S is for Shock (Medical) – The A-Z of First Aid with Optimum First Aid

Do you know what medical shock is and how to treat a person suffering from this?

If you don’t, spare 2 mins of your day to read up on how you can recognise and treat a person suffering from medical shock – YOU COULD SAVE SOMEONE’S LIFE!

After reading an article regarding a lady being treated for shock in today’s Bristol Post (see link below), I thought I would ask how many of my readers would know what action they would need to take if they came across someone suffering from shock. It is one of those conditions that unless you have received some training on, you would not necessarily know what to do.

http://www.bristolpost.co.uk/woman-treated-after-double-deck-bus-crashes-into-tree-in-hill-house-road-downend/story-30105154-detail/story.html

Medical shock is a very serious and critical condition.  If it is not treated, it can be result in death!

There are lots of different types of life threatening shock e.g.

  • Cardiogenic Shock – Fall of blood pressure i.e. heart related conditions.
  • Hypovolaemic Shock – Loss of body fluids i.e. bleeding, burns, vomiting, diarrhoea, excessive sweating that results in a low blood volume.
  • Anaphylactic Shock – Massive over reaction of the body’s immune system.

However, it is essentially:

A lack of oxygen to the tissues of the body, usually caused by a fall in blood pressure or blood volume.

 

But what will a person look like when suffering from medical shock?

  • Early signs may include pale, clammy skin and a rise in their pulse rate. This is caused as a result of adrenaline being released in the body.
  • Later, there may be blue tinges to their lips and skin. They may have a rapid, weak pulse, be sweating and/or feel sick or dizzy.
  • As the brain is starved of oxygen, the person may be confused/anxious or become unconscious.

 

And what can we do to support a person suffering from medical shock?

  • Lay the person down and elevate their legs if no broken bones.
  • Treat the cause of the shock (if known)
  • Call 999/112
  • Keep them warm (do not overheat)
  • Monitor breathing, pulse and levels of response
  • Be prepared to resuscitate
  • Do NOT allow the person to drink, eat or smoke
  • Loosen tight clothing around neck, chest or waist

 

 

 

R is for Resuscitation – The A-Z of First Aid with Optimum First Aid

The biggest thing you can do in first aid is simply to be willing to stop and offer help. According to UK research conducted back in 2010 only one in ten people were willing to do CPR if they found a child on the street lying unresponsive and not breathing.  A further 62% of the UK adults surveyed by The British Heart Foundation, did not know what to do when a cardiac arrest occurs, while over half of them have never received training for CPR.

The skills we’re going to look at today in our blog are what most of us think of when we talk about first aid.  CPR.  The letters CPR stand for cardiopulmonary resuscitation.  

First aiders refer to CPR as the basic first aid procedures that can be used to keep someone alive until the emergency medical services can get to the scene. The most important skills are chest compressions to pump blood around the body, and rescue breaths to provide oxygen. Rescue breaths are also known as the ‘kiss of life’.

Here’s our very simple and easy guide to CPR best practice (DR ABC).

Danger – Look for any danger (you, casualty and any bystanders).

Response – Are they alert? Are they responding to voice (talk into each ear) or touch (pat their shoulders).

Airway – Check nothing is in the front of the mouth (remove). Open the airway.

Breathing – Check for regular, rhythmic breathing (looking down the line of the chest, feeling for breath against the cheek and listening for breathing in your ear).

Call for Help 999/112 & AED – If adult.  If child 5 initial inhalations, continue repeating 30 compressions & 2 inhalations for 1 min then get help.

CPR – 30 Compressions to 2 inhalations, repeat until help arrives.

Top tips:

Always remember that you should not put yourself in danger.  

There are only 4 instances in which you should stop giving CPR, these are:

  1. When a healthcare professional tells you to stop.  
  2. When you are physically too exhausted to continue.  
  3. When the casualty regains consciousness and is fully alert and breathing normally.
  4. When another first aider is able to provide CPR support.  Minimise delays when changing and do not interrupt chest compressions. The optimum time for first aiders to swap over is every 2 mins.

Did you know?

You can improve someone’s chances of survival by up to 75% if CPR is given in the first 3 mins.

Depths of compressions are: adult – 6cm, child – 5cm, baby – 4cm.  It is better to go deeper than not deep enough!

There is a strong possibility that you detach a rib and so don’t be surprised if this happens.  This is a secondary problem, your priority is inhalations and compressions.

If you are unwilling (infection) or unable (not trained or unable to provide a seal over the mouth) to give chest compressions, carry out chest compressions only.

If the person vomits whilst giving CPR, roll the casualty onto their side, tip the head back and allow the vomit to run out.  Wipe their face and continue giving CPR, using a protective barrier if possible.

R is for Recovery Position – The A-Z of First Aid with Optimum First Aid

Many of us have all been in a situation when we have had one too many glasses of wine or beer and we are feeling a little worse for wear the next day.  Or, we have been that person who has watched over our friend throughout the night when they have been in that situation.   But when this happens, what is the best position to put them in?

With Christmas fast approaching and social events filling your diary, I thought it would be timely to link this week’s blog with November’s National Alcohol Awareness Day and talk about the ‘Recovery Position’ or what is known as the ‘Safe Airway Position’.

When someone is lying on their back unconscious, the airway can be blocked in 2 ways:

  • Tongue touching the back of the throat OR,
  • Vomit if the person is sick

Because of this, It is essential that unconscious casualties take priority and obtain urgent assistance.

