Emergency at home: What do you do?
View(s):Here’s your guide of do’s and don’ts, compiled by Dr. Steve Cockeram with Smriti Daniel
It could be a stranger or a member of your family but the chances are that at some time in your life you will be a witness to a health emergency. “A loved-one, a work colleague or a complete stranger may suddenly become ill or be injured and need our help,” says Dr. Steve Cockeram, the Chief Medical Officer for the emergency service Falck Sri Lanka.
“Would you know what to do? Do you have the knowledge and skills to save someone’s life?” Of the estimated 10,000 Sri Lankans who are admitted every day to the nation’s emergency rooms, only a fraction receive any medical care before they arrive at the hospital. Sometimes the difference between life and death can be the action taken by bystanders before medical help arrives.
It is why Dr. Cokeram would encourage you to attend a reputed first aid training course where you can practise the essential skills of life saving before you actually need them. For this week’s Mediscene, Dr. Cockeram shares his list of some basic ‘do’s and don’ts’ to guide you in the face of a health emergency.
Chest pain
There are many possible causes of chest pain, the most serious of which is a heart attack. This is when there is a sudden blockage of blood flow to the muscle of the heart.
As your heart needs a constant supply of oxygen-rich blood, a blockage can rapidly lead to permanent damage and even death.
If you are with someone who suddenly experiences severe chest pain, tightness or heaviness, ask them if the pain is spreading to anywhere else.
Pain going to a person’s arms, neck, jaw, back or stomach may indicate a heart attack. Other suspicious features are difficulty in breathing, sweating and looking pale.
Do:
- Sit them down in a comfortable position, even if it is on the floor.
- Call for help from an emergency medical service.
- Reassure them that you will stay with them until help comes.
- If the pain is not settling and they are not allergic to it, give them an aspirin/Disprin to chew. This stops the blockage from getting worse and can save their life.
Do not:
- Move the person or allow them to walk
- Assume that it is just a bit of indigestion or ‘gastric’
- Wait and hope that it will go away. If the pain is not gone in less than 15 minutes you should call for professional help.
We usually think of burns as being caused by fire, however burns may be caused by hot water, electricity or chemicals. The first thing to think about when helping someone with burns is to avoid being burned yourself. Someone whose clothes catch fire should be told to stop (don’t run), drop (drop to the ground) and roll (roll over and over until the fire is out). If an electrical current is involved make sure that the power is switched off before approaching.
Do:
- Cool the burn immediately using lots of running water and keep cooling the burn for 20 minutes. This simple treatment can prevent permanent scarring.
- Once the burn is thoroughly cooled, cover it with a clean lunch sheet or food wrap. This will reduce pain, keep it clean and won’t stick to the burn. It also enables a health professional to assess the burn without removing the sheet.
- If an arm is burned, remove all jewellery immediately. Swelling of the fingers and hand may make it impossible to remove them later and can even cut off the blood circulation.
- Call emergency medical services to help you decide if the patient needs hospital treatment.
Do not:
- Apply anything to the burn. Butter, creams or toothpaste keep the heat locked in and may make the burn worse. They also cover the burn making assessment of the burn more difficult.
- Removing clothing that is stuck to the burn.
- Use ice to cool the burn, it may cause more damage.
Bleeding
There are three main types of bleeding depending on the blood vessel that is affected. Oozing of dark red blood is a minor concern, but dark red blood that is flowing can be serious if not stopped. Bright red blood that squirts or pumps out is severe and can rapidly lead to death. Simple measures that anyone can do will reduce or even stop severe bleeding.
Do:
- Protect yourself from contamination with blood, if time allows. Gloves or a plastic (‘siri siri’) bag is sufficient.
- Place a clean cloth over the bleeding site and press firmly with your hand.
- Use a bandage or long thin cloth to secure the cloth firmly in place.
- Lie the person down and raise the affected part up.
- Call an emergency medical service
Do not:
- Panic, the sight of blood can be frightening, but you will need to remain calm.
- Remove the bandage, even if it gets soaked in blood. Just add another one over the top of the first. Removing it will disturb any clot that is forming and worsen the bleeding.
