First Aid Kits
There are several different kits available, each with slightly different
contents and quantities. However, most good home first aid kits will
contain the following items:
3 x
roller bandages (50mm)
3 x
roller bandages (75mm)
2 x
triangular bandages
Gauze
dressing
2 x
small wound dressings
2 x
medium wound dressings
2 x
large wound dressings
1 roll
adhesive tape (1m x 2.5cm)
Roll
of cottonwool for padding
1 pair
bandage scissors
Safety
pins
1
eyebath
Tweezers or forceps
1 x
burn dressing e.g. Burnshield
1 tube
antiseptic ointment
1 pair
disposable gloves
1
mouthpiece for administering CPR
1
packet assorted plasters
Calamine lotion for soothing skin irritations, sunburn and stings
Thermometer
Rehydration fluid such as Sorel or Rehidrat
Measuring spoons
Dealing with an Emergency No one wants to imagine having to deal with emergencies. But
you can be a lifesaver if you know what to do and are able to help.
Emergencies need quick action, not panic. It sounds like a cliché, but
remaining calm is the key to acting sensibly and with confidence. The
person in need of help will need your assurance, and sensing your own
anxiety and panic will only increase his/her distress.
Don’t wait for an emergency before you refer to these pages. Prepare
yourself now by studying this information and, better still, attend a
first aid course. The information given here is not meant to replace
practical training that is given on a first-aid course. Contact an
Ambulance, the Red Cross or other first aid training organisations for
courses in your area. If you have taken a course previously, make sure
your skills are up-to-date. Make sure that your childminder knows first
aid. Again, don’t wait until it is too late.
Post emergency telephone
numbers next to all phones in your home and office and save them on your
cell phone. Important numbers to keep are of an emergency service, fire
department, nearest hospital, the poison information centre and your GP.
Know the shortest route to hospital.
Any family member with a serious medical condition, such as a heart
condition, epilepsy, diabetes or a drug allergy, should wear a MedicAlert
tag or carry a card. This will ensure that proper care can be given.
MedicAlert identification can be obtained at your pharmacy or doctor. List
any serious medical conditions family members may have and keep the list
handy. Teach your children how to call emergency numbers, and tell them to
show the list to emergency medical personnel.
Keep a well-stocked first aid kit at home and in your car.
There is a wide spectrum of conditions that can be considered emergencies.
Many may turn out not to be as serious as initially suspected, but if in
doubt, it is better to react promptly now, than have regrets later. Dealing
with accidents and injuries
Stay calm,
sum up the situation quickly and act fast.
Before you
act, adopt the SAFE approach.
Shout for assistance, Approach with care, Free the
victim from dangers, and Evaluate the victim. Protect yourself
and the injured person from danger or further injury. Look out for
hazards such as oncoming traffic and fire. If you cannot reach the
person without putting yourself in great danger, leave him or her and
call the emergency services immediately. Remember that you will not be
able to help anyone if you become a victim yourself.
Do not move
the person unless there is imminent danger such as a fire. If the person
must be moved, there should preferably be someone controlling the neck
and head to keep them in alignment, and at least two other people on
either side of the person to lift him without moving the spine.
Get help.
Call out for someone to phone for emergency assistance.
Check for
breathing.
Prioritise
problems. Remember that the most obvious injury is not necessarily the
most serious. Deal with the most life-threatening problems (such as
blocked airway and excessive bleeding) first.
Check to see
if the person is wearing a MedicAlert tag or other medical
identification.
Loosen tight
clothing and cover the person to keep him or her warm.
If there are
no suspected back and neck injuries and breathing is normal, move the
person into the recovery position.
In the case
of serious injury or shock, don't give anything to eat or drink.
When
to call an ambulance Calling for an ambulance is generally the fastest way to reach
a hospital. A private car may be an alternative option, but only if the
hospital is very close by.
In case of poisoning, contact the poison control centre immediately as
emergency steps need to be taken before leaving for the hospital.
Call an ambulance if:
You
don't know what to do or are uncertain of the severity of the injury
Someone is unconscious or struggling to breathe
You
suspect a back or neck injury
Someone may be having a heart attack
A
person is seriously injured
A
small child is injured, unless you have another adult with you who can
drive
There
is serious bleeding that you cannot stop
When you call an ambulance, state clearly:
The
site of the emergency (include names of cross streets, if possible)
What
happened to the victim and the victim’s condition
The
number of the people injured
The
age of the victim
Your
name and contact telephone number
Any
first aid currently being given
Do not hang up until the
operator tells you to. This way you'll be sure that you have given all the
necessary information.
