Stroke - Know what to do

Stroke occurs when the blood supply to the brain is blocked. Part of the Brain becomes damaged. This often effects the persons appearance, speech, body functions, and sight.

Know how to recognise Stroke:

Think FAST:

• Face: If the face drops on one side
• Arms: If there is a loss of control or strength in the Arms
• Speech: If Speech becomes slowed or slurred
• Time: To call 999 / 112. This is an emergency, get help!

Talk to the person suffering Stroke, reassure them, comfort them. Keep Calm.

For more information, visit :

http://www.stroke.org.uk/

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How do we beat Ebola?

Whichever way you look at it, the Ebola dilemma is raising a lot of unanswered questions, and worryingly, the speculation over what to do about the transience of it simply doesn't seem like affirmative action to prevent the spread.

The USA have announced screening at Airports, the UK is considering the same (At the time of writing) - but checks at Airports are simply no good - carriers in their early stages are non symptomatic - so could bring Ebola into their respective countries unwittingly to all concerned.

So perhaps some form of quarantine is required, as was maintained in New York Harbour in days gone by - however, the amount of people commuting in the 21st Centenary is far greater, making this impossible. Simply sit in any airport for several hours, and the daily passage from one terminal here alone is far greater than found at a port in the Victorian Era.

The only true way to beat Ebola is to nip it in the bud - attacking it's spread at source, however, it does seem that effected countries have been more or less left to fight it out alone.

The British Army recently announced they are sending 100 Army medics to Sierra Leone, and the USA has pledged even more boots on the ground.

Now lets not forget, Ebola isn't caught from the air, if it were, we would all be nearly dead by now, so sending troops, isolated from the main population, is reasonably safe. When there is contact, then they will be in full Protective Gear.

They will establish centres for administering the diagnosis and care of patients presenting with symptoms of Ebola.

This is a great start, and a move in the right direction - however, more is needed, and people are required to replace the troops. 

How do we Beat Ebola? 

Simple, we Educate, Control, and Eradicate cases.
1) Educate.
Let people know about it, tell them not to come into contact with the infected, give them new means to dispose of waste, and the dead. Provide with PPE.

2) Control

Marshall law, restrict movement, assign local authority leaders to enforce suspected case protocols.

3) Eradicate

Wherever cases present, they are isolated. The dead are disposed of swiftly without time for emotion or religious rights.

 Bringing about all 3 sections are as tough as the last. 

There is understandably a fear over Ebola, yet the education hasn't been sufficient to tempt people not to wash their dead, or to have physical contact with people showing symptoms, or to increase their personal hygiene. Instead we hear of Westerners sneezing, and being thought to be carriers - as if this is a westerners epidemic alone.

This is due to poor education on the part of the state, and potentially insufficient investment to educate, or the investment by donation being squandered. 

As we prepare to put together a incident package, Ebola is very much in the forefront of our minds. It is our hope that it's spread ceases, and doesn't enter out country. 

If it does, then we all need to be prepared, and thankful that we have the resources to manage Ebola containment with reasonable ease.

Video to follow of our preparations. Follow us on Facebook: www.facebook.com/First.Aid.Training.Centric

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#Ebola 

Contents of a First Aid Kit, At home, and Abroad

It's important to have a well-stocked first aid kit in your home, so you can deal with minor accidents and injuries.Your first aid kit should be locked and kept in a cool, dry place, out of reach of children.Many people also keep a small first aid kit in their car for emergencies.

Your basic first aid kit

A basic first aid kit may contain:

• plasters, in a variety of different sizes and shapes
• small, medium and large sterile gauze dressings
• at least two sterile eye dressings
• triangular bandages
• crêpe rolled bandages
• safety pins
• disposable sterile gloves
• tweezers
• scissors
• alcohol-free cleansing wipes
• sticky tape
• thermometer, preferably digital
• skin rash cream, such as hydrocortisone or calendula
• cream or spray to relieve insect bites and stings
• antiseptic cream
• painkillers such as paracetamol (or infant paracetamol for children), aspirin (not to be given to children under 16), or ibuprofen
• cough medicine
• antihistamine tablets
• distilled water, for cleaning wounds
• eye wash and eye bath

It may also be useful to keep a basic first aid manual or instruction booklet with your first aid kit.

