So I completed a First Aid course today. It was not the first one I’ve done. At a guesstimate I’d say it was about the eleventh, one every two years for the past twenty in my capacity as an early childhood teacher . Techniques have changed over the years but the underlying foundations of first aid remain. In 40 short years I have racked up quite a collection of not only my own medical moments, shall we say, but those of others too. As the day unfolded, the tragic enormity of this reckoning did play upon my mind somewhat.
Broken bones are the leading injury in my family, currently the tally sits at 15. During the explanation and treatment of such an injury, I found myself all too familiar with terms like stable, open, compound, transverse, oblique, fracture, and displacement.
I know a little something about casts, most memorable to date, the Spica; a body cast that wraps itself from ones foot to their waist, completely immobilizing its patient at a 25 degree half lying half sitting angle. The hanging cast, which is traction by gravity, consists of a heavy plaster cast applied to the upper arm, at a 90 degree angle, to the lower wrist. Patients must sit upright 24/7, so as to maximise the effect of the hanging cast, as the weight of it pulls the broken bone into line. One can only describe it as a ‘horror’ scene when ones child suffers an accident that requires both a spica and hanging cast for treatment of both a broken femur and a broken humerus. The weeks I sat beside my darling 9 year old, a witness to her agony, was almost more than I could bear.
Splints, yes we’ve done those. Same daughter fell once, in a park on the other side of the city, we’d arrived by ferry boat, and had no access to a car. The fall was decent, causing a distal radius fracture, or simply said, a broken arm. The medics splinted my daughters arm, using cardboard and bandages, then told me it would be quicker to cross back on the ferry, rather than go by ambulance, and have someone meet us at the terminal to transport us to Hospital. It was nearing the end of the day and the motorway was packed with traffic. Needless to say, the splint worked a treat, the ferry was quick, and the thirty other children I had in my care (I was managing a holiday programme at the time), were all amazing too.
Slings, I’ve gotten pretty good at twisting and tying these, and can recommend a good rehabilitation stockist for speciality slings, they are dark blue and have lots of padding in the neck strap, great for broken collar bones.
Sprains can be as bad as, if not worse, to recover from as a broken bone. As a keen athlete I’ve had my share of sprained wrists and ankles, but the worst by far I can still hear. The ‘crunch’ as I snapped my tendon rolling my ankle, in the rain, outside a public library. The experts say RICE, rest, ice, compress, elevate. Or in my case, a cast, rest, and elevation.
Choking, I recalled the time a child in my care swallowed and choked on raw carrot sticks. I remember vividly giving back blows and chest thrusts, running to call for an ambulance, waiting for the ambulance, the ride to hospital, not being able to contact his mother, arriving at the Hospital, and the x-rays that showed the chunk of carrot lodged firmly in his windpipe, but not entirely blocking it. The poor little poppet had to have a general anaesthetic to have the carrot removed.
Strokes, are nasty business. I thought of the morning we found my friends elderly father, stiff as a board, unresponsive, yet breathing, his face distorted. And my own darling husband once suffered a series of mild mini strokes. Whilst one is often unsure what to do in these situations, best practice is always to call an ambulance.
Bleeding, a few times over I recall seeing blood. My heart especially sank at the memory of my eldest daughter, the moment the ambulance doors opened and I saw her swollen bloodied face. I remember the smell of her blood as it dripped from her broken nose hour upon hour as she lay on her hospital bed. Her teeth were wired back into place, her collar bone broken, and her knees badly damaged, the night she fell face first, from a bunk. I sliced my finger on a guillotine late one night as I finished an art assignment, my Dad has had his leg sliced to the bone by a rouge trailer-end flying open, and my son once sliced open his nose on the sharp corner end of a TV cabinet. Best first aid practice for bleeding is to apply pressure, and elevate the wound above the heart. For unmanageable bleeds call an ambulance. If a patient loses a finger from a door slam accident, did you know you should never put the severed finger in ice, apparently it kills off the nerve endings. Place it in a sealed plastic bag, and rest the bag in a bowl of cold water to help preserve it until further medical assistance in hospital.
Electrocution, well that would be me, again, in a house my parents were building. I held onto some exposed wires behind a light switch that was detached from the wall. I blew a hole in my finger and felt the true force of the opposite wall as I literally slammed back into it. If you suspect someone has suffered an electrical shock, first task at hand is to secure and make the area safe by either turning off the power or calling in the experts to. The patient will require immediate medical attention, call an ambulance. If unconscious, administer CPR.