CPR You and CPR (cardiopulmonary resuscitation) can save a life:
here’s how.
Summary
CPR is an
emergency procedure performed if someone has stopped breathing or whose
heart has stopped.
The
firstaider continues to give CPR until the patient starts breathing
unaided or professional help can take over.
CPR involves
giving a repeated cycle of 30 chest compressions followed by two
breaths.
It is better
to give CPR imperfectly than not at all.
If the brain
is starved of oxygen for more than four minutes, as may occur in a
near-drowning or heart attack, permanent brain damage can result. Thus
immediate action is required: every second counts.
The role of
the lay rescuer/first-aider (i.e. anyone who is not a certified medic or
paramedic) is to continue to give CPR until the patient starts to breathe
unaided or professional help arrives to take over.
Even if you
are not an experienced first aider, rather err on the side of giving CPR
imperfectly than not giving it at all - it is always better to try than
not.
Action plan
In an emergency situation it is difficult to remember what to do and so we
learn the simple routine of H H H ABC:
H is for
Hazards
Ask yourself: Are there any life-threatening hazards or dangers to you or
the patient? If so, you need to manage them, or move yourself and the
patient out of harm’s way.
There is
significant risk of infection with mouth-to-mouth contact and so unless
the victim is a family member it is best to use a pocket mask during
resuscitation. (This simple mask, which covers the patient’s mouth and
nose, prevents any contact with body fluids).
If a pocket
mask is not available it is acceptable to do compression-only CPR if there
are no signs of circulation.
H is for
Hello
Is the patient awake or unconscious? Ask loudly: Are you OK? If there is
no response, tap the shoulder. In the case of a baby, tap the feet.
If there is no
response it means the patient is not getting enough blood and oxygen to
the brain and needs help.
H is for
Help
Call for others around you to come and help – there may be a doctor or
paramedic within shouting distance!
Phone for
emergency medical help on one of the following numbers:
112 on a
cellular phone
10177
National medical emergency number for ambulance services
082 911
Netcare
084 124 ER24
Tell the
operator that you have an unconscious patient and state exactly where you
are. They will ask for a call-back number if you have one. If you need
advice on how to do CPR they can assist you over the phone.
A is for
AIRWAY Open the airway.
The patient
will normally be lying on his or her back. Place two fingers on the
forehead and two fingers under the bony part of the chin and gently tilt
the head backwards – the so-called “head- tilt chin-lift” method of
opening the airway.
B is for
BREATHING Listen, look and feel for breathing. Kneel next to the patient with
your head close to his or her head. Look to see if the
chest/abdomen rises and falls. Listen for any sound of breathing.
Feel for any air moving in or out the mouth or nose: hold your
cheek near the patient’s nose and mouth to feel for exhaled air. Do this
for up to 10 seconds.
If there is
breathing (about 12 breaths or more per minute), place the person in the
recovery position.
If there is no
breathing (or if you are unsure), log-roll the patient i.e. roll their
body as a unit (the vertebral column must be kept in a straight line from
head to buttocks) onto his or her back.
If the
patient is not breathing you need to breathe for them:
Again, ensure
the airway is open by tilting the head back - keep one hand on the
victim’s forehead and two fingers of the other hand under the chin to lift
the jaw. Place the pocket mask over the patient’s mouth and nose.
Blow gently
and slowly while you watch to see if the chest rises.
Each breath
should take 2 seconds (one in one out). Between breaths, lift your head
and see if the chest moves. If the chest rises and falls, it is
effective breathing. If it does not, adjust the head and try again. Make
up to 5 attempts if necessary.
(Airway
obstruction is normally related to the tongue and is very seldom due to
foreign body obstruction. However, if there is no chest movement at this
stage, check for a foreign body, and, if there is a blockage, switch to
obstructed airway manoeuvres.)
C is for
CIRCULATION
In addition to breathing for the patient, you need to perform chest
compressions to keep blood circulating to the tissues.
It is
difficult for the lay rescuer to effectively determine whether the patient
has a pulse or not. Therefore, the appropriate action is to start
immediately with chest compressions once you have given 2 effective
breaths.
Chest
compressions:
Kneel beside the patient. Place the heel of one hand in the centre of the
chest on the nipple line (imaginary line joining the two nipples) on the
breastbone. Place the heel of your other hand on top of the first hand.
