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FIRST AID KIT (a miniature hospital)

First aid kit is a collection of equipment,materials and over-the-counter drugs used in giving first aid.

Do you have one? If No,get one as soon as possible from a store or you can assemble the item into a portable box.

Have one in your house and another in your car.

COMPONENTS OF FIRST AID KIT

* First aid manual
* 25 adhesive bandage (assorted sizes)
* Dressing packs
* Crepe bandage
* Adhesive tapes
* Disposable gloves
*safety pins

* surgical mask
* scissors and tweezers
* A pair of artery forceps
*Disposable syringes (2ml,5ml)
* A bottle of spirit
* A bottle of salvon
* 5 Antiseptic ointment/solution (e.g hydrogen peroxide)
* cleansing soap


* Tetanus injection ampoule
* Pain drug( acetaminophen and ibuprofen )
* Calamine lotion
* 2 hydrocortisone cream packs ( 1%, approx 1gram each)
* Antacid
* Asthama drug
* Antihistamine e.g phenhydramine
* antibiotic ointment packs
* packs of Aspirin
* Petroleum jelly
* Saline solution
* Anti diarrhoea medication (e.g. Oral rehydration salt)


* flashlight and extra batteries (nigerian power issues,for those in developed countries you might find yourself in dark place)
* Blanket
* Mouthpiece for administering CPR
* list of emergency phone number including that of family doctor.


PRECAUTION
* store kit out of reach of children but still within the reach of grown members of the family.

* Replace missing or expired item

* Re check the kit often (the flashlight may not be work or the battery is exhausted,...better to turn the battery in ++ direction,in that way it wont discharge)

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CARDIOPULMONARY RESUSCITATION(CPR)

The new guideline from the American Heart Association recommends that compression of the chest is started before airway. That is C-A-B instead of A-B-C

Here are the steps for CPR under 3 basic heading; C-A-B:

APPROACHING THE PERSON

* Ask yourself: is it safe for me to approach the person? Is it safe for the person too? Check for dangers and clear them or more the person out of the danger. You can do this by placing a hard board or blanket and roll the person onto the material or simply roll the person out of the dangerous area.

* Is the person conscious or unconscious? If he appears unconscious...tap or shake his shoulder and ask loudly...'are you okay'...or...call his name. If the person responds and breathing is good,then leave CPR and give other necessary first aid.
If no responds,the roll the person on his back.

* Call the paramedic or police
However,for suffocated person like drowning, do CPR for one minute before calling.

* Call for an assistant,if available.

COMPRESSION ( ensures adequate circulation )

Start chest compression

* Kneel next to the person's neck and shoulders.

*place the heel of your hand on the centre of the person's chest between the Tips,then put the other hand on top of the first with your fingers interlaced. Your elbow should be straight and your shoulders directly above your hands.

* Press down the chest to at least 2 inches or approx 5cm (for adults and children) and 1.5 inches (for infants).

Do 30 compressions (if well trained in CPR) or 100 per minute (if not well trained). Then move to airway.

AIRWAY

* Clear the airway of any obstruction

* Open the airway with a head tilt and chin lift.

* Check for normal breathing,chest movement, feel for the person's breath on your cheek or ear (this shouldn't take more than 10secs)

BREATHING (mouth to mouth)
while keeping the head tilted and chin lifted.

*pinch the nose of the person to close it. Take a normal breath,cover the person's mouth with yours to create an airtight seal.

* Then give 2 breaths,each should take one second,as you watch for the chest to rise during each breath.

* Continue the compression and breath...30 compressions to 2 breaths...until help comes.
This ratio is the same for one-person or two-person CPR.


DON'Ts

Don't do head tilt and chin lift if you suspect the person has neck injury or fracture.








Self CPR


1 Let’s say it’s 7.25pm and you’re going home
(alone of course) after an unusually hard day on the job.

2 You’re really tired, upset and frustrated.

3 Suddenly you start experiencing severe pain in your chest that starts to drag out into your arm and up in to your jaw. You are only about five km from the hospital nearest your home.

