“
An ‘A-B-C ‘ Of Home Health Care: A List Of Things You NEED To Know (Which Might
Just Save Your Life, Or The Life Of Someone You Love), Incomplete As It May
Be…Still “
Part
III of IV
04/28/12
My most dear, and wonderful friends, and ever-loyal
readers, there will inevitably be a time, following illness or accident at
home, that will necessitate calling ‘911’ for assistance, or intervention, or
transport to a Hospital emergency room; as I may have mentioned before, trauma
centers refer to a term called; “The Golden Hour”, during which there still
remains a good chance that the person will survive after intervention and
treatment. This refers to major accidents
at home, or while driving, whether they are serious injuries, strokes, or heart
attacks, to name but a few.
And even though many of you have cell telephones
that you take with you everywhere, nevertheless, this, “Golden Hour”, is
precious, and any extra time you can contribute for intervention and treatment
to be given soon enough, can only help increase one’s odds of survival.
Too often—though—valuable minutes are wasted from
the time the ‘incident’ is discovered, to ‘911’ being called, to the arrival of
the ambulance, by otherwise caring individuals, standing-around, looking either
dazed, or confused, not knowing what to do, to even, where to begin. Or when,
the incident—itself—is discovered late.
You must intervene as soon as possible.
Depending upon the severity of the illness or
injury, a person may not have a “Golden Hour”, when just five minutes could—if
correctly acted upon—help a person to survive.
Of course accidents and injuries can happen anywhere, any time, to
anyone: family member, friend, neighbor, acquaintance, or even casual
strangers.
So many times—especially in the case of those
unknown to us—we hesitate to become involved.
Only YOU can listen to your heart’s voice in deciding the extent of your
interaction. However, situations differ
so much that, while you may be reluctant to begin C.P.R. on a complete
stranger, you might not hesitate a second to remove someone away from fire, or
a burning car spotted along the road.
There are two things to always keep in mind,
whenever someone has fallen, or must be removed from harm; that is, unless
absolutely necessary, never move a person who may have sustained back
injuries. Make the person comfortable of
course, with a flat pillow to facilitate their breathing, and—when necessary,
ever so slightly elevate the feet, and provide a blanket, to ward off potential
shock.
These days, this reluctance is quite understandable,
what with AIDS, Hepatitis C, other, blood-borne diseases, and a few air-borne
ones like Tuberculosis. Without proper
precautions, the ‘helper’ places him or herself at risk, especially when potentially;
massive quantities of body fluid are either directly observed, or discovered.
On those few occasions when I was there, observed
the incident, and took action, it was my choice to do so; but then…neither did
I rush in, and do it foolishly. I took
what precautions that I needed to ensure my own survival; which is why it is of
vital importance that you remain calm so you can think, even if the scene is
one of nightmare.
But, even if the circumstances may make you afraid,
legitimately or not, taking NO action should leave you with a bruised
conscience. At very LEAST—should you
come upon an injury or an accident, or abuse….too many carry cell telephones
these days, to simply not use them, to call ‘911’. You must make up your own minds, and often,
very quickly, too. And in regards to
helping a complete stranger, even one whose aspects you might find distasteful,
I will only list two things:
1)
As a Director Of Nurses once told me,
“…whether you may like or dislike a person, doesn’t matter, if you but consider
all to be ‘God-made’ souls.
2)
I consider the prudent intervention on
behalf of even strangers to be but part of the price that I must morally pay to
assert my claim to being human.
However, it must be mentioned, that
since—perhaps—something like 80-90% of all injuries, and accidents occur at
home, you will then be—of course—more likely to on an ascending scale to help neighbors,
friends, relatives, to direct family members such as a spouse, or child. And in being more informed in how to give
such care, it may eventually prove to be of help to you.
Few homes—if any—have on hand, a usable, and
reliable ‘First Aid Kit’, beyond—perhaps—a rusted box of band aids, or some
peroxide, or Q-tips, which will NOT be of any help to you in a ‘real’
emergency. And so, after having given
the matter much thought, I am going to list what I think every family should
have on hand, in case of an emergency, and how to use them properly, and to
best effect.
While ‘my’ “First Aid Kit’, consists of things you
may NEVER need, needless to say, all of the items do have a valued place, kept in
a resealable, cardboard box, placed, so that it will not get wet—in every home,
thus enabling you to prepare for accident, or injuries, and to follow some
basic tips, while waiting for the ambulance to arrive. Thus, you may have helped provide that
“Golden Hour” for you, or someone you love, when—on occasion—there may be NO
“Golden Hour”, but only scant minutes.
Nevertheless, it can be YOUR calm intervention that may well prove to
save a life.