Lean over the victim with your arms straight and elbows locked, and your
shoulders directly above your hands. Press down vertically on the victim’s
breastbone 4-5 cm to a count of “one-and-two-and-three-and-four…”, giving
one push each time you say a number. When saying “and”, release the
pressure but do not move your hands from their location on the chest. Give
30 pumps at a rate of 100 per minute. Push hard and push fast.
Then give 2
slow breaths.
Repeat the
cycle of 30 pumps and 2 breaths until help arrives or the patient starts
to recover. If you are not sure that the patient is breathing unaided,
continue with CPR. Is it not always obvious when someone has started to
breathe unaided; they may be breathing but not well enough.
Even if the
patient appears to have fully recovered, stay with them and monitor them
closely until medical help arrives.
The American
Heart Association (AHA) recommends a compression-to-ventilation ratio of
30:2 for all lone (single) rescuers to use for all patients from infants
(excluding newborns) to adults. This recommendation applies to all lay
rescuers and to all healthcare providers who perform 1-rescuer CPR.
For lay
rescuers who have not been trained in CPR, or who have recieved training
but feel uncertain about or unwilling to perform ventilation, the AHA
recommends performing compression-only, or "hands-only" CPR i.e. pumping
the chest at a rate of 100 compressions per minute until emergency help
arrives.
Dislocation A dislocation is an injury in which the ends of your bones are
forced from their normal positions. The cause is usually trauma, such as a
blow or fall, but dislocation can be caused by an underlying disease, such
as rheumatoid arthritis.
Dislocations are common injuries in contact sports, such as football and
hockey, and in sports that may involve falls, such as downhill skiing and
volleyball. Dislocations may occur in major joints, such as your shoulder,
hip, knee, elbow or ankle or in smaller joints, such as your finger, thumb
or toe.
The
injury will temporarily deform and immobilize your joint and may result in
sudden and severe pain and swelling. A dislocation requires prompt medical
attention to return your bones to their proper positions.
If you believe you have dislocated a joint:
Don't delay medical care.
Get medical help immediately.
Don't move the joint.
Until you receive help, splint the affected joint into its fixed
position. Don't try to move a dislocated joint or force it back into
place. This can damage the joint and its surrounding muscles, ligaments,
nerves or blood vessels.
Put ice on the injured joint.
This can help reduce swelling by controlling internal bleeding and the
buildup of fluids in and around the injured joint.
Fainting Fainting occurs when the blood supply to your brain is
momentarily inadequate, causing you to lose consciousness. This loss of
consciousness is usually brief.
Fainting
can have no medical significance, or the cause can be a serious disorder.
Therefore, treat loss of consciousness as a medical emergency until the
signs and symptoms are relieved and the cause is known.
If you feel
faint:
Lie
down or sit down.
If you
sit down, place your head between your knees.
Discuss
recurrent fainting spells with your doctor.
If someone
else faints:
Position the person on his or her back.
Elevate the legs above heart level — about 12 inches (30 centimeters),
if possible.
Check the person's airway to be sure it's
clear. Watch for vomiting.
Check for signs of circulation (breathing,
coughing or movement). If
absent, begin CPR. Call your local emergency number. Continue CPR until
help arrives or the person responds and begins to breathe.
Help restore blood flow.
If the person is breathing, restore blood flow to the brain by raising
the person's legs above the level of the head. Loosen belts, collars or
other constrictive clothing. The person should revive quickly. If the
person doesn't regain consciousness within one minute, dial local
emergency medical assistance.
If the
person was injured in a fall associated with a faint, treat any bumps,
bruises or cuts appropriately. Control bleeding with direct pressure.
Nosebleeds Nosebleeds are
common. Most often they are a nuisance and not a true medical problem. But
they can be both.
Among
children and young adults, nosebleeds usually originate from the septum,
just inside the nose. The septum separates your nasal chambers.
In
middle-aged and older adults, nosebleeds can begin from the septum, but
they may also begin deeper in the nose's interior. This latter origin of
nosebleed is much less common. It may be caused by hardened arteries or
high blood pressure. These nosebleeds begin spontaneously and are often
difficult to stop. They require a specialist's help.
To take
care of a nosebleed:
Sit upright and lean forward.
By remaining upright, you reduce blood pressure in the veins of your
nose. This discourages further bleeding. Sitting forward will help you
avoid swallowing blood, which can irritate your stomach.
