06/01/2011 – Common first-aid mistakes and how to avoid them.

Common first-aid mistakes and how to avoid them.

KNOCKED-OUT TOOTH

Common mistakes:

• Not attempting to replant a knocked-out adult tooth.
• First-aid treatment:
• An adult tooth may be replanted. Clean the tooth in saliva or milk and replace in its original position.
• If unable to do so, wrap the tooth in plastic or store it in milk or sterile saline.

Seek advice from a dentist.

NOSE BLEEDS

Common mistakes:

• Squeezing the bridge of the nose to stop a nosebleed and tilting the head back to stop the bleeding.
• First-aid treatment:
• Apply firm pressure over the lower half of the nose using your thumb and index finger for 10 minutes.
• Sit casualty up, lean their head forward and encourage them to breathe through their mouth and not blow their nose.

Seek medical aid if bleeding is not controlled in 10 minutes.

POISONING

Common mistakes:

• Inducing vomiting after ingesting a poison.
• First-aid treatment:
• Follow the DRABCD action plan (see ACTION STATIONS below).
• Seek advice from the Poisons Information Centre’s 24-hour advisory line 13 11 26 or use the instructions on the container label. However, if following label instructions, ensure that no other substance has been consumed.
• Wash any burning substance off the mouth and face with water.
• Give nothing by mouth.
• Save all evidence of poison taken.

Give oxygen if available and seek urgent medical aid.

SEIZURE

Common mistakes:

• Putting something in the mouth of the person having a seizure to stop them from biting their tongue.
• First-aid treatment:
• During a seizure protect the casualty, remove them from danger or remove dangerous objects that might cause them injury. Don’t restrict movement and do not put anything in their mouth.
• After a seizure complete DRABCD action plan (see ACTION STATIONS below), rest and reassure the person, keep them warm and give them oxygen if available.
• If casualty falls asleep, do not disturb them but continue to check and monitor for signs of life.

Seek medical assistance if the person is injured, if it’s their first-ever seizure, if they are a known epileptic and the seizure lasts longer than five minutes, if another seizure follows quickly or if you are in any doubt.

FAINTING

Common mistakes:

• Placing the person’s head between their legs when they feel faint.

First-aid treatment:

If a person is feeling faint, lay them flat and elevate their legs. Loosen tight clothing and ensure they get plenty of fresh air until the symptoms pass.

CONCUSSION/HEAD INJURY

Concussion is a temporary loss or altered state of consciousness occurring after a head injury followed by rapid recovery.

A subsequent decline in consciousness is a symptom of a more serious brain injury which requires urgent medical attention.
Common mistakes:

• Waking someone up regularly if they fall asleep in the hours after a concussion rather than regular monitoring.
• First-aid treatment:
• Medical assistance is required if a casualty has been unconscious or has not lost consciousness but displays symptoms such as drowsiness, slurred speech, lack of co-ordination, headache, vomiting, bleeding from the ears, nose or mouth or develops changes in the size of the pupils.
• If casualty is conscious and shows signs of drowsiness, place in recovery position and seek urgent medical aid.

If casualty is unconscious and breathing, place them in the recovery position, monitor signs of life and airway and seek urgent medical aid.

HYPOGLYCAEMIA

Hypoglycaemia or a “hypo” happens when blood glucose levels drop too low. It can occur in people with diabetes who are on insulin or certain medication.

Signs of hypoglycaemia can vary but include: weakness, trembling or shaking, sweating, headache, dizziness/light-headedness, lack of concentration/behaviour change, numbness/tingling around the lips and fingers, rapid pulse and irritability.
Common mistakes:

• Not recognising that someone is having a hypo. Hypoglycaemia can cause a change in a person’s behaviour – for example, they may appear to be drunk because of slurred speech or loss of co-ordination, be confused and even lose consciousness or start fitting.
• First-aid treatment:
• Take some quick-acting carbohydrate (containing 15g). Options include: one glass of soft drink (not diet or sugar-free); or half a glass of Lucozade; or one tube of Glucose Oral Gel; or 3 teaspoons of sugar dissolved in tea/coffee or water; or glucose tablets containing 15g of glucose (check the dose of each tablet); or five to seven jelly beans.
• Follow with some longer-acting carbohydrate if next meal is not within 15-20 minutes. This could be either a sandwich; or one glass of milk; or one piece of fruit; or one small tub of low-fat yogurt.

It’s important that if the person having a hypo is unconscious or unable to swallow, they are not given any food or drink by mouth. Place the person on their side, making sure that their airway is clear, and call for an ambulance.

ANAPHYLAXIS

A severe, life-threatening allergic reaction that can result in a rash, swelling around the mouth and throat, restricted airway, abdominal pain, vomiting, feeling faint and loss of consciousness.  Most cases occur after a person with a severe allergy is exposed to an allergen, usually a type of food, insect or medication.
Common mistakes:

• People with allergies not carrying an adrenaline auto-injector such as an EpiPen or Anapen with them; not using the auto-injector or using it too late; and administering the auto-immune injector incorrectly.
• First-aid treatment:
• Give medications if prescribed, antihistamines may be used to treat mild to moderate allergic reactions, however, adrenaline is the only suitable medication for anaphylaxis.
• Locate adrenaline auto-injector if available, people with severe allergies usually carry them with them in their bags or in their pockets.
• Contact parent/guardian or other emergency contact.
• Administer the auto-injector into the thigh, following the instructions on the device, if any one of the following symptoms presents: difficult/noisy breathing, swollen tongue or throat, difficulty talking, a wheeze or persistent cough, loss of consciousness and young children who become pale and floppy.
• Call 000 for an ambulance.
• Lay the person flat and elevate legs. If breathing is difficult, allow them to sit but not stand.
• Further adrenaline doses may be given (when an additional adrenaline auto-injector is available) if there is no response after five minutes.

