
• ·        Keep the victim in warm place.
• ·        Do not massage the frostbitten part. It may further damage the underlying tissues.
• ·        Do not expose frostbitten part directly to fire.
• ·        It is better to put the frostbitten part in lukewarm water.
• ·        Provide warm water or fluid to the victim.
• ·        Seek medical assistance as far as possible, if the condition is worsening.