All of the items in ‘my’ dream “First Aid Kit”, are
readily obtainable in drug stores, or near the pharmacy in grocery stores. You do not have to go to a medical supply
house; all you need—to begin—is a list of things to get.
And…I will—where necessary—explain:
1)
Why you may need it.
2)
When to use it
3)
And importantly, when to NOT use it
4)
Remember, please, that I may
inadvertently either list too much, or miss an item or two; so, I will err on
the side of caution, in listing too much, even though, ALL items might prove to
be of life-saving value.
Above all...try ever to
remain calm; there will be occasions when—perhaps—you might be the ONLY calm
person in the room; it is vital that you be so, to better access the situation,
and to take prompt action. Save your
nerves for later. Only after, when the
ambulance is on its way to a hospital, do you have the ability and time to
scream, yell, cry, or otherwise, ‘break-down’.
Often—for example—while you are intervening, you may need someone to
bring things to you such as blankets, or, someone to telephone ‘911’; assume
that you are the only one capable of successful intervention (with the possible
exception of C.P.R., which CAN be done alone, if you must, but is better done
by two ‘first responders’, and anyone else nearby, who can relieve you, as it
is VERY tiring to do alone, or to be done properly).
Please know that not
every injury or accident will require such drastic intervention, or call to
‘911’. Accidents include slips, falls,
cuts, burns, insect bites, allergies, headaches, bruises, that run the gamut
from, ‘boo-boos’, to that which may prove catastrophic. It is, of course, up to your powers of
observation while inspecting, and treating.
However, the decision may not be yours to make.
If that small voice
inside says that something is very, very wrong, or, should it say that it is
beyond your capabilities, play it safe, and call ‘911’. Some conditions warrant
always calling ‘911’, to have an ambulance take the injured or the ailing to a
hospital’s emergency room.
Some of these
‘situations’ demand that you leave the evaluation of, and treatment of to
professionals; at best—then—your involvement should be limited to some required
stabilization, in attempting to lessen the severity of symptoms, or of
preparing the individual for transport—by ambulance—to an emergency room; or,
to simply make the person more comfortable, and less likely to go into shock
before the ambulance arrives.
There are so many ‘if/thens’
that happen that will necessitate an ambulance trip to the emergency room; and
while there are a few palliative measures that you can take, putting off
dialing ‘911’, and summoning help may be foolhardy, wrong, and may—in
fact—lessen that person’s chance of survival.
As I have mentioned,
before, I am NOT licensed, nor am I a professional, so that anything I may say
is—in fact—my own opinion, no matter how well read, or assumed experienced;
and, I always try to err on the side of caution. I do feel that the majority of my suggestions
are based on personal experience, to, ‘help, do no harm’, but some of these
measures should be read, not so much with skepticism, but always with the
knowledge that I love you, and want you and yours to be ever safe and well.
You will—from time to
time, however rarely, experience events that require calling ‘911’ for an
ambulance, without delay. I list some of
them, in no particular order of magnitude; as I consider each, in its own way to
be seriously sufficient to warrant immediate action by professionals:
1)
Any slip or fall, that results in
unconsciousness.
2)
Any suspected fractured, or broken bone,
especially, if there is bone protruding and visible.
3)
Any injury to the eye.
4)
Any fall by an elderly person, that
might indicate a fractured or broken hip.
5)
An adult, sustained, elevated
temperature of 103.0. WARNING: should this temperature not respond to aspirin
or Tylenol, or, continues to rise, call ‘911’ immediately. The general purpose of an elevated temperature
is to an attempt by the body to create an inimicable climate for bacteria or
viruses to live. However, sometimes the
body—in response to the pathogen—will continue to rise. At around 105.0, there is a decided danger
that the person may begin to have seizures; unchecked, the person may go into a
state called, ‘status epilepticus’, or non-stop seizures, that prevent oxygen
from reaching the brain; it WILL either result in a vegetative state, or, most
likely be fatal ! In the old days, that
person would be placed in a bath tub, and covered with ice.
My
advice is to always keep four or five packages of frozen peas in the
freezer. They not only conform better to
an inflamed area, such as a sprained ankle, but they can be quickly refrozen,
again, for future use. And since the packages are not compromised, the peas can
still be eaten later!
In finding someone with an elevated temperature of
103.0 of higher, while waiting for the ambulance, place these bags under each
armpit, and on each interior side of the groin, where the leg joins the
torso…near the genitals. Until proper help can arrive, what you are doing is
trying to lower the temperature a little, by ‘chilling’ the blood. This is nothing to play around with, and
should only be used while waiting for an ambulance to arrive. They then, can try to stabilize the
temperature with special ice packs, until they can arrive to the emergency
room.