Medicines should be checked regularly to make sure they are within their use-by dates.

For every travel kit

• First aid kit

For minor injuries, use antiseptic with gauze squares, non-adherent dressings, bandages, fabric plasters, adhesive tape, scissors, tweezers and safety pins. You can buy bottles or sprays of standard antiseptic such as TCP from all major chemists, or get ready-prepared antiseptic wipes. A first aid kit may be useful if you're going off the beaten track or taking part in high-risk activities.

• Insect repellent

Mosquitoes usually bite between dusk and dawn, and are attracted to humans by our body heat, smell and the carbon dioxide we breathe out. Research shows that products containing the chemical DEET are the most effective insect repellents and are safe when used correctly. DEET products are available in sprays, roll-ons, sticks and creams. Your GP or travel health clinic will tell you whether the area you are going to is malarial and what protection is advised.

• Condoms

Condoms are recommended for everyone who is sexually active. Buy condoms with the CE mark on the packet. This means they have been tested to the high safety standards that are required in Europe. Condoms that don't have the CE mark won't meet these standards, so don't use them. Condoms can be damaged by oil-based products, such as suntan lotion, baby oil and lipstick. Heat can also cause damage, so store them in a cool, dry place. For more information on using male and female condoms, see How to use a condom.

• Antihistamines

Over-the-counter antihistamines can reduce itching and inflammation caused by allergies and insect bites. Antihistamines are available as tablets (oral antihistamines), creams (topical antihistamines) and nasal sprays. Antihistamines work by blocking the effects of a protein called histamine.

• Anti-diarrhoea pills

Anti-diarrhoea drugs, such as loperamide, can relieve symptoms of diarrhoea by slowing down the movement of bowel contents and sometimes by increasing water absorption from the gut. Loperamide can be taken once or twice a day, over a long period. However:

• Do not take anti-diarrhoea drugs if there is blood in your stools or if you have a high temperature (check with your pharmacist). 
• Do not give anti-diarrhoea drugs to your child.

Travel in the developing world

• Rehydration sachets

Rehydration sachets help replace fluids and salts lost through diarrhoea, vomiting and too much sun. You can buy sachets of rehydration salts from your pharmacy and add them to water. They provide the correct balance of water, salt and sugar. Your doctor or pharmacist may also recommend rehydration drinks for your child, if you are worried they may become dehydrated. Do not use homemade salt or sugar drinks. Always consult your pharmacist.

• Mosquito net

A mosquito net is vital for sleeping in malarial countries. When buying a net, make sure it is impregnated with permethrin. Permethrin is a contact insecticide, which will kill insects landing on the net and, therefore, increase the net's effectiveness. Generally, nets will need to be impregnated again with permethrin after six months of use. Carry a small sewing kit so you can repair any holes that develop in the net.

• Anti-malarial drugs

Visit your GP, pharmacist or practice nurse four to six weeks before you leave to find out what malarial cover you'll need. They will also have up-to-date advice about the cover you need, and which strains of malaria are resistant to which drugs.

• Emergency medical supplies

Kits available from pharmacies, including sterilised and sealed syringes, sutures and needles, can be useful when visiting developing countries, where hospitals and dentists may not have properly sanitised equipment.

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Ebola - Getting protected - Basic Advice

There is no effective antiviral treatment. Instead, treatment is supportive, and is directed at maintaining renal function and electrolyte balance and combating haemorrhage and shock. 

Transfusion of convalescent serum may be beneficial. 
Post-exposure treatment with a nematode-derived anticoagulation protein and a recombinant vesicular stomatitis virus vaccine expressing the Zaire Ebola virus glycoprotein have been shown to have 33% and 50% efficacy, respectively, in humans. 
Recent studies have shown that small interfering RNAs (siRNAs) can be potentially effective in silencing Zaire Ebola virus RNA polymerase L, and treatments in rhesus macaque monkeys have resulted in 100% efficacy when administered everyday for 6 days; however, delivery of the nucleic acid still remains an obstacle.

IMMUNIZATION: None.