4 Unfortunately you don’t know if you’ll be able to make it that far.

5 You have been trained in CPR, but the guy that taught the course did not tell you how to perform it on yourself.

6 HOW TO SURVIVE A HEART ATTACK WHEN ALONE?
Since many people are alone when they suffer a heart attack without help, the person whose heart is beating improperly and who begins to feel faint, has only
about 10 seconds left before losing consciousness.

7 However, these victims can help themselves by coughing
repeatedly and very vigorously. A deep breath should be taken before each cough, and the cough must be deep and prolonged, as when producing sputum from deep inside the chest.

A breath and a cough must be repeated about every two
seconds without let-up until help arrives, or until
the heart is felt to be beating normally again.

8 Deep breaths get oxygen into the lungs and coughing
movements squeeze the heart and keep the blood circulating. The squeezing pressure on the heart also helps it regain normal rhythm. In this way, heart attack victims can get to a hospital.


DR.N Siva
(Senior Cardiologist)

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SEIZURE

This is commoner in children and epileptics.
Note that seizure can occur without convulsion or loss of consciousness.

Pointers:
_unresponsiveness _staring without blink _twitching involuntarily _fall to the floor _rigidity _loss of bladder or bowel control _foaming in the mouth


WHAT TO DO:

* The goal is to keep the person from injury until the seizure stops or until the person is taken to hospital

* BE CALM (mothers tend to loose their composure in this situation) it's important to be calm and reassure other people who may be nearby.

* Loosen any tight cloth or necklace around the person's neck

* Remove any dangerous object around the person even furniture. If in public,clear people around.

* Time the seizure,note when it started and when it stopped. Also observe the character of the seizure (the doctor will ask you all these in the hospital )

* Don't try to restrict the person's movement or hold him down,unless he moves towards a dangerous object.

* However,if if twitch is not violent...you can cushion his head. Turn him to his side(to prevent choking from saliva or fall back of his tongue). Keep the person airway open by gripping his jaw and gently tilting his head back.

* If the person is a child...tepid sponge his body with cold towel

Call the paramedic or rush to hospital.

For Epileptics...

* Rush the person to hospital if it lasts for more than 5mins otherwise allow the seizure to resolve on its own.

* As soon as the seizure ends,quickly roll the person onto his side,open and clear his airway and mouth.

* Allow the person to sleep until fully recovered.but check for reflex responds every few minutes. However,if he does not wake within 10mins or not breathing well,then seek medical attention.


DON'Ts

Do not put anything (not even drug) into the person's mouth during the seizure or immediately after,unless fully conscious. It's wrong practice to put spoon into the child's mouth during the seizure.

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BLEEDING

This range from mild,moderate to severe bleeding. And can also be internal or external.
The major aid you're required to give here is direct and indirect pressures. Indirect pressure is mostly for moderate to severe bleeding uncontrolled by direct pressure.

EXTERNAL BLEEDING

* If possible, start with washing of your hand,avoid contact with the person's blood or body fluids. Use gloves or plastic (waterproof) bag to cover your hand.

[ DIRECT PRESSURE ]

* Use a pad, clean cloth or hand to apply direct pressure over the wound for 10-15 minutes (for mild and moderate bleeding). For severe bleeding,keep applying the pressure.

* Remove obvious dirt and debris but do not remove embedded foreign material in the wound. Just apply pressure beside it.

* Raise the affected area (this reduces blood flow to the area),...if it's in the arm,you can make an arm sling with a cloth or any available material.

* Raise the person's leg (this returns move blood to the rest of the body and to vital organs like the heart.brain,kidney...)

* If the bleeding stops, hold the pad in place with a bandage.

* Rest the person and the affected part.

* Cover the person to provide warmth.

* For mild bleeding,pressure can stop it and you may then use ur tools in first aid for dressing of the wound or seek help. Medical attention will be needed for moderate to severe bleeding.

* If blood leaks through the padding, apply a second pad over the first one. If the pad is soaked with blood,remove quickly and apply another pad.

