WHAT TO DO IN A MEDICAL EMERGENCY BEFORE HELP ARRIVES


Before the holidays are upon us, read up on what to do in case of emergencies. The experts we consulted with all emphasised that the most important thing is to be prepared – by which they mean don’t panic, and know who to call.


WHAT TO DO IN A MEDICAL EMERGENCY

CPR – CARDIO- PULMONARY RESUSCITATION

THIS TECHNIQUE SAVES MANY LIVES. It is used in cases where breathing or heartbeat has stopped. Here are some basics:

  1. Lie the patient on their back on a firm surface. Get two or more people to help.
  2. Keep the airway open by tilting the head backwards and lifting the chin.
  3. Do chest compressions at 100 per minute. Medical students often do it to the rhythm of ‘Staying Alive’ by the Bee Gees, to give an estimation of the speed.
  4. Compress the chest from the midpoint between the nipples and push down 5cm for adults and to about a third of the depth of the chest for children. Don’t be afraid to push hard and fast with full chest recoil (allowing the chest to rise fully again). Never practise this on a friend or family member; there are special mannequins for this.
  5. Minimise interruptions and keep up the pace.
  6. Remember to keep the airway open.

ICE ON YOUR PHONE 

ICE (In Case of Emergency) is a simple system that allows first responders like paramedics to know which number to call if you are an emergency patient. Save the numbers of your next of kin with the letters ICE in front of them. For example ICE – Husband, ICE – Mom, ICE – Dad or ICE 1, 2 & 3.

RECOVERY POSITION
If a person is unconscious but breathing and has no other life threatening conditions, place them in the recovery position to ensure their airway remains open and that any fluid will not cause them to choke. With the victim on their back and you on their left side:
  1. Straighten their legs and remove any sharp objects, if any, from their pockets.
  2. Position the victim’s left arm at right angles to their body, with the palm facing up.
  3. Lift the right arm and place the back of their hand against their left cheek. Hold there.
  4. Lift the right knee up so their foot is flat on the ground.
  5. With your right hand, keep their hand against their cheek and use your left hand to pull on their right knee, carefully rolling them towards
  6. you and onto their left side, with their cheek on their right hand.
  7. Place their right leg at right angles to their body so their position is stable.
  8. Tilt the head back and gently adjust so the airway stays open.
  9. Open the victim’s mouth to allow drainage and to monitor breathing.

A FEW SCENARIOS…



DROWNING
The Plan of Action (POA)

Call for help. Get as many people aware of the situation as possible, so emergency services can be contacted. Don’t try to dive in or swim to the person. Andrew Ingram, who volunteered with the National Sea Rescue Institute for many years, explains: ‘Unless you are a trained rescuer, trying to save the person is dangerous because in their distress they can pull you down with them. If you are not a strong, trained swimmer, this can mean you drown too.’ Find something to try to pull the person out with. ‘Use something like a pool net or a piece of clothing to try to pull them out of a pool, or throw a ball in to help them float,’ says Andrew.

What if they’ve stopped breathing?
If they’re out of the water and unconscious or you find no signs
of breathing, get medical help if you haven’t already. Then start CPR. Put them in the recovery position once they start breathing and prevent hypothermia by rewarming them slowly, then get them to a hospital to check for secondary drowning.

What you should NEVER do

  1. Don’t get into the water without training or equipment.
  2. Don’t hesitate. If you don’t know what to do, call an emergency operator – they can talk you through it.



BEE STING
The Plan of Action (POA)

  1. Remove the sting immediately by scraping it off with a blunt blade or your nail.
  2. Soothe with ice or cold water and take antihistamine medication.
  3. Most bee stings result in swelling or redness due to inflammation that can last a few days. This isn’t life threatening; patients can take antihistamines for about five days following the sting.

What if the person is allergic?
People who are known to be allergic should carry their EpiPen or adrenaline with them at all times. If they don’t have it on them, get to the nearest emergency unit as soon as possible.