So how do we do this?

 

Take a look at this Toddler demonstrating the recover position – a great example that anyone can learn the skills required to keep someone safe.

 

Then……..continually monitor the person, checking:

  • Airway open
  • Breathing (regular and rhythmic)
  • Circulation (pulse)
  • Levels of Response
  • Ambulance is on its way

REMEMBER THE DOs and DONTs

  • DO turn the person onto the opposite side every 30 mins if they are in a position for a prolonged period
  • DO place an unconscious heavily pregnant person on her left side to help circulation
  • DO NOT place a pillow under the head whilst the person is on their back
  • DO NOT place anything in an unconscious person’s mouth

Top Tip:

Once in the recovery position, ensure the airway is open and the mouth is facing downwards.  If it is still facing up, move the shoulder towards you by a few inches and you should find the head (mouth) will drop downwards.

B is for Bleeding – The A-Z of First Aid with Optimum First Aid

Today we’re continuing to follow the alphabet and looking at the letter “B” for Bleeding as part of our alphabetical approach to First Aid. We know, we’ve skipped slightly out of order on A-Z having taken a deviation via chocking and burns before bleeding but it’s all been relevant given recent celebrations for Halloween and Bonfire Night. 

So as you may have guessed in first aid training we deal with many different scenarios involving blood, we’re not generally too squeamish about the red stuff. The scenarios we look at range from the the straightforward nosebleeds to internal bleeds, in addition to the unpleasant task of dealing with complicated fractures, embedded objects and significant blood loss. If you consider the different types of bleed, wound management and how blood loss affects the body, there is a lot to learn!   If you’re feeling squeamish, we’d recommend stopping here, we go into quite a lot more detail in this post. 

Catastrophic Bleeding: Whilst checking to see if the person is breathing regularly and rhythmically is normally our highest priority, an exception to this is if you are faced with a catastrophic bleed i.e. a major arterial or venous bleed where a person is bleeding so fast, they could die within 3 minutes.  In this instance, the bleed would take the highest priority.  Once controlled, you would revert back to the ABC (Airway, Breathing, Circulation) protocol.

Internal Bleeding:  This is a very difficult condition to recognise but one that can be very serious. Consider internal bleeding if there are no signs of external bleeding but the person is displaying bruising, swelling, pain and/or signs and symptoms of shock i.e. pale, clammy skin and a rise in pulse rate.  Possible injuries could be lung, abdominal, brain haemorrhage injuries or bleeding from a stomach ulcer.  If you suspect internal bleeding, call 999/112 and treat for shock.

Treatment: With regards to general treatment for external bleeds, with effect from Oct 15, ‘elevation’ was removed from the list of steps when dealing with bleeding.  This was because ICLOR (International Liaison Committee on Resuscitation) found that there was not enough evidence to suggest that ‘elevation’ would stop the bleeding on its own. It was subsequently removed to allow first aiders to focus on the steps where there was sufficient evidence that did stop the bleed on its own i.e. direct pressure.  The use of indirect pressure points (brachial and femoral artery) as a last resort was also removed.  In its place, is the introduction of tourniquets and haemostatic dressings (used effectively by the military for many years) for life-threatening bleeds that cannot be controlled by direct pressure. Haemostatic dressings and tourniquets are easy to use, however, specific training is essential to make sure the application is safe and effective.

Before treating you should always consider the following:

  • If the casualty is conscious, remember to ask the person’s consent before treating.  If unconscious, assume implied consent.
  • Wear gloves/apron.
  • Use a dressing that is a low-adherent and an appropriate to the size of the injury.
  • Check the dressing packaging has not been tampered with and that it is in date.  Use immediately.
  • Avoid touching the part of the dressing that covers the wound.

The basics for managing external bleeding is to remember something really simple ‘SEPD’:

  • Sit or lay the person down.  Consider location of wound and extent of bleeding.
  • Examine – Identify type of bleed, exact location and look for foreign objects.
  • Pressure – Continuous for 10 mins. Place around embedded object.
  • Dress (maximum of 2 bandages)

Check circulation is flowing at the far side of the dressing. Adjust dressing if required.

After treating:

  • Ensure the contaminated dressings, wipes etc are disposed of correctly i.e. yellow/orange ‘clinical waste bag’.
  • Wash hands thoroughly.

Effects of Blood Loss:

We know that as a general rule, we can afford to lose approximately 10% (approximately 1 pint) of our blood volume without feeling any real negative effects.  However, anything in excess of this, the body will start to show some signs and symptoms of hypovolemic shock (low blood volume) i.e. loss of body fluids which include blood, burns, vomiting/diarrhoea and excessive sweating. Trying to establish how much fluid has been lost can be very difficult as it can be absorbed by clothing or diluted with water/liquid or different surfaces.  Recognising the signs and symptoms of hypovolemic shock is therefore essential e.g. increase in pulse, pale clammy skin with possible grey/blue tinges, dizziness, nausea & vomiting etc   Critical blood/fluid loss levels are 30%, and if left untreated , it could be fatal.  Treatment for bleeding  and shock is necessary.

 

Thanks for tuning in today to take a read of our blog.  We like to leave you with an interesting fact.  This one, caught our eye recently.  Did you know, Mosquitoes prefer blood type O to any other?

Tune in again next week for more A-Z First Aid Top Tips.

If you’d like to learn more about First Aid, please get in touch to discuss training.