PROPHYLAXIS: None. Management of the Ebola virus is solely based on isolation and barrier-nursing with symptomatic and supportive treatments.

Based on the stark facts of Ebola, people are understandably very concerned. When another case arises, the press rush the news to print, making the spread seem wider than it is.

But what can we do to safeguard ourselves? What lessons can we learn from this recent outbreak, that may afford us better protection in the future?

Firstly, the mechanism of spread must be evaluated. Coming into contact with contaminated hosts, both dead and alive clearly is a major player in all of this. Isolation of those contaminated can help reduce the spread, but as we are seeing, with the 21st Century routine migration of travellers, suspected cases can arrive anywhere in the world, at any time.

A closed borders for entry policy is not economically viable, but, is plausible in a major outbreak to which containment is not possible. 

In the mean time, local level migration control in countries worst effected (Such as Sierra Leone) is utilised to try and gain control.

We are left to trust decision makers that our best interests are catered for - but, systems fail, non symptomatic travellers, within the incubation period, can travel freely to home countries, residing with their families, before potentially infecting others nearby.

As citizens, it is our duty to do everything we can to protect our living environments around us, not just for neighbours, but also for ourselves, and our families.

Good levels of hygiene are critically important, washing of hands for example, using sanitising gel regularly, and particularly after making contact with another person. 

Sanitising the entire work environment, phone systems, keyboards, light switches, door handles, and in our case, we maintain a staff toilet, and a customer toilet. Both are kept incredibly clean - but one is controlled over who uses it - all these things help cut down cross contamination.

Food eaten is prepared by the consumer only - no outside food is consumed wherever possible, all food prepared is cooked properly, or is within its own natural packaging (i.e. Banana's), the exterior of which is cleansed before unwrapping. 

This is the daily routine, and although it sounds extreme, it falls into good practice, and prevents to the greater part, picking up lots of other bugs.

But, we cannot avoid all human contact in day to day life. We should not become recluse. It is important to engage with other people, and to do so in a familiar way without an eye of suspicion that could otherwise damage a relationship, be it professional or personal.

The game changer comes when cases become prevalent within our community. 

A whole range of respiratory protective aids are available, from basic face masks through to CBRN respirators, which cost more, and are less available than the paper counterparts. Full CBRN suits are used by professionals, in conjunction with decontamination units and full assistive backup.

But without these resources, the lay responder, the worker, the citizen is most vulnerable to contamination, so more austere measures are required.

All the above sanitisation regimes should be used, as well as protecting from outside contact. 

This extreme measure requires some forethought in preparation - without shopping for food, and supplies, we would soon become unstuck, without going to work, we would soon become financially void.

Good preparedness in home storage is needed, with a backup food supply of canned goods, and water, as well as toiletries, means the need to enter society for trivial means can be avoided.

All avoidance is impossible, and socially problematic, so keeping distance is appropriate instead. Avoiding physical contact, and sharing of food is an aide to preventing cross contamination.

Managing the dead - ensuring disposal of the body is prompt, and complying with local authority guidance is all important in preventing the spread too, and of course managing your own form of decontamination is vital.

Good resources to keep at home include:
Strong Surgical Gloves - Many pairs of Marigolds
Bin Bags
Face masks
Alcohol Gel  
Camping toilets
Bottled Water
Tinned food of all varieties
Camping cookers
All of this seems extreme, but, up until quite recently, it formed part of the British education in preparedness for Nuclear Attack. After the dissolution of the communist government in Russia, it was felt the risk had been removed, however, although the risk may have changed, there is still the need for protection of one form or another. 

Society has a Pronoia well established in its minds eye, always expecting the best outcome from the powers that be. This post in contrast may seem like Paranoia, but, the very same thing that may have attracted the reader, also encouraged the poster.

It takes one major event to change the thinking of others, but that major event may be one step too far for the survivability of many.

Further information is encouraged by visiting:
http://www.redcross.org.uk/en/What-we-do/Preparing-for-disasters/How-to-prepare-for-emergencies

https://www.gov.uk/government/publications/emergency-preparedness

https://www.gov.uk/browse/citizenship/government/emergencies-preparation-response-and-recovery

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https://www.facebook.com/First.Aid.Training.Centric

When First Aiders are involved with an End of Life event.