* In a case of amputated part, secure the part in a container or a plastic bag and take it with you to the hospital.

[ INDIRECT PRESSURE ]

* If with the above measure the bleeding still continues (and medical help is not available yet)...SQUEEZE A MAIN ARTERY.

Apply a pressure to the artery delivering blood to the area...

Pressure points on the body:

#For arm:
Apply pressure on the inside of the arm just above the elbow and another just below the armpit.

#For leg:
Apply pressure just behind the knee and another in the groin.

Squeez the main artery in these areas against the bone. Keep your fingers flat while with your other hand,continue to exert pressure on the wound itself.




INTERNAL BLEEDING

Seek medical attention at once.

Pointers:
_bleeding from body cavities
_vomiting or coughing up blood
_bruising on neck,chest,abdomen or side
_wound that have penetrated the skull,chest and abdomen.
_abdominal pain tenderness following a trauma, possibly accompanied by rigidity or spasm of the abdominal muscles
_fractures
_shock,indicated by weakness,thirst or skin that's cool to the touch.


WHAT TO DO:

* Lay the person with the head lower than the rest of the body,or just lay flat if the former is not possible. Then elevate the legs.


NOTE:
Some people would prefer managing mild wound at home. But remember that if the wound is deep or resulted from a rusty,metal object,the person requires a tetanus shot.

Tetanus booster doses are given every 10years.

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NOSE BLEED

Common causes:
_picking of nose
_foreign body
_blowing of nose
_allergic reaction
_head injury
_others: tumor,high blood pressure, cocaine use, anticoagulants.

This is commoner during the dry season in nigeria and during winter.


WHAT TO DO

* Put the person at rest,better sitting.

* The person holds his head forward,pinches the whole soft part of his nose with his thumb and index fingers (for about 10 to 20 minutes) and then breaths through the mouth.

* Repeat,if bleeding persist

* Ice pack or cold towel can be applied to the bridge of the nose.

* If the person is a child,distract with TV/stories/songs etc.

* The person should not try to swallow the blood in the throat.

* If re-bleeding occurs after the above, blow out forcefully to clear your nose of blood clots and spray both sides of your nose with decongestant nasal spray containing oxymetazoline. Then pinch your nose as described above while you make your way to the hospital.

* If you're on anticoagulants,control the bleeding and see your doctor as soon as possible.

* Call a doctor if the above does not stop the bleeding or if the bleeding occurs too often.



DON'Ts
* Don't tilt the head backward,the blood can trickle down into the airway.

* Don't bend down for several hours after the bleeding episode and keep the head higher than the level of your heart.

* Avoid picking,blowing or rubbing the nose for 2 days.

* Don't close mouth while sneezing

* Use humidifier at night during dry weather.

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CHOKING

Children are more prone to this. They usually play with small objects like coins,beans, groundnuts, etc. These objects can get lodged in the nose or throat blocking the air flow.

Pointers:
_difficulty breathing
_noisy breathing
_cough or inability to cough forcefully
_loss of consciousness


WHAT TO DO: five-and-five cycle

* Give 5 back blows. Deliver 5 back blows between the person's shoulder blades with the heel of your hand.

* Give 5 abdominal thrusts (Heimlich maneuver)

* Call paramedic or police or rush to hospital

* Alternate between 5 blows and 5 thrusts until help comes or the object is dislodged. Check the person's mouth for the dislodged object.

* If the person becomes unconscious, start CPR (cardiopulmonary resuscitation).


HEIMLICH MANEUVER

# Stand behind the person. Wrap your arms around his waist.

# Tip the person forward slightly.

# Make a fist with one hand. Position it slightly above the person's navel.

# Grasp the fist with the other hand. Press hard into the abdomen with a quick upward thrust_as if trying to lift the person up.

NB: Do a high abdominal thrust if the person is obese or pregnant.