Allergic reactions, my least favourite medical subject. I’ve lost count how many times I’ve eaten fish or seafood by accident, causing the most unsightly condition of anaphylaxis, anextreme and severe allergic reaction. My whole body is affected, often within minutes of exposure to the substance which causes the allergic reaction. I am practised in using an Epi-pen, and having had adrenalin administered know too well the full awfulness of it. I’ve had the odd quick ambulance ride to seek higher medical assistance after losing the ability to breathe and see out of swollen eyes. Ingestion is the worst, but the mere touch of seafood on my skin will trigger my body into physically shutting down. If you know a person who suffers from a severe allergy, talk to them about it, be aware of what type of medication they take, and how to help administer it. If an auto adrenalin epi-pen has been administered the patient will require immediate medical attention, call an ambulance.
Asthma, I grew up with, exercise induced asthma, I am not a regular everyday sufferer of Asthma, but have enough to warrant using an inhaler and knowing too well what it’s like to not be able to breathe. My dad is a chronic asthma sufferer, I’ve seen him breathless, it’s always awful. If someone is having difficulty breathing, making wheezing sounds, etc, ask them if they are asthmatic?, if they have an inhaler?. A Ventolin inhaler is one of the only types of personal medication that can be shared, often a patient in difficulty can be aided by another asthma patients inhaler.
Burns, who hasn’t burned themselves? Days before my wedding, I was making pop-corn in a preschool microwave, I opened the door before the popping had stopped, one little kernel flew at me and landed right under my eye, it was so hot it burned a little hole right there where it landed. A minor burn requires cooling under cold running water for at least 20 minutes, for serious burns do the same and call an ambulance.
Heatstroke, well yes, I’ve been guilty of sunbathing, in baby-oil, for far too long. If a child is suffering heatstroke, best practice is to remove most layers of clothing, do not cool in a cold shower as this can put a patient into shock.
Car accident, the one I caused, I fractured both my thumbs, a result of tightly gripping the steering wheel as I braced myself for the impact I knew was coming after being unable to stop quick enough behind an unsuspecting car infront of me. The one I observed involved a car and a vesper, and it was horrid. The poor patient, a woman, lay limp and lifeless on the road in front of me. She was knocked from her bike by a left turning car, as she drove forward in a cycle lane. I felt like a sergeant major as I asked people to help direct traffic, call an ambulance, support the patients leg and a whole lot more. I conversed with tow truck drivers and police officers too.
Speaking of calling for an ambulance, I remember the day a staff member had fallen, slipping on wet lino at a preschool. First aider me was on the scene first. After assessing her injury, which looked to be a horrific looking broken leg, I glance up and asked the next nearest staff member to “call an ambulance”. She looked at me in a stressed-out state and said “what’s the number”? Being from Australia, she had no idea what the number was to call for an ambulance in NZ, it’s 111 in case you’re not from here either. This ensued a conversation about who which service to ask for and what information is needed when making a 111 call. I don’t like making these calls, but have made them. Like the night my daughter got her retainer caught in the back of her throat, it peirced her uvula, the dangly thing at the back of your throat, and as she screamed it sucked back into her throat blocking her airway. The three paramedics that arrived with siren and flashing ligts, could not detach the offending piece of expensive orthodontic wear from her throat. So it was my job to hold it, just off her airway, deathly still so as not to rip or tear it from her uvula. As the ambulance made it’s painstakingly slow way to Hospital, slow because they feared any bump could further lodge it deeper into her throat, I sat, arm locked in place, reassuring her the whole way that she would be ok. Oh that was awful.
Heart-attack, most scary and very life threatening, requires an ambulance pronto, and CPR if the patient is unconscious. Knowing people who have died from these, is sad. So very sad.
So ultimately my day on the first aid course was fraught with memories. I can truly say though, that the information and hands-on demonstrations I experienced, reiterated and consolidated my prior knowledge, and gave me new knowledge, on effective first aid skills. How important it is to be able to help others. Finding someone in need of desperate medical attention can be scary stuff indeed.
DRS ABCD, the first aid mantra, is ultimately one that can save a life.
DANGER – check/assess the scene for hazards etc,
RESPONSE – is the patient awake and responding/ or unconscious,
SEND FOR HELP – get someone to call an ambulance/ get a defibrillator,
AIRWAY – tilt the patients head and lift their chin,
BREATHING – look for normal breathing,
COMMENCE CPR – if not breathing normally, place your hands on the centre of chest, push down hard 30 times, then give 2 breaths,
DEFIBRILLATION – attach a defibrillator if available. Continue cycle of 30 compressions and 2 breaths.
Knowing first aid is empowering, one day you may be in a situation where someone needs your help, would you be able to save a life?
By Shiree Meikle.