I am pleased to say I've been involved with several end of life events...

What an odd thing to say I know. 

I have in reality been involved in more than several end of life events, but there are only several I have been pleased to be involved with, and it is these I shall speak of. The others were very different. They were events that ended life far too soon, and were the result of accidents / incidents which potentially could have been prevented. These I consider as unnatural, but it is not for me to judge the course of terminality.

The End of Life events I speak of all involve the elderly, and none of them have passed in my company, none have required major intervention to extend life until such a time as they could be handed over.

They have been pretty much alive, however, an event has occurred, which for so many elderly patients starts the ball rolling for the demise of their life. It may be days, weeks, months, or perhaps even a few hours since the event, but, experience tells me, that such an event symbolises the beginning of the end. Again, a word to the wise, it is not for me to second guess death, and the level of care / treatment given has no reflection on the casualties state of age. It is merely understanding a probable outcome, and manipulating the events that occur in the little time available.

As people who are duty bound either through employment, or morales to assist with an emergency, we have protocols to follow. We work our way through our algorithms, delivering aid at each point as we are taught. But, outside of treating respiratory and coronary failure, and stemming the flow of blood, or stabilising a break, there is little else we can do whilst we await for an ambulance. The patient who has a clear airway, has a heart that's working, is not bleeding, but is elderly, and in the eve of their life, requires something all together different. 

Of course, we are aware of shock, of course we analyse the method of injury and treat appropriately, but this treatment is usually quite quick, and the arrival of the process to remove the casualty is reasonably slow in comparison. 

Take for example an elderly lady who trips and falls in the street. There were no uneven slabs, there was no loose drain cover. She just fell, and banged her head. Perhaps it was stroke, perhaps a heart condition, perhaps she is just weak from age.

One such case we dealt with, and as she started to slip away quietly in my arms, I had the power to bring her back to this world with a squeeze of the shoulders, and comforting conversation. Undoubtedly the head injury was the route cause of the problems. Assistance was on route, and with limited resources, the level of treatment that could be physically provided was low.

Her husband, close by was brought into the equation to share words of compassion and love for her, which I don't doubt stemmed back from before I existed.

This process of maintaining her level of consciousness meant two things, firstly, I wasn't required to deal with a patient who entered respiratory failure, and secondly, the valuable moments she and her husband had together to share words of love would remain for the rest of his days, and perhaps take the edge off the trauma of it all. It also would act as a bridge for the great unknown. Comforting her final moments perhaps, making whatever happens as we die not so scary (In my experience, the elderly handle their own deaths quite adequately, with little fear).

An Ambulance arrived on scene, and I was able to hand over a live casualty, whilst my colleague continued to attend to her, and assist.

Sadly, once they had loaded her into the vehicle, it remained stationary for some time with both attendants and husband in the rear. It was at this point that she undoubtedly passed. 

When we first start on the road of being a First Aider, or higher, we often think only of the fast paced world of rushing to save a life. The busy hustle and bustle in the kit bag, or back of an ambulance to get chest seals, the commands of a defibrillator shouting out as we stick pads to a lifeless body, the fast pace of compressions as we force the heart into motions.

But reality is often far from this, ranging from very minor injuries that could be self treated, through to life support, and of course, the events to which we can do little but just be human.

Compassion I suppose can be taught in later life, but where better to gain it than in your formative years. I am most fortunate to have had family that did just that.

After every event, it is right and proper to review actions to ensure protocol was followed, and to talk out any issues. 

This particular event wasn't traumatic in any sense of the word, and the only regrets, as always, were that we were not adequately equipped to deal with a casualty - who is outside of the Hospital or Ambulance. We could not do our duty to the best of our ability due to the lack of resources - yet our duty, and more, was done to the best in the circumstance. 

And I am pleased, and comforted in the knowledge that for these people, in this instance, the lasting memory will not be one of panic, or the sight of tubes, or electric shocks on the street, but one of being able to share a few final moments together in thought before one of them crossed over into the great unknown. 

Emergency Communications - When the lights go out...

I was asked today by a student why it was we still used handheld radios, in a time when mobile phones are everywhere.