DON'Ts
* Never do a finger sweep unless you can see the object in the person's mouth

* don't give fluid

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ACUTE ASTHMA

Asthma is regarded as a chronic inflammation of the airway which tend to cause muscle spasm,increase mucus secretion and cause narrowing of the airway. Hence the breathlessness the sufferers experience. Its usually triggered by a factor.

Common triggers:
Chest infection,pollen,dust,fur,smoke,fumes from frying oil,cold,exercise,excessive emotions...


Pointers:
_Breathlessness
_difficulty in speech
_chest tightness
_Wheezing
_Persistent cough
_Poor skin colour


¤ Mild attack:


Short of breath, wheeze, cough, chest tightness.



¤ Moderate attack:
Loud wheeze, breathing difficulties, can only speak in short sentences.



¤ Severe attack:
Distressed, gasping for breath, difficulty speaking two words, blueness around the mouth.

WHAT TO DO:

* Remove the person from source of triggering factor

* Rest the person,usually the person sits up,leans forward with his hand on a table or on his knees.

* Administer his reliever medication,one puff at a time (usually one minute interval), use spacer if available,especially for a child.

* Give 3 puffs (mild attack) then 6-8 puffs (severe attack) waiting for a minute between each puff and, if no improvement, repeat after 4 to 6 minutes(depending on the severity).

* Rush to hospital or call paramedic,if these measures are not helpful.



HOW TO GIVE THE PUFFS

#1. Using the inhaler with spacer...

*Remove cap and shake inhaler well.



* Insert inhaler into spacer.



*Have the person breathe out completely and put mouth tightly around spacer mouthpiece.



*Press inhaler once to deliver a puff.

Have the person breathe in slowly through the mouth and then hold breath for 10 seconds.



* Give a total of 4 puffs( for mild attack) or 6-8 puffs (for severe attack), waiting about a minute between each puff.



#2. Using Inhaler Without a Spacer...

*

Remove the inhaler cap and shake well.

*

Have the person breathe out all the way and seal lips tightly around inhaler mouthpiece.



* As the person starts to breathe in slowly, press down on inhaler one time.

The person should keep breathing in as slowly and deeply as possible (about five to seven seconds) and then hold breath for 10 seconds.

*

Give a total of four puffs ( for mild attack) and 6 to 8 puffs( for severe attack), waiting about one minute between each puff.

* After each set of the 4 or 6 puffs, wait for 4 or 6 minutes (depending on the severity). If the person still has trouble breathing, give another set of 4 or 6 puffs.

*

If there’s still little or no improvement, repeat the steps

until ambulance arrives or hospital is reached.

[ Remember to start CPR when the need arises ]

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BURNS

Children,mentally unstable people,light skin and albinos are mostly affect.

Causes:
Fire, hot water, electricity, chemicals, sun ray, lighting.

Pointers:
Severe pain,red skin, peeling or blistering of skin (blackened,if caused by electricity), watery fluid from the affected part, swelling of the affected part.

WHAT TO DO:

* Remove the heat source or the person from the heat source.

* Remove his clothing if it contains the source of the burn

* Use running cool water (but not cold,so no ice pack) to cool the affected part for about 20minutes or immerse the affected part in water...this reduces inflammation and swelling.
Beer or soft drink can be used if water is not available.

* apply first aid gel (if available) to the affected part.

* Remove any ornamentals, jewelries, watches or tight clothing (these maybe difficult to remove when the affect part swells.

* If the person is a victim of burning house...
bring him out in the open space for fresh air...
Check his airway and breathing and clear nose/mouth.
Do CPR, if unconscious or breathing is bad.

If the person is feeling faint,lay him down.

If clothing is on fire...
Cover the flames with coat or blanket and set the person onto the ground to remove oxygen from the burning area.



DON'Ts:

# don't break blisters or remove peeled skin

# don't remove any fabric stuck to a burn

#don't apply creams,ointment or lotion...it can lead to infection

#don't immerse severely burnt area in cold water.