What you should NEVER do
Don’t pull the sting out with your fingers, tweezers or anything similar. This just releases more poison, aggravating the sting.

REMEMBER: If allergic to bee stings, always check the expiry date on your medication and replace immediately after use.

THE BASICS REMEMBER THE 3 HS:

HAZARD Ask yourself: Are there life-threatening dangers to you or the other person? If so, manage them, or move yourself and them out of harm’s way.
HELLO Is the patient responsive? If not, get help and place the patient on their side.
HELP Dial the correct emergency number to get professional help as soon as possible.

SNAKEBITES
It’s summer, so the snakes are out to soak up the sun too. Snakebites are complex, explains snake expert Johan Marais. ‘There are a number of factors affecting every bite – the general health, age and size of the victim, the site of the bite, the snake responsible and, very important, how much venom is injected. Most venomous snakes have full control over their venom glands and decide how much venom to inject – if any. More than 80 percent of snakebite victims who are hospitalised do not need antivenom, and more than a third of them show no symptoms at all. Having said that, there are some snakebite best practices to follow.

The Plan of Action (POA)

  1. Keep the casualty calm this might be difficult but it’s extremely important.
  2. Immobilise the casualty and lie them down.
  3. Promptly and safely transport the casualty to the closest hospital with a trauma unit and ICU.

What if we didn’t see what snake it was?
Don’t worry. ‘The identity of the snake is not that important; focus on getting the casualty to hospital. Doctors don’t treat the snakebite specifically, but rather the symptoms of a snakebite.’

What you should NEVER do
Don’t use antivenom as a first aid measure. Although carrying some antivenom with you sounds like a great backup, Johan explains that it’s not the case. ‘This is only to be used by doctors. The best first aid for a snakebite is a bag valve mask, but you need training on how to use it.’ Find out more about snakebite first aid and courses at reptileventures.com/

Don’t ‘suck out’ venom – It’s for movies only. It’s actually not possible to suck out venom.

Good to know
‘Cytotoxic envenomation (venom injection by the snake) causes severe pain, progressive swelling and blood oozing from the fang marks. Typical cytotoxic envenomation is from snakes like the puff adder, night adder, any spitting cobra or the stiletto snake. If the patient gets progressively weaker, has slurred speech, excessive saliva discharge, ptosis (drooping eyelids), nausea and difficulty breathing, it could be neurotoxic venom from a mamba or cobra. These are life-threatening bites as the casualty could stop breathing. In severe cases victims might experience difficulty breathing within half an hour. It’s vitally important to get a snakebite victim to a hospital as soon as possible, and in a safe manner.’ Keep them still and calm to prevent the venom spreading faster in their body.



JELLYFISH AND BLUEBOTTLE STINGS

The Plan of Action (POA)

‘The best treatment is hot water (as hot as you can stand without burning yourself), followed by cold packs and constant monitoring for anaphylactic shock,’ says Andrew. Unseasoned meat tenderiser actually helps! If you have that on hand, apply it to the affected area. Then take antihistamines and pain medication if possible.

To pee or not to pee?
Although there is anecdotal evidence that urinating on the sting can help, it’s not guaranteed to work and uric acid could cause more nematocysts (the little structures in the venom that cause the sting) to fire.

ALCOHOL POISONING OR SUSPECTED DRUG OVERDOSE
The festive season often means more indulgence than usual. The line between stupidly drunk and dangerously intoxicated is difficult to recognise. If unsure, it’s better to be safe than sorry: phone a toxicology centre or emergency services.

The Plan of Action (POA)

  1. Try to get the patient to an Emergency Unit for further management. Where possible, take a sample of the drugs or substance they’ve taken.
  2. On your way to the ER, or while you wait for an ambulance, keep the person upright and awake if they are conscious.
  3. Keep them warm as they are likely to feel cold.