It got me thinking, here I am with the latest mobile technology in my pocket, I can check my email, Facebook, Ebay and all other sites with the flick of a pointer finger. I can call, with crystal clarity to one of my colleagues on speed dial, and likewise, summon assistance from the Ambulance, Fire and Police if needed. I have an Ap that acts as a metronome for CPR (I use it for training), and of course, the good old British Red Cross First Aid Ap is there too.

But, there are still parts of the UK with no mobile coverage - I should know, one such place is my living room!

Our training exercises for Emergencies often simulate a crashed car, or downed aircraft in remote places, or perhaps a missing person in the hills of Wales... again, like my living room, there's little or no signal.

This is because the signal isn't strong enough, we're too far away from the antenna, or the geography is blocking the line of sight, it's frustrating.

But similar outages occur during major incidents too - the mobile networks become blocked as the closest antenna has to deal with thousands upon thousands of instantaneous requests to connect.

A power failure results in Mobile Repeater stations going onto their generator setup if it has one, and then falling onto battery UPS, and when that runs flat, all coverage drops. You can expect during a major incident, the local authority will authorise the closure of communications, bar those essential for emergency communication - to which, we are not privy.

So, we have handheld radios. They are secure, with ability to encrypt the signal on some obscure frequency, and have a pretty decent range. The communication is often quicker, and more direct, and of course, all parties can get a message as oppose to just the person your calling.

But we also maintain a pretty cool communications system that we've had for some time, and that's satellite phones.

In our Emergency box, we can instantly find the communications satellite from the portable dish, and connect via satellite, calling around the globe in real time. Sat phone to Sat phone is ultra reliable, taking its power source from its own battery, or vehicle hook up, or even from Solar if things are real bad, and the satellites, which are self powering, are mostly unaffected by worldly events.

It is plausible to imagine a time though where even this form of communication can go down, either by choice, or circumstance, and this again is where our trusty handheld radios come into play.

So, why do we still use handheld radios? See above!

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Defibrillators in the Community

We were very blessed to visit the Emergency Services Show this year at the NEC in Birmingham. The works diary allowed us one day of freedom to go to this tremendous event, and boy are we glad we did!

We have long advocated the provision of defibrillators in the community, and are well aware of the numerous charities out there helping villages and towns achieve this goal.

One such charity is 'Community Heartbeat' ( www.communityheartbeat.org.uk ), and they were at the ESS 2014.

We got speaking with them, and were enthused by their passion for this critical service, so much so, that we fully hope to be able to support them in the future in any way we can.

Having a defibrillator in the community makes such a difference - a life saving difference. In my 35 years of life, I already know of 5 people who suffered SCA (Sudden Cardiac Arrest) all of whom died as a result. 4 of these people had bystanders, or family nearby at the time of their arrest.

It is tragic to note, that in not one of the mentioned cases, was CPR delivered, and neither was a AED (Automated External Defibrillator) called for.

2 were in reasonably public places, where one should like to think an AED was available.

It is impossible to say if good quality CPR, and access to a defibrillator would have made a difference in these cases, but, at least it would have provided a fighting chance of survival. As it stood, the bystanders didn't know what action to take, and death was inevitable.

On all of our First Aid Courses, we go above and beyond mentioning defibrillators, we allow our students hands on experience via one of our AED Trainers. Not to be confused with our CPR & AED courses, we sadly do not go into as much detail, but, we talk about the reasons why, then without any real training at all, throw in the AED mid CPR practice.

Our students understand the importance of this device, and are amazed at how easy it is to use it, with no previous contact.

The simple 1-2-3 approach is well established, and, in all cases, the students, if presented with a real life scenario in replacement for the training, would be able to deliver a shock if required.

The devices have significantly come down in price, as much as they have become easy to use, and the maintenance free life of each unit has increased - some offering an outstanding 3 years pads, and as much as a 6 year battery life.

In all consideration, we question why there aren't more AED's around! Businesses should invest, Local Authorities should invest, Communities should invest.

We certainly give it our stamp of approval, and look forwards to working with Community Heartbeat to deliver the knowledge, and life saving resources around the country.

www.communityheartbeat.org.uk
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