6)
Should that person be on a ‘blood
thinner’ such as Coumadin, or warfarin, it works to prevent clots by
lubricating the arteries and veins.
However, its action also makes it extremely difficult to clot at the
site of a cut. A surprising amount of
blood can be lost in this fashion. A
band aid will not help, nor will a hundred band aids. What you can do in this situation, AND, for
sustained cuts that run deep, and
produce copious amounts of blood, is to apply a ‘pressure dressing’, by
covering the open area, and then grabbing it, or, pressing down upon it with
great force, holding tightly to it; in this way, you literally mash the cut
closed. Your goal—while waiting for help—is to momentarily stop, or slow don
blood loss, that, unchecked will render the person unconscious; there is also
the risk of ‘exsanguination’ , or, bleeding to death. A significant, and deep,
arterial cut can shoot blood thirty feet into the air, and ‘bleed-out’ happens
rapidly.
7)
Unless diagnosed with a history of
Migraines, a head-pounding, blinding headache that—despite home treatment—lasts
longer than two or three days.
8)
Any burn, beyond that which causes
redness, and can be attended to by burn cream; this would include burns that
raise the skin with blisters, and may or may not ‘hurt’, depending if nerve
cells are damaged, or not.
9)
A resting ( at rest ) radial (wrist)
pulse above 120. Please note that ‘100’
is high, as damage to the heart could follow. As important, is if the sustained
pulse is 50 or less. Which could imply cardiac arrest.
10) A
blood pressure whose top number is greater than 150, and whose bottom number is
greater than 110. While both have names: systolic, and diastolic, the top
number represents the heart in action, while the bottom number represents the
heart ‘at rest’. Both values are
important, but the higher the bottom number is of somewhat more importance, and
if it is inordinately high, together, may bode signs of heart attack, or
stroke.
11) For confirmed diabetics, both very high
numbers or low numbers are critical. A
blood glucose of 60 or lower needs to be raised immediately, lest the person go
into insulin shock. Look for signs of
diaphoresis (profuse sweating), redness of face, unsteady gait, incoherency,
and/or tremors. Former wisdom warranted
giving the person orange juice to bring up the low blood glucose. But what if they are semi-conscious, and
cannot swallow? Several packs or a
teaspoonful of regular white, table sugar should be placed in the person’s
mouth, under their tongues (sublingually), as the glucose in the sugar will
then pass directly from under the back of the tongue, to the palette, and into
the limbic system of the brain. Don’t
overload the person, but the administration of the equivalent of three or four
packs of sugar should help stabilize them until the ambulance arrives.
12) Nausea
and vomiting, with or without elevated temperature, with or without lower
abdominal pain, that lasts over two days. This might be evidence of a number of
conditions such as food poisoning; however, sustained nausea and vomiting will
swiftly dehydrate an individual, and deplete them of necessary electrolytes;
meanwhile, try to administer sips of either power aid or gator aid, as these
drinks contain valuable electrolytes—besides hydration—that help keep the heart
running, and other body functions.
13) Constipation
that lasts longer than a week, which does not respond to laxatives (which
should always be given prudently). Pain
medications are notorious for their constipating effects, and—with the guidance
of your Provider-- usually, a stool softener is concurrently prescribed. However, constipation that lasts a week (or
longer) may indicate the presence of an impaction, wherein the stool has
hardened, and cannot pass normally through the intestines. The person may feel
uncomfortably ‘full’, but may only produce mucous and a little diarrhea as normal
stool tries to pass around the impaction.
Untended, constipation may prove fatal, as stool continues to back up
the digestive system, into the stomach.
Only in an emergency room can it safely be physically removed,
difficult, if the impaction is ‘high’, or at the start of the intestines. In
extreme cases, surgery may be advised.
And, please, please remember, to NEVER sit there and strain and strain
with all one’s might; this stimulates the Vegas nerve that runs up past the
heart; such straining can precipitate heart attacks, especially those with a
prior history of heart problems.
14) Persistent,
achy to sharp lower middle abdominal pains, or similar pains more to each side,
towards the back, under the ribs. The
pain may become unbearable, with or without elevated temperature. Only a trip
to the emergency room can rule out appendicitis; pancreatitis; urinary tract
infections (which are sometimes accompanied by dark, cloudy, painful urination;
gall stones; or, kidney stones). A perforated appendix sprays the interior body
cavity with infections and poisons, can result in unconsciousness, and—if
untreated—IS fatal. Do not wait for the appendix to rupture. It must be surgically removed.