Pinch your nose.
Use your thumb and index finger and breathe through your mouth. Continue
to pinch for five to 10 minutes. This maneuver sends pressure to the
bleeding point on the nasal septum and often stops the flow of blood.
To prevent re-bleeding after bleeding has
stopped, don't pick or blow
your nose and don't bend down until several hours after the bleeding
episode. Keep your head higher than the level of your heart.
If re-bleeding occurs,
blow out forcefully to clear your nose of blood clots and spray both
sides of your nose with a decongestant nasal spray containing
oxymetazoline (Afrin, Neo-Synephrine, others). Pinch your nose in the
technique described above and call your doctor.
Seek
medical care immediately if:
The
bleeding lasts for more than 20 minutes
The
nosebleed follows an accident, a fall or an injury to your head,
including a punch in the face that may have broken your nose
For frequent
nosebleeds
If you experience frequent nosebleeds, make an appointment with your
doctor. You may need to have the blood vessel that's causing your problem
cauterized. Cautery is a technique in which the blood vessel is burned
with electric current, silver nitrate or a laser. Sometimes your doctor
may pack your nose with special gauze or an inflatable latex balloon to
put pressure on the blood vessel and stop the bleeding.
Also
call your doctor if you are experiencing nasal bleeding and are taking
blood thinners, such as aspirin or warfarin (Coumadin). Your doctor may
advise adjusting your medication intake.
Using
supplemental oxygen administered with a nasal tube (cannula) may increase
your risk of nosebleeds. Apply a water-based lubricant to your nostrils
and increase the humidity in your home to help relieve nasal bleeding.
Puncture wound
A puncture wound doesn't usually cause excessive bleeding. Often the wound
seems to close almost instantly. But these features don't mean treatment
isn't necessary.
A puncture
wound — such as results from stepping on a nail or being stuck with a tack
— can be dangerous because of the risk of infection. The object that
caused the wound may carry spores of tetanus or other bacteria, especially
if the object has been exposed to the soil. Puncture wounds resulting from
human or animal bites, including those of domestic dogs and cats, may be
especially prone to infection. Puncture wounds on the foot are also more
vulnerable to infection.
If the bite
was deep enough to draw blood and the bleeding persists, seek medical
attention. Otherwise, follow these steps:
Stop
the bleeding. Minor cuts and scrapes usually stop bleeding on
their own. If they don't, apply gentle pressure with a clean cloth or
bandage. If bleeding persists — if the blood spurts or continues to flow
after several minutes of pressure — seek emergency assistance.
Clean the wound. Rinse the wound well with clear water. A
tweezers cleaned with alcohol may be used to remove small, superficial
particles. If larger debris still remains more deeply embedded in the
wound, see your doctor. Thorough wound cleaning reduces the risk of
tetanus. To clean the area around the wound, use soap and a clean
washcloth.
Apply an antibiotic. After you clean the wound, apply a thin
layer of an antibiotic cream or ointment (Neosporin, Polysporin) to help
keep the surface moist. These products don't make the wound heal faster,
but they can discourage infection and allow your body to close the wound
more efficiently. Certain ingredients in some ointments can cause a mild
rash in some people. If a rash appears, stop using the ointment.
Cover the wound. Exposure to air speeds healing, but bandages
can help keep the wound clean and keep harmful bacteria out.
Change the dressing regularly. Do so at least daily or whenever
it becomes wet or dirty. If you're allergic to the adhesive used in most
bandages, switch to adhesive-free dressings or sterile gauze and
hypoallergenic paper tape, which doesn't cause allergic reactions. These
supplies are generally available at pharmacies.
Watch for signs of infection. See your doctor if the wound
doesn't heal or if you notice any redness, drainage, warmth or swelling.
If the
puncture is deep, is in your foot, is contaminated or is the result of an
animal or human bite, see your doctor. He or she will evaluate the wound,
clean it and, if necessary, close it. If you haven't had a tetanus shot
within five years, your doctor may recommend a booster within 48 hours of
the injury.
Severe Bleeding
Severe bleeding can rapidly lead to shock, loss of consciousness or even
death. It is usually the result of a stab wound, gunshot, a severe blow, a
deep cut, or a fractured pelvis or femur.
Warning: Never
touch someone's blood without latex gloves unless you are certain of the
person's HIV or hepatitis B status. If gloves are not available, use
plastic bags.
