First Aid International

Medical Conditions

Stroke (Cerebrovascular accident)

A stroke occurs when the supply of blood to part of the brain is suddenly disrupted. Oxygenated blood is carried to the brain in arteries. The blood in these arteries may stop moving because of either a clot blocking the artery or a rupture in the blood vessel.

When blood flow to part of the brain is inadequate, the cells in that area will die and the brain can become permanently damaged. Stroke is currently the most common cause of death after heart disease. However, there is good evidence that the outcome can be improved through urgent admission to hospital, therefore the need for early recognition and management is essential.

Signs and Symptoms

The warning signs of stroke may include one or more of the following:

  • Weakness, numbness or paralysis of the face, arms or legs.
  • Difficulty communicating (speaking or understanding)
  • Difficulty swallowing
  • Dizziness, loss of balance or unexpected fall
  • Loss of vision, sudden blurred or decreased vision in one or both eyes
  • Sudden onset of headache
  • Drowsiness

FAST is a simple way of remembering the signs of stroke

Facial weakness - can the person smile? Has their mouth or eye drooped?
Arm weakness - can the person raise both arms?
Speech difficulty - can the person speak clearly and understand what you say?
Time to act FAST - seek medical attention immediately. Call "000".

Management:

  • Call an ambulance and stay with the casualty
  • If the casualty is conscious provide reassurance, make the casualty comfortable and do not give them anything to eat or drink
  • If the casualty is unconscious, follow DRABCD principle. If they are unconscious and breathing normally, place them into the recovery position and monitor their airway and breathing until medical help arrives.

Seizures

A seizure may occur for various reasons such as:
  • In a person with epilepsy
  • In most conitions effecting the brain (head injury, stroke, meningitis, brain tumour, lack of oxygen to the brain)
  • Poisons and drugs
  • Withdrawal from alcohol or other drugs
  • In children under five years of age due to a sudden rise in temperature (febrile convulsion)

Signs and Symptoms

There are many different types of seizure and the signs and symptoms may vary from person to person. Seizures not resulting in a loss of consciousness require little first aid management other than reassurance and protection from injury.

However, in a major seizure which is commonly termed a "tonic clonic" seizure, good first aid management is vital. The signs and symptoms are:

  • Sudden spasm of the muscles producing rigidity and the casualty will fall down. This is known as the "tonic phase".
  • Violent jerking movements of the arms, legs and head may occur. This is known as the "clonic phase".
  • Unconsciousness
  • Noisy breathing
  • Salivation
  • Urinary incontinence

Management

  • Make sure the area is safe and move any objects away so that the casualty will not injure themselves.
  • Do not restrain the casualty during the seizure unless it is essential to avoid injury
  • Place the casualty onto their side (recovery position) as soon as possible to open and maintain a clear airway
  • Check the casualty for breathing and if not breathing, resuscitate
  • Allow the casualty to sleep under supervision once the seizure stops
  • Do not attempt to place anything into the casualty's mouth
  • Protect the head from hitting the floor during the seizure by placing something soft underneath their head.
  • Seek medical advice immediately

Febrile Convulsion

This is due to a sudden rise in temperature, usually above 38 degrees celcius. Febrile convulsions occur in approximately 3% of children at some stage in the first 5 years of life.

Febrile convulsions are brought on by a high fever which is usually caused by a viral infection.

Management

  • Follow the guidelines above for the management of a seizure
  • Following the seizure, leave the child resting on their side
  • Seek medical advice as soon as possible for the treatment of any underlying infection.

When to call an ambulance

  • The seizure lasts more than a few minutes
  • The casualty has repeated seizures
  • The casualty has injured themselves
  • The casualty is pregnant
  • The casualty has diabetes
  • The casualty is an infant or child
  • It is the casualty's first ever seizure
  • The seizure has taken place in water
  • The casualty remains unconscious
  • You are uncertain about the cause of the seizure

NOTE: If there is any doubt, call the ambulance out.

Heart Attack and Angina

Heart disease is the biggest cause of death in the world. It is vitally importnant to get the casualty to hospital if you suspect they are having a heart attack. Early recognition and management is essential and "every minute counts". Dial "000".

Causes of heart disease

  • Smoking
  • Stress
  • High blood pressure
  • Poor diet
  • High cholesterol
  • Lack of exercise
  • Genetics

There are seven causes of heart disease. Six of those seven, we can do something about, so "Why is heart disease the biggest killer in the world?"

Angina

This is a condition which occurs when the coronary arteries become seriously narrowed by disease and the supply of oxygenated blood tot he heart becmes insufficient for the increased oxygen required during activity.

Signs and Symptoms

  • Chest pain is usually associated with exertion or stress
  • The pain may radiate to the neck, jaw, shoulder or arms. (Usually the left arm)
  • Shortness of breath

Management

  • History (Do they suffer from heart disease and are they on any prescribed medication for it)
  • Rest the casualty, sitting if possible and reassure them
  • Assist the casualty to "self administer" their own medication if they haven't already sone so. (If they have self administered their own medication, do not tell them to anymore unless advised to do so by the ambulance operator)
  • If the rest and medication does not resolve the problem, then call "000" immediately
  • If the casualty becomes unconscious follow the DRABCD principle and resuscitate if necessary.