- Put sand or any other powder on the wound, this will not stop severe bleeding and may cause infection of the wound.
- Apply any cream or ointment to a bleeding wound.
Head injuries are a common problem, particularly in children. Fortunately most are nothing to worry about, but it is important to know what to look out for in case it is a more serious injury. Any of the following features should prompt you to seek urgent medical assessment: loss of consciousness at the time of the injury, vomiting, drowsiness, double vision or a severe or worsening headache.
Do:
Allow the person to rest quietly in a comfortable position.
Put an icepack on the injured area to ease pain and reduce swelling. The ‘home remedy’ of applying eau de Cologne is ok, but is not as effective as ice and should never be applied to an open wound.
Keep a close check on the person for the next 24 hours.
Do not:
Give any painkillers. This may cause a delay seeking professional help by hiding that the person is getting worse.
Leave the person alone.
Seizure
Some people with epilepsy have a tendency to have sudden attacks of unconsciousness and violent body movements called seizures. Seizures may also happen in small children with a high fever, so called ‘febrile convulsions’. Seizures can be dangerous if they continue for too long or happen during a risky activity like swimming or crossing the road. Usually the ‘fit’ will stop by itself within a few minutes and the person will regain consciousness. They may initially not know where they are or what has happened and feel embarrassed.
Do:
- Protect them from injury by moving hard or dangerous objects away from them and putting something soft under their head like a folded cloth
- Once it stops, roll them on to their side, tilt their head up and check for breathing
- Keep a check on how long the seizure is going on.
- Call for help from emergency medical services if it is going on longer than five minutes, they injure themselves or they are not known to have epilepsy.
Do not:
- Try to hold them down or stop the violent movements.
- Put a spoon or anything else in their mouth. It will not stop them biting or swallowing their tongue, but may damage their teeth or cause choking.
- Put water on their face.
A broken bone in the arm or leg typically causes severe pain, swelling, inability to use the affected part and the limb may be misshapen. Not all broken bones are as obvious as this description, but most breaks can be identified by the severity of pain. Broken bones are often treated incorrectly causing more harm than good.
Do:
- Ask the person to support the broken limb.
- Find things to provide support and padding to the broken limb such as pillows, towels, folded clothes.
- Gently apply an icepack, if you have one.
- Call emergency medical services for help getting the person to hospital.
Do not:
- Try to force the bone back into place; you will cause more damage to the muscles, nerves or blood vessels, not to mention cause severe pain.
- Move the person unnecessarily. Only if the person is in danger, or there are no emergency medical services in your area should you consider moving them yourself.
Asthma attack
People with asthma may have sudden difficulty breathing due to an allergy, breathing dust or smoke or intense emotion such as crying or laughing. This happens because the muscles in the tubes of the lungs spasm causing them to narrow. The result is wheezing, coughing and difficulty breathing. Attacks may settle down in a few minutes with the proper treatment, but can rapidly become worse and even life-threatening.
Do:
- Sit the person down and make them comfortable, usually they will prefer to sit straight up or slightly forward.
- Ask them if they have any medicine with them for wheeze. If so, help them find it and take it.
- If it is not settling within a few minutes, call an emergency medical service
Do not:
- Lie them down
- Leave them alone
- Ask them to breathe into a bag
Fainting or unconsciousness
Feeling ‘faintish’ or becoming unconscious may happen for many reasons. Common causes include overheating, dehydration, head injury, emotions such as fear and some types of medication. The feeling of fainting or blacking out mat rapidly lead to unconsciousness if the correct actions are not taken.
Do:
- Lie the person down
- Lift their feet about one foot above the level of their head
- Loosen any tight clothing like shirt and tie, saree jacket
- Fan them if they are hot
- If they do not recover within a couple of minutes, then call for emergency medical services
- If they become unconscious, then roll them gently onto their side. Whilst supporting their head, gently tilt their head up. This will ensure that they can breathe and will not choke on any vomit or blood.
Do not:
- Hold them upright if they collapse. Allow them to slowly crumple to the ground.
- Put anything into their mouth, they could choke.
- Give anything to drink unless they can sit up and are able to talk normally
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