An accident has happened…Wachira John
It’s a cold night in a town far away; away from the city. There is a laptop on the table and a lad seated behind it; thinking. A man is seated on an adjacent couch. The lad asks a question. That lad is me, at home with a man; this man I’ve known for over 20 years. (Boy, I feel old). That’s dad. The question escalates to a conversation which is mainly about first aid. As we go on, I begin to realize how important it is to have information about first aid. Some practices done by first aides to help a patient after an accident is the reason the patient’s condition deteriorates. The intention is fine alright but it does not necessarily mean they’re doing the right thing. Quite honestly, I was shocked that some things I thought were right to do in the event of an accident are actually wrong. I thought it wise to share the information I received.
To illustrate how lack of information can cause even more trouble, he gave me the example of a fracture. A fracture, or bone fracture is a medical condition where the bone is broken due to stress or force. Take a spinal fracture for instance, which could happen after someone falls from a tree, or hit by a car, or just simply as a result of high impacting force. Most of the times, the condition of the spinal fracture patients is made worse by people who arrive first on the scene to try help the situation. And this happens because of the way they lift these patients. A good first aide would first clear any danger surrounding that person, ensuring that there isn’t an object or anything where the patient is that could further harm him/her. What mostly happens is; the patient is hauled into a vehicle and rushed into hospital. What such first aides do not know is that the fragmented broken bones near the spine pose as potential risks that can pierce the spine if the patient is lifted incorrectly causing paralysis.
A sprain is a soft tissue injury. There isn’t bone damage here as is in fractures. Your joints have a given scope of movement. If for some reason they are overstretched, you might have partial tear or complete tear of tissue (ligaments) in the affected area. When this happens, the body triggers the inflammatory process which involves a lot of blood being pumped into the injured area. (Or like dad would like to simplify it, to bring food and oxygen to the affected area; all this with good intention.) But then, the blood vessels cannot cope with the sudden upsurge of blood and so they are overstretched. At this stage, pain is experienced. Swelling comes in because since blood vessels cannot hold, the liquid part of the blood, serum, sips out of the vessels to the surrounding tissues and because there wasn’t an ‘empty’ space for it to occupy, there is corresponding swelling to accommodate the serum surrounding the tissues of the affected area. Ultimately, when such a patient gets to hospital, doctors administer anti-inflammatory drugs which reverse the effects of the inflammatory process of the body. This reduces the swelling and eases the pain.
The following paragraph presents the first aid you should administer should you encounter such a person.
R.I.C.E is an acronym depicting the first aid that should be administered when a sprain or fracture situation is encountered. You do not necessarily have to do the activities listed under R.I.C.E in their exact order.
R – Rest
After everything is said and done, the affected area whether a sprain or fracture should not be used at all. The part is supposed to be rested. The reason why the part aches is because that’s the body’s way of preventing you from using it. When you go to hospital, usually they put a cast which is commonly referred to as plasta. That plasta has no medicinal value. If the doctor knew you’d not use that part for a prescribed period of time, he/she wouldn’t put the cast on. But since we are very stubborn and will sure work that part after some time before it fully heals, the doctor certainly puts on a cast whenever it’s necessary after a fracture or sprain injury to prevent you from using that part for a given period of time.
I – Ice
Inflammation as a result of sprains or fractures comes with heat. Cold will cause contraction. Heat is a good environment for swelling. The case with blisters when there is a burn. Ensure to provide a cold environment to the affected area. Use ice.
C – Compression
To counter the swelling, gently bandage the affected part.
E – Elevate
The importance of elevation is that it makes it hard for blood to flow in raised areas. Blood would not flow as easily as it should if you raised your hand. Since inflammation would cause the body to pump a lot of blood to the area and this in turn causes swelling, it would help a bit to reasonably elevate the injured part.
(Then I asked about fainting.)