Heart Attack

This occurs when an artery supplying the heart with oxygen (coronary artery0 becomes blocked. The part of the heart where the blockage is will not receive oxygen and will die. This is termed a heart attack. This is usually sudden onset and the casualty may not have any history of heart disease.

Signs and Symptoms

  • Sever central chest pain described as a heaviness or crushing sensation on the chest, radiating to the arms, jaw, shoulders, neck and back
  • May occur at rest
  • The pain may not be relieved by rest
  • Pale, cool and clammy (cardiogenic shock)
  • Breathing difficulty
  • Sweating
  • Nausea and vomiting
  • Dizziness
  • May feel terrified and have a feeling of impending death

Management

  • DRABCD
  • Call "000" immediately
  • Rest and reassure the casualty (NO NOT allow the casualty to walk about)
  • Assist with any prescribed medication
  • Make sure you stay calm
  • Be prepared to carry out resuscitation

Asthma

This is a condition where the air passages to the lungs become narrowed by muscle spasm, swelling of the mucous membrane lining the lungs and increased mucous production in the lungs. The airways become narrowed and the casualty will have difficulty breathing. Air is trapped in the lungs because the casualty cannot easily breathe out.

Astma Triggers

  • Colds and infections
  • Exercise
  • Inhaled allergens (pollens, moulds, animal dandruff, house dust mites)
  • Sudden weather and temperature changes
  • Tobacco smoke
  • Food additives
  • Emotions or stress

Signs and Symptoms

  • Shortness of breath
  • Unable to finish full sentences
  • Dry or moist cough
  • Increased heart rate
  • Blueness of the lips
  • Exhaustion
  • Anxious and distressed
  • Wheezing

Please note that if the casualty is suffering a sever asthma attack and their wheeze disappears they need hospital treatment now. It takes two things to make a wheeze: narrowed airways and airflow. If the attack is very severe and there is scarcely any air moving in and out of the lungs, wheezes may be absent. "IN AN ACUTE ASTHMA ATTACK, SLENCE IS NOT GOLDEN - IT'S DEADLY".

Management

  • Sit the casualty upright and give reassurance. Do not leave the casualty alone.
  • If the casualty is co-operative, give 4 puffs of a bronchodilator every 4 minutes. A spacer should be used if available.
  • If there is no improvement after 4 minutes, call "000".
  • If the casualty is unable to take the medication, call "000"
  • If the casualty becomes unconscious, DRABCD and resuscitate if necessary

Diabetes

The cells of the body not only require exygen, they also require glucose to function normally. Food is broken down into sugar hrough the digestive process. Sugar requires a transportation link into the body celld. This link is called insulin, a hormone which is produced in the pancreas. Thos people that do not produc enough or no insulin do not have the ability to transport their sugar into the cells of the body, Diabetes is an illness caused by the inability of the body to produce insulin.

There are two types of diabetes:

  • Type 1 - Insulin dependant, occurs when the body produces little or no insulin. Most people with this type have to inject insulin into their body on a daily basis.
  • Type 2 - Non-insulin dependant occurs when the body produces insulin but not in sufficient quantity for the body's needs. These people generally control their diabetes with diet and tablet.

There are two types of illnesses produced by diabetes:

  • Hyperglycaemia - High blood sugar. This condition develops when the casualty has not taken their insulin. It is not commonly seen by first aiders as its onset is usually gradual and the casualty is able to take corrective measures.
  • Hypoglycaemia - Low blood sugar. This condition is quick onset and if not treated can lead to unconsciousness or death. Should a diabetic inject too much insulin, miss a meal, develop an infection or over exercise, they can develop low blood sugar levels. This is the most common type of diabetes that a first aider will come up against.

Signs and Symptoms of Hypoglycaemia (low blood sugar0
  • Weakness and/or light headed
  • Confused and aggressive (commonly mistaken for drunkenness)
  • Pale, cold, sweaty skin.
  • Levels of consciousness may deteriorate
  • Casualty may develop seizures

Management

  • DRABCD
  • Call "000"
  • Give the casualty something sweet to drink or eat.
  • If the casualty becomes unconscious, check airway and breathing. If the casualty is breathing normally, place them into the recovery position and monitor their airway and breathing
  • If the casualty is not breathing normally, continue CPR until help arrives.

WARNING. NEVER administer insulin to a casualty as if this is done incorrectly, it can be fatal. Always seek medical advice.

The biggest problem that first aiders will encounter is deciding whether the casualty is suffering from high or low blood sugar. A good indicator is the casualty's skin colour. If they are high the skin will be flushed and dry, if they are low they will be pale and sweaty.

Contact First Aid International - 1300 36 56 75

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