Severe Bleeding

Severe bleeding involves loss of large amount of blood  This may occur externally through natural openings, like mouth  A cut on the skin too can lead to bleeding  Internal bleeding occurs due to an injury to blood vessel 

Symptoms

Discharge of blood from a wound  Bruising  Blood in stool/urine  Blood coming from other areas, like mouth/ear 

   Treatment

Wash hands well before administering to patient  Wear synthetic gloves  Make the victim lie down  Slightly elevate the legs  If possible keep the affected area elevated  Remove any obvious debris/particle  Apply direct pressure using clean cloth/bandage  Use hand if cloth is not available  Apply pressure continuously for at least 20 minutes  Do not remove the cloth to check the bleeding  Hold the bandage in place using an adhesive tape  If bleeding seeps through bandage, do not remove it  Add extra bandage on top of the first one  Apply direct pressure on the artery if necessary  The pressure points for arm--below arm- pit/above elbow  For leg--behind knee/near groin  Squeeze the artery keeping finger flat  Continue applying pressure on the wound  Once bleeding stops immobilize the affected part  See a doctor 

First Aid

1. Have the injured person lie down and cover the person to prevent loss of body heat. If possible, position the person's head slightly lower than the trunk or elevate the legs. This position reduces the risk of fainting by increasing blood flow to the brain. If possible, elevate the site of bleeding.

2. While wearing gloves, remove any obvious dirt or debris from the wound.  Don't remove any large or more deeply embedded objects. Don't probe the wound or attempt to clean it at this point. Your principal concern is to stop the bleeding.

3. Apply pressure directly on the wound until the bleeding stops. Use a sterile bandage or clean cloth and hold continuous pressure for at least 20 minutes without looking to see if the bleeding has stopped. Maintain pressure by binding the wound tightly with a bandage (or a piece of clean cloth) and adhesive tape. Use your hands if nothing else is available. If possible, wear rubber or latex gloves or use a clean plastic bag for protection.

4. Don't remove the gauze or bandage. If the bleeding continues and seeps through the gauze or other material you are holding on the wound, don't remove it. Instead, add more absorbent material on top of it.

5. Squeeze a main artery if necessary. If the bleeding doesn't stop with direct pressure, apply pressure to the artery delivering blood to the area of the wound. Pressure points of the arm are on the inside of the arm just above the elbow and just below the armpit. Pressure points of the leg are just behind the knee and in the groin. Squeeze the main artery in these areas against the bone. Keep your fingers flat. With your other hand, continue to exert pressure on the wound itself.

6. Immobilize the injured body part once the bleeding has stopped. Leave the bandages in place and get the injured person to the emergency room as soon as possible.

Appendicitis

Appendicitis is a condition in which the appendix, a small inconsequential appendage to

the colon, becomes inflamed and swollen.

Signs and Symptoms

The pain may begin on the lower right side of the abdomen, but it may also start as a vague discomfort in the center of the abdomen and then move to the lower right side. Although not every pain in the abdomen indicates appendicitis, a person should report any pain that persists and that is accompanied by loss of appetite, nausea, vomiting, and fever to a physician. Until a doctor determines what is wrong and what should be done, a person should not take laxatives or enemas.

There are no specific tests for appendicitis, but blood tests (such as a white blood cell count) and x-rays may help a physician make a diagnosis. Abdominal ultrasound has proven to be useful in differentiating causes of abdominal pain.Physicians can perform a laparoscopy by placing a thin telescope-like instrument through a small incision in the abdomen. This enables a physician to view the abdominal organs directly. If the cause of pain is appendicitis, the physician will usually remove the appendix immediately. However, if the appendix is abscessed, the patient may have to take large doses of antibiotics to reduce infection before the appendix can be removed.