If in doubt, give the adrenaline auto-injector. Withholding or delaying the giving of adrenaline can result in deterioration and death.

ASTHMA

Symptoms of an asthma attack can vary but commonly include wheezing, coughing, tightness in the chest and shortness of breath.
Common mistakes:

• Not recognising an asthma attack – it doesn’t always involve audible wheezing; waiting until symptoms are severe before starting to use reliever medication; using only a small amount of reliever medication during an asthma attack for fear of overdosing; or using preventer rather than reliever medication during an attack.
• First-aid treatment:
• Anyone with asthma should carry a reliever puffer (such as Ventolin which is blue) and spacer, and should not hesitate to use it when they start to feel symptoms.
• Use the correct puffer – some asthma medications, such as the orange or brown preventers or purple combination medications are for day-to-day management of asthma and will not help in an emergency.
• In the event of an asthma attack, sit the person upright and give medication.
• Shake the reliever puffer (usually a blue device), use a spacer if you have one, give four separate puffs into the spacer. Ask patient to take four full breaths from the spacer after each puff. (It’s important to note that giving reliever medication to someone who doesn’t have asthma is unlikely to harm them.)
• Wait four minutes and if there is no improvement give another four puffs of reliever medication.

If there is still no improvement call 000 for emergency assistance. Keep giving four puffs every four minutes while you wait for emergency assistance.

BURNS

Common mistakes:

• Treating burns with butter or creams and popping blisters. Peeling off clothing adhered to burns or using ice or ice water to cool burns because this can cause further tissue damage.
• First-aid treatment:
• Cool burn by placing it under cool or tepid running water for up to 20 minutes.
• Cover the burn with a wet cloth or non-adherent burns dressing to help prevent infection.
• Give oxygen if available.
• Encourage the casualty to rest.

Seek medical aid if it is a deep burn, a superficial burn larger than a 20-cent piece or for any burns involving the airway, hands, face or genitals.

ALCOHOL POISONING

Drinking large amounts of alcohol can result in poisoning. Alcohol depresses the activity of the nervous system and can cause unconsciousness. There is a danger that if a person vomits then that may be inhaled and block the airway.

Symptoms of alcohol poisoning include slow breathing (less than 12 times per minute or periods of no breathing for 10 seconds or more), the person is unable to be woken, they appear cold, clammy, pale, or bluish in colour.ommon mistakes:

• Inducing vomiting; giving the affected person fluids if they are unconscious; and, leaving someone alone to let them “sleep it off”.
• First-aid treatment:
• Whether the casualty is conscious or unconscious, place them into the recovery position as this will protect their airway and protect them from choking on vomit.

Monitor regularly and seek medical aid if concerned.

DISLOCATIONS

Common mistakes:

• Attempting to put a dislocated joint back into position without medical supervision.
• First-aid treatment:
• Follow the DRABCD action plan (see ACTION STATIONS below).
• If there is no blood flow around the affected joint, move the affected limb gently to try to restore it.
• If possible, apply icepacks directly over the joint.
• Rest and support the limb. If it is a shoulder, support the arm in a position of least discomfort. If it is a wrist, apply a sling in a position of comfort.

Seek medical assistance.

EMBEDDED OBJECT (for example: stick or knife)

Common mistakes:

• Removing the embedded object; putting pressure over the object; cutting the protruding end of an object (unless the size makes it unmanageable).
• First-aid treatment:
• Control bleeding by applying pressure to the surrounding areas but not on the foreign object.
• Apply a ring pad around the object or a bandage on each side of the object to stop it from moving and causing further damage.

Seek medical assistance or call 000.

SNAKEBITE

Common mistakes:

• Trying to “suck out” the venom, attempting to catch the snake for identification; washing the bitten area; elevating the bitten area and removing a bandage once applied. Using a tourniquet which can cut off circulation to the limb or elevating the bitten limb as this can speed the spread of the venom.
• First-aid treatment:
• Keep the victim at rest and under constant observation.
• Commence resuscitation if necessary.
• Apply a pressure bandage over the bite site as soon as possible, using the same bandage or a second bandage extend coverage from the fingers or toes over the entire affected limb.

Splint the leg and call an ambulance

SPRAINED ANKLE

Common mistakes:

• Using heat instead of an icepack.
• First-aid treatment:
• Treatment of sprains follows what is known as the RICE method – rest, ice, compression and elevation.
• Rest the strained limb/joint.
• Ice the sprain with ice wrapped in a damp cloth for 15 minutes every two hours for the first 24 hours, then for 15 minutes every four hours in the second 24 hours. Never apply ice directly on to skin as the skin is too thin and may freeze.
• After icing, apply a compression bandage to the strained limb or joint and elevate the limb.

Seek medical aid if necessary.

TICKS

Common mistakes:

• Squeezing the body of the tick during removal.
• First-aid treatment:
• Remove ticks using fine-tipped forceps or equivalent, press skin down around the tick’s embedded mouth part. Grip the mouth part firmly, lift gently to detach the tick – avoid squeezing the body of the tick during removal.

Seek medical aid if necessary for allergic reaction or infection.

ACTION STATIONS DRABCD

(Dr ABCD makes it easier to remember) is a checklist of actions a first-aid provider should take in assessing whether a casualty has any life-threatening conditions and if any immediate first aid is necessary.

• check for Danger
• check for Response
• check Airway
• check for Breathing
• give CPR

• apply a Defibrillator (if available)

Sources: St John Ambulance WA, Asthma Foundation WA, Diabetes WA, Anaphylaxis Australia, www.resus.org.au and Thewest.com