How do I know when it’s alcohol poisoning?
Alcohol poisoning can present with seizures, loss of coordination, blue-tinged skin, slow or irregular breathing, hypothermia, repeated vomiting and passing out.

What you should NEVER do

  1. Don’t induce vomiting. This can result in aspiration or choking on the vomit, which can be very dangerous.
  2. Don’t let them ‘sleep it off’. Alcohol and other drugs can interfere with a person’s gag reflex and they could choke.
  3. Don’t put them under a cold shower. Toxins can cause lowered body temperature and this could make it worse.
  4. Don’t give them coffee as it could dehydrate them even further.



HEART ATTACK
The Plan of Action (POA)

  1. Loosen tight clothing – remove ties and unbutton a collared shirt.
  2. If the patient is unconscious and you do not know how to do CPR, turn them on their left side while you wait for the ambulance.

How can I tell if someone is having a heart attack?
There are many ways in which a heart attack can present. Generally the patient has chest pain behind the breastbone and often refers to the left arm. This pain is usually severe and accompanied by nausea and sweating.

What you should NEVER do
If you are having a heart attack, do not drive yourself to the hospital unless you have no other choice. An ambulance can start treatment on the way to the hospital, so let them take you instead if possible.

SLIPS AND FALLS
The Plan of Action (POA)

  1. Position the patient comfortably.
  2. If a wound is bleeding, use a clean cloth/gauze and pressure bandage to stop the bleeding. 
  3. Try to splint and immobilize the injury – rolling up your Jet Club magazine to act as a splint works very well!

How do I know if it’s broken or just sprained?
A sprain will be swollen and sore but generally look normal. A fracture is very painful and can have abnormal angles or bones protruding. Have a doctor look at the injury to determine whether it is just a sprain or needs further investigation.

What you should NEVER do
Do not apply a tourniquet.

REMEMBER: THE ABOVE ADVICE SHOULD BE SEEN AS A GUIDE, BUT IS BY NO MEANS A REPLACEMENT FOR BASIC FIRST AID OR PROFESSIONAL ASSISTANCE.

DIRECTORY
Important numbers:

SA national
Er24 (medical emergencies): 084 124 
Netcare (medical emergencies): 082 911 
Netcare (helicopter): (010) 209 8555
Police: 10111
Ambulance: 10177
Fire: 10177

GENERAL EMERGENCY NUMBERS
Cape Town: 107
Johannesburg: +2711 3755911
Pretoria:  10177
Durban:  10177
Bloemfontein:  10177

Sea rescue institute
National:  112 from your cellphone

Toxicology centres
(from anywhere in SA)

Red Cross
: +2721 689 5227 
Tygerberg: +2721 931 6129 
Bloemfontein: 082 4910160 

Roadside assistance
AA emergency rescue
:0861 000 234 
(if not a member and you want to join on the spot, it will cost you 1 275.00 for one year if you’re under the age of 60, and 85900 for a year if over 60) 

DIRECTORY
Important numbers:

Botswana
Ambulance: 997 (Toll-free)
Police
999 (Toll-free) 
Fire brigade:9 98 (Toll-free) 
Medical rescue911 (Toll-free) 
Medical air rescue390 1601 

Eswatini
Police emergency
2404 2221 / 999 
Ambulance: 977 
Fire: 933 

Lesotho
Police
: 10111 
Ambulance10177 
Crimestop08600 10 111 
Er24: 084 124 
Fire brigade998 / 999 
Lifeline086 132 2322 

Namibia
Police emergency
+264 61 10111 
Aeromed+264 61 249 777 / 230 505
Medrescue
+264 61 230 505/6/7 
Crime stoppers+264 61 254 299 


WHAT TO DO IN A MEDICAL EMERGENCY BEFORE HELP ARRIVES WHAT TO DO IN A MEDICAL EMERGENCY BEFORE HELP ARRIVES Reviewed by Michelle Pienaar on December 02, 2019 Rating: 5
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