It is important to understand what has happened in order to know what to do. When you say a person has fainted, what you are actually saying in very simple words is; the brain is lacking ‘food’ or nutrients. This might be as a result of two things. The blood which supplies nutrients to the brain lacks adequate nutrients to nourish the brain or there isn’t enough blood to transport nutrients. In case of an accident and a person loses a lot of blood internally or externally, they are bound to faint. There also are drugs that would cause blood vessels to dilate therefore causing blood pressure and movement to decrease. If the brain does not get a certain amount of nutrients, you will go into hypovolemic shock what we know as fainting. The brain is a pretty sensitive organ and starving it even for short period of time could cause permanent damage. In such cases what a first aide should do is reverse that effect (blood not getting to the head.) Ensure that patient is comfortably inclined in a position that has his/her head positions below the heart (elevate ribs/chest) in order to ease and enable more blood flow to the head. Or quite simply make sure the patient’s legs are elevated. Also make sure where the patient is lying has good ventilation. Eventually, the person should seek medical attention.
The same reasoning (as is in inflammation) is applied in asthmatic patients. When such a patient is exposed to an allergen, (an allergen is a substance that causes an allergic reaction. An allergy is a condition which the immune system reacts abnormally). For instance, there are people allergic to dust, grass, pollen, fur et cetera. Some common symptoms include red rash, swelling and nose blocks. So when an asthmatic person encounters an allergen, the body releases histamine which causes nose blockage by triggering production of mucus to avoid further inhaling the allergen. It’s a good move from the body but then the person has difficulty in breathing because the airway has been shut. The first aid you should provide is to ensure that the person is free from the allergen if it is known, ensure that where the person is has good ventilation with good exposure to clean air. Also, make the patient sit down because that’s the best posture that allows chest expansion. Ultimately, take the patient to hospital. Doctors will administer anti-histamine drugs to reverse the effects of histamine.
There are two types of burns:
- Liquid burns
- Dry burns.
In the event of a liquid burn, the first thing to do is dip that part in cold water. A lot of cases we receive are of little children. In the event that a hot liquid burns a child, or anyone for that matter, before you even try to take their clothes off, pour cold water on them to cool off the heat. If you try to take off the clothes before administering cold water, you will peel off the skin and break the blisters formed hence causing the body to loose body water (dehydration) therefore risking kidney failure which is a likely cause of death in burn patients.
Make sure you pour cold water on a person who has had a liquid burn. After that, tear their clothes using scissors. Removing the clothes normally would risk peeling off of the skin. After this, rush that person to hospital. There are people who pour flour on the burn patient. NEVER do that! It makes it worse.
For dry burns, rush that person to hospital the fastest you can.
The following acronym summarizes what any first aide should generally do in the event of an accident.
D – Danger
A good first aide will ensure that the patient is under no further danger. That itself is first aid. Rushing to bundle them onto a car could aggravate their condition as we saw earlier. The first aide should ensure that the scene of the accident is a safe zone. It is not once that there’s been a road accident and shortly afterwards, on lookers are swept off by on coming vehicles. The first aides there failed to secure the scene to prevent lurking danger. Since you are informed on first aid practices, take control of the situation, be firm on your stance and give appropriate directions.
R – Response
To the patient, try getting a response from them. If they are able to respond, try getting their name and any other information you can get about them. This is because the patient can go into comma.
A – Airway
Make sure the patient’s airway is clear. Could be the patient is not positioned correctly or something is blocking their airway, as a first aide, it is your job to ensure their airway is clear.
B – Breathing
Make sure the patient is breathing. This comes after the previous step of ensuring the airway is clear.
C – Circulation
Feel their pulse to know if there is blood circulation. Arrest any bleeding on the patient. Tie the area that is bleeding with a clean cloth. To further arrest the bleeding, tie the preceding part before the bleeding area to reduce blood flow.
I will end this post with a statement mum mentioned in the course of the conversation, “The first approach given to a patient is very vital. It is the determinant of survival for that patient.”