PREVENTION OF BURNS

# install fire or gas leak alarm in the house or workplace

# have fire extinguisher installed in an easily accessible corner of the house.

# put gas cylinders outside the house and well protected from reach of children

# use silk paint instead of oil paint on the walls

# switch off any electical appliance after use.

# always keep hot water or chemicals on the floor but not in pathway. And store chemicals properly.

# albinos, when under the sun, should wear clothing well covering the body and use umbrella and sun shade.

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BITES AND STINGS

Common causes:
Scorpion,snake,bee,ant,wasp...

Pointers:
Pain and swelling of the affected area, discolouration, altered sensation like numbness or 'pins' and 'needles'
Others: nausea,vomiting,headache,poor vision,muscle weakness/paralysis,difficulty breathing.
A small percentage of people can develop severe reaction (anaphylaxis), signs of which include facial swelling, difficulty breathing and shock(clammy skin,racing pulse,confusion or sleepiness).

WHAT TO DO:

* Wash the area with soapy water or salty solution or savlon antiseptic wound wash.

* If it's a bee sting, remove the stuck venom sack by scrapping or direct pull,otherwise it keeps releasing its venom.

* keep the person still/calm. Nervousness increases the spread of the venom.

* keep the affect area lower than the level of the heart.

* If the wound is bleeding apply steps in listed in the first aid for bleeding.

* If it's a snake bite,make effort to kill it and get a picture of it to the hospital or simple note the features of the snake. It will help the doctor decide whether the snake is poisonous or not.
Don't panic when bitten by snake because over 80% of snake are non poisonous and only very few of the of the poisonous get to bite people.

*seek medical attention immediately.

Features of a poisonous and non poisonous snakes:

[Non Poisonous]

Snakes

Head - Rounded

Fangs - Not present


Pupils - Rounded


A'nal Plate - Double row of plates


Bite Mark - Row of small teeth.



[Poisonous Snakes

]

Head - Triangle - except Cobra


Fangs - Present


Pupils - Elliptical pupil

A'nal Plate - Single row of plates


Bite Mark - Fang Mark



DON'Ts

# Don't cut the wound
# Don't drink things like kerosine,oil,alcohol etc
# Don't apply ice

# Applying a tourniquet above the affected area is still controversial.

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MUSCLE CRAMPS

Most of us must have experienced this ugly phenomenon at some point especially during youthful days.
It can occur during activity or at rest. Even at nite, the most annoying...wakes you up from your sweet sleep!
The hardening that occurs will be visible and palpable. It's duration varies and can recur.
The commonest sites are the calf, thigh and foot muscles but can occur on any muscle.


Possible causes:

The exact cause is unclear.
_straining or over use of the muscle
_dehydration and low blood flow to the muscle
_vitamin deficiency
_low level of calcium,magnesium or potassium
_some drugs (that cause deficiency of above named minerals)
_injury to a nerve


Pointers:
Sudden local pain, twitching of muscle, tenderness, firmness, swelling/hardening, inability to use the affected part.


what to do:

* Relax and stretch the affected part (for calf muscle cramps,stretch by standing against wall or pull the foot upwards towards the shin)

* Firmly massage the part

* Apply warm or cold towel or ice pack(whichever that is available) to the affected part. Apply for 20 minutes,then repeat every 3 hours for 24 hours depending on the severity.

* The person should take adequate water and over-the-counter drug for pain.


When to see a doctor:

Cramps are generally harmless but the pain can be excruciating. However,see a doctor in the following situation...

# when it's too severe
# Cramps occur too frequently
# The first aid given isn't helping
# The cramps are not associated with any obvious cause like strenuous exercise.


NOTE:
Cramps (mainly pain) that occurs when you're exercising but goes as soon as you stop the exercise could be pointer to an underlying vascular disease causing poor blood supply to the affected part.


Prevention:

# Fruits
Banana and pineapple for potassium and vitamin E respectively, and other fruits. Milk for calcium.

# Multi-vitamin supplements...especially for night cramps.

# Drink adequate amount of water in day.

# Drink water before, during and after exercise/activity.

# Avoid having your night sleep on a hard surface

# When going for a strenuous exercise like football,first do a warm up like running,this prepares the body.