P Files 20-Jan-2012
“Why are you so worried Mum?”
“Your temperature is over 100 degrees Fahrenheit” “What happens if it gets too high Mum?”
“Well dear if it gets over 105 you can get brain damage”
So with those reassuring words I dived into the nearest cool bath and quickly started shivering.
From Roman times…
There is evidence of first aid dating back to the ancient civilisations. The Roman Legions were the first to have retrieval teams for those soldiers injured in battle and the actual treatment, the first aid, was stolen from the Greeks, such as Hippocrates, considered the Father of Medicine. This was common sense stuff such as splinting a broken limb and stopping blood from wounds. Chopping off infected limbs, were all part of the job description for these early ambos. It is hard to imagine what first aid was like during early human times. Surely there must have been mothers like mine who did something bordering on common sense, but everything else was probably made up on the spot. Mortality rates were spectacular and the acceptance of death as a part of life is very different from our expectations now. There are many parts of the world today where first aid is the only option, we are very lucky to have the healthcare system we do.
In Australia, St John’s Ambulance has a regularly updated manual and thousands of Australians complete their first aid course, or one from many certified first aid organisations. Most homes have a first aid kit, which can vary in size and complexity depending on what sort of injuries the mum is prepared to tackle. With the summer upon us, it makes sense to check the kit.
The home check list is probably all that is really needed for minor issues but if you visit the St John’s Ambulance website you will see a whole range of kits, from the camper to the boaty, even a bites and stings kit. For all their first aid kits for Qld check out www.stjvmrd.stjohnqld.com.au.
Out and About
So let’s assume you will be highly unlikely to be carrying a copy of Kids on the Coast in your back pocket when suddenly you are called on to perform first aid; so we won’t go through first aid in detail here. What is more likely though is you will be carrying around a phone. When at the local shopping centre you may notice that carrying a phone seems to be more important than wearing shoes. But love them or hate them they have some amazing uses and they have come into their own regarding first aid. St John’s have produced and excellent application (app) that is relevant to Australian conditions. It is free, sensible and up to date. Download it and practice using it, so you can navigate quickly to the right section. Unfortunately St John’s not yet developed an app for the Android market. There are some are excellent Android apps available, though the free ones do have some scrollbar advertising.
Phones are also useful for their camera. Sometimes there are situations where videotaping or photographing a particular event involving first aid can be quite useful. No, not a macabre video for YouTube, but to help with a particular diagnosis.
Examples include the following:
- Seizures. If someone else is present to administer first aid, it is very useful to videotape the actual event as it will help answer questions later on.
- Allergic rash. Sudden onset of rash, with lip swelling, possibility of anaphylaxis, if someone is free to take some photos or videotape the episode to clearly establish what sort of reaction occurred, this can be useful later when discussing it with your doctor.
- Snake bite. It is important to try and identify the snake, to ensure the right anti-venom is given. It is ill-advised to catch the snake but picture from a safe distance is useful. This is not advisable if you are the victim. Ring the ambulance first and stay still.
Closer to home
Let’s look at some first aid situations which are more conducive to our part of the world. This list is just a few examples.
After our last few summers it would be more pertinent to include a section on flooding! But here’s hoping we have some summer days. Sunburn is a superficial burn to the exposed skin. This can occur as quickly as 15minutes. Prevention is the ideal, but doctors still see parents presenting with cases of significant sunburn in toddlers and infants. The management is very similar to other burns. Cool compresses, leave blisters alone and paracetamol. There is no place for ‘butter’ (sorry Mum) or any other products. Aloe Vera is trendy and cooling, but there is no evidence it enhances healing.
A common home accident is a toddler reaching up and grabbing a cup of coffee. These can be particularly nasty and if it involves the face or extensive parts of the chest keep applying cold water and you will need to get to the nearest emergency department.
Whilst waiting for the ambulance lie the patient down. Do not touch the wound or wipe away venom. Apply a pressure immobilisation bandage. This involves wrapping a bandage or clothing firmly from the fingers or toes as far up the limb as possible, splint and elevate the limb. Any venom left on the skin can be used to accurately detect which snake caused the bite.
Gently remove the remaining tentacles with sea water (ideally wearing gloves).Place affected area in a bucket of hot water (45 degrees) for 10 - 15mins. This will denature the protein and dramatically improves the pain. Cold water and vinegar are not recommended.
Apply ice and if a funnel web or redback spider (or unknown), call an ambulance. Spider bites are very painful whereas snake bites are painless.
Such as wasp, bee, centipede, scorpion - apply ice. This numbs the area lessening the discomfort and lessens the spread of the toxin.
Unlike in small animals where paralysis is an issue, in children the tick is annoying and simply needs removing. There are myriads of ways of removing these. I favour the lasso method with a granny knot in a piece of cotton tightened after being placed over the tick. This theoretically compresses the jaws allowing for easier extraction.
Upper limb injuries
Usually this is a fall on an outstretched hand which results in either a fracture to the wrist, forearm, elbow or collar bone. In all these cases immobilise the arm with either a bandage or even using the clothing worn and seek medical attention.
Knocked out permanent tooth
Gently clean tooth with saliva or water, and then replace in socket. If this is not possible store in milk or saliva (anyone’s) and try and get to a dentist within 30mins.
A word (or two) about fever in children
There is absolutely no evidence that a high fever from an infection can cause brain damage. The most important aspect of a fever is that this indicates some sort of infection, and the cause of this needs to be established, particularly in infants and toddlers. About 3% of children can suffer a seizure with a temperature, usually this is a one off event though frightening. There is no evidence that controlling the fever with medications or cool compresses will prevent this from occurring. The good news is that febrile seizures are not serious. For more information on fevers and febrile seizure see the Melbourne Royal Children’s website, www.rch.org.au.