15) Painful
urination, that may look dark, cloudy, or be odiferous (awful smelling); it
pain may be present all along the urinary tract, can produce ‘flu-like’
symptoms, and an elevated white cell blood count, which would indicate
infection; this may be a urinary tract infection, or U.T.I. Treatment involves antibiotics, along with
extra hydration. Cranberry juice is
recommended for women, apple juice for men, to help create a hostile
environment for the pathogens, but, please also note, that apple juice—taken in
great quantities—also can act like a laxative.
16) Should
you ever find that a person has become unconscious, and is NOT breathing, nor
has any determinable heart beat, then--until the ambulance arrives--you should
begin C.P.R. (cardio-respiratory-resuscitation). Often referred to as, ‘the breath of life’,
it involves a concerted attempt to blow into a person’s open airway (mouth and
throat), and push down upon the person’s chest, both at regular intervals,
which if memory serves is about one breath to every four compressions. The goal is to provide oxygen to the lungs,
to the brain, while compressing the heart to facilitate blood flow throughout
the body. While individuals differ—of
course—it is a rough estimate that—without C.P.R. being performed, a person has
about nine minutes, until becoming oxygen brain starved; except in rare
cases—particularly in children who have been rescued from icy waters at
bear-freezing temperatures—death will result.
And even if C.P. R.—begun too late, restarts breathing and heat beat,
the person will be in a vegetative state, with a so-called, ‘flat-line E.E.G.’
My very, very dearest, and precious friends, while I
do not mean to fuss at you, I must in all candor say that there is no such
thing as ‘half-ass’ C.P.R. If you want
to learn how to perform it (and I recommend that everyone does), learn to
perform it properly. Your local County
Health Department should be able to tell you when and where classes in C.P.R.
and First Aid may be given, as well as your local Fire Station.
If you learn it, learn it well; and when you commit
to using it, commit fully, with no reservations. Now I completely understand why the notion of
your putting your mouth over the mouth of a stranger—after first clearing the
airway—might repulse you, and make you want to gag, especially these days with
so much drug use and STD’s and illnesses, at least, learn it for your friend’s
and family’s sake. Mouth pieces or
guards can be purchased, as can little, portable machines to, ‘jump start’ a
heart. But I would not recommend your buying one.
17) Insect
bites. We all are familiar with ant
bites (at a picnic), or mosquito bites, where insect bites become serious, or
potentially deadly, is when the person bitten has an demonstrated allergy to
such bites, such as; spiders, snakes, scorpions, or ticks. These bites warrant treatment at a hospital
emergency room, but there are a few things you can do; keep on hand a bottle of
Benadryl 50 mg. tablets, as well as Benadryl cream in tubes; Benadryl is also
known as diphenhydramine. Also wise, in
the treatment of even minor injuries, would be to have several tubes of Triple
antibiotic cream to apply to the site to facilitate healing; When doing so,
NEVER squeeze the contents onto your bare finger. Neither touch the tube end directly to the
wound, as it is very easy to contaminate those creams, and if so, they will be
counterproductive, and too dirty to use.
Instead, apply all creams with Q-tips, using more than one should you
need to apply more cream.
18) For
those who have definitive allergic reactions to any bites, having one, or two,
‘Epipens’ on hand is wise; these are syringes that contain epinephrine to help
minimize the reaction. These ‘pens’ are
obtained by prescription, only, and be sure to always look at the expiration
date.
19) Benadryl
tabs are also of great help—until the ambulance arrives—to slow the effects of
a medication allergy. An allergy may demonstrate the following symptoms:
itching; a red face, and body that feels swollen and ‘cracked’, changes in
respirations, foggy, or loss of consciousness; and falling blood pressure. Where available, Benadryl liquid is also
helpful. But please, for a severe
allergic reaction of ANY kind, call ‘911’ immediately.
20) Since
hands, even if washed, are particularly dirty, you do not want to inadvertently
infect a wound by touching it with bare hands.
And so, the purchase of rubber, or latex gloves, in a size comfortable
to you is extremely important. Please
also know that some individuals are allergic to latex products, so be
prudent—please—in your purchase; one disaster at a time is more than enough!
I realize, my very dearest friends that this entry
has been very, very long, I nevertheless would urge you to please make, and
keep a copy of it as a reminder, even if you do not care to read it in full
now.
There are yet a few things that I’d like you to
purchase in the making of your own First Aid Kit, and these, I will attempt to
elaborate on, in part IV of this series.
As always, your feedback and comments are vitally
important to me, for they help guide me to better help you if I can. Please ever feel free to give you criticisms
and your suggestions to me anytime.
But, please, my dearest, dearest friends, and gentle
readers, I am ever motivated to try to be of some help to you, being—as I am—so
grateful to you for your kind friendships, and your caring, and support.
This concludes Part III of IV; Part IV to follow.
And,
please know I love you dearly,
‘Zahc'/Charles