Home treatment
Call an
ambulance.
Apply firm
pressure directly on the wound with a clean pad, bandage or even a piece
of clothing. Apply pressure around an embedded object.
Elevate the
injured limb. Lie the person down.
Remove any
obvious superficial dirt and debris from the wound. Do not attempt to
clean the wound or probe it. If an object is embedded in the wound,
don't remove it. If the wound is abdominal and organs have been
displaced, don’t try to reposition them. Cover with a wet dressing or
cloth.
If the
bandage becomes soaked with blood, do not remove it. Apply a fresh
bandage over it.
Continue to
apply pressure for 10 minutes. If bleeding stops, bind the original
wound dressing tightly with a clean bandage. Check for circulation
beyond the bandage every 10 minutes, and loosen the bandage slightly if
it is restricting circulation. Do not use a tourniquet.
If bleeding
does not stop despite continued pressure on the wound, apply firm
pressure to the main artery between the wound and heart. Squeeze the
artery against the bone. With your other hand, continue to apply
pressure on the wound.
While
waiting for help to arrive, immobilise the injured limb and don't give
the person anything to eat or drink. Treat for shock if necessary.
Signs of internal bleeding
With internal bleeding, a person can lose a huge amount of blood
with no visible bleeding. Suspect internal bleeding if a person has been
in a car accident, has suffered a severe blow to the body or head or has
fallen from a height.
Signs include
coughing up or the vomiting of blood, bleeding from the ears, nose, rectum
or vagina, bruising on the chest, abdomen or neck, wounds that have
penetrated the skull, chest or abdomen, abdominal tenderness or swelling
or fractures. Signs of shock may be present. Get help immediately if you
suspect internal bleeding.
What to Do:
For a Suspected Broken
Bone:
If the
injury involves your child's neck or back, do not move
him/her unless the child is in imminent danger. Movement can cause
serious nerve damage. Phone for emergency medical help. If your child
must be moved, the neck and back must be completely immobilized first.
Keeping your child's head, neck, and back in alignment, move the child
as a unit.
If
your child has 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.
If
your child 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.
Place
cold packs or a bag of ice wrapped in cloth on the injured area.
Keep
your child lying down until medical help arrives.
For a Suspected Sprain or
Strain:
If the
injury involves your child's neck or back, do not move
him unless the child is in imminent danger. Movement can cause serious
nerve damage. Phone for emergency medical help. If your child must be
moved, the neck and back must be completely immobilized first. Keeping
the head, neck, and back in alignment, move your child as a unit.
It may
be difficult to tell the difference between a sprain and a break. If
there is any doubt whatsoever, phone your child's doctor or take your
child to the nearest hospital emergency department. An X-ray can
determine whether a bone is broken.
First
aid for sprains and strains includes rest, ice, compression, and
elevation (known as PRICE).
Protect the injured limb from further
injury by not using the joint. You can do this using anything from
splints to crutches.
Rest
the injured part of the body.
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.
Wearing an elastic compression bandage (such as an
ACE bandage) for at least 2 days will reduce swelling.
Keep
the injured part elevated above the level of the
heart as much as possible to reduce swelling.
Do not
apply heat in any form for at least 24 hours. Heat increases swelling
and pain.
Your
child's doctor may recommend an over-the-counter pain reliever such as
acetaminophen or ibuprofen
Stroke A stroke occurs when there's bleeding into your brain, or
normal blood flow to your brain is blocked. Within minutes of being
deprived of essential nutrients, brain cells start dying — a process that
may continue over the next several hours.
A stroke
is a true emergency. Seek immediate medical assistance. The sooner
treatment is given, the more likely it is that damage can be minimized.
Every moment counts.
If you
notice a sudden onset of one or more of the following signs or symptoms,
call local emergency number immediately:
Sudden
weakness or numbness in your face, arm or leg on one side of your body
Sudden
dimness, blurring or loss of vision, particularly in one eye
Loss
of speech or trouble talking or understanding speech
Sudden, severe headache — a bolt out of the blue — with no apparent
cause
Unexplained dizziness, unsteadiness or a sudden fall, especially if
accompanied by any of the other symptoms
Risk
factors for stroke include having high blood pressure, having had a
previous stroke, smoking, having diabetes and having heart disease. Your
risk of stroke increases as you age.
National medical emergency numbers: 112 on a cellular phone
10177 National medical emergency number for ambulance services
082 911 Netcare
084 124 ER24