Treatment

The surgery that corrects appendicitis, called an appendectomy, is a procedure with relatively little risk. Normally, the patient stays in the hospital for less than a week and can usually count on being back to a normal routine in three weeks. Many surgeons are performing laparoscopic appendectomy in which the appendix is removed through three small incisions (less

than half an inch long) using special instruments and a special camera. With laparoscopic appendectomy, most patients can go home within 24 hours of the operation. However, if the appendix is ruptured, the patient may need to stay in the hospital for a considerably longer period of time and the risk of complications is much greater. A very ill patient may require special measures, such as stomach tubes and intravenous medications. If such complications have occurred, it may be two to three months before the patient can resume normal activity. Once the useless appendix is removed, there is no danger of appendicitis recurring.

Heart Attack

A heart attack, also known as a myocardial infarction (MI), generally occurs when there

is a blockage of blood flow to the heart, resulting in the heart not recieving the oxygen and

nutrients it needs.

Symptoms of Heart Attack

Warning Signals

The key to surviving a heart attack is promptly recognizing the warning signals and getting immediate medical attention. If you feel an uncomfortable pressure, fullness, squeezing or pain in the center of your chest (that may spread to your shoulders, neck or arms) and your discomfort lasts for two minutes or longer, you could be having a heart attack. Sweating, dizziness, fainting, nausea, a feeling of severe indigestion, or shortness of breath may also occur, although not all symptoms do necessarily occur.

When a person has these symptoms, it is natural for him or her to deny what is happening. No one wants to think that he might be having a heart attack. It is important to know that over 300,000 heart attack victims died before reaching the hospital last year, many of them because they refused to take their symptoms seriously.

Treatment of Heart Attack

Initial treatment may include nitrates - e.g., sublingual (under the tongue) nitroglycerin, oxygen, aspirin and pain medication (e.g., morphine).

The objective of thrombolytic (lysing the thrombus) therapy in acute myocardial infarction is to lyse (dissolve) the coronary thrombus (clot) and allow oxygenated blood to reach the heart muscle as quickly as possible. The goal is that intervention early in the course of infarction will limit infarct size, preserve left ventricular function, prevent pump failure and ultimately, prevent death.

The four thrombolytic agents that have been evaluated extensively in acute infarction are: streptokinase, tissue plasminogen activator (t-PA), reteplase and anistreplase (APSAC).

Although there is much debate over which agent to use, the overriding consideration is early adminstration of any one of them.

A number of medical centers now manage acute myocardial infarction with primary angioplasty of the affected coronary artery. Your physician may suggest other treatments as well.

Prevention of Heart Attack

Studies in recent years have shown that taking an aspirin every day may reduce the risk of having a heart attack or a stroke caused by a blood clot forming in an artery. However, it is important that you first consult your doctor before beginning aspirin therapy.

Some studies have shown that the risk of a heart attack during or just after heavy physical exertion is two to six times greater than the risk during less strenuous physical activities or no activity, but regular physical activity diminished the added risk to practically none at all.

Normally sedentary people who try something strenuous like shoveling snow, sprinting to catch a bus, playing tennis or pushing a car out of a snowdrift, may be especially at risk.

Among the cardiovascular benefits of regular exercise are a diminished tendency of blood to form clots, an improved cholesterol profile, more efficient use of oxygen by the muscles, a larger volume of blood pumped with each heartbeat, and during periods of exertion, greater dilation of the arteries, a lower heart rate and lower blood pressure.

Stroke

A stroke occurs when the arterial blood flow leading to or in the brain becomes blocked or ruptures.

Blood carries oxygen and nutrients to the neurons (nerve cells) in the brain, so when the blood flow stops, the cells begin to die. As a result, the functions of the body controlled by the nerve cells can lose their ability to function.

Symptoms of Stroke

The warning signs of stroke are:

Sudden weakness or numbness of the face, arm and leg on one side of the body. Loss of speech, or trouble talking or understanding speech. Dimness or loss of vision, particularly in only one eye. Unexplained dizziness, unsteadiness or sudden falls. "Temporary strokes" (transient ischemic attacks or TIAs). These can occur days, weeks

or even months before a major stroke. TIAs result when a blood clot temporarily clogs an

artery and part of the brain does not get the supply of blood it needs. The symptoms occur rapidly and last a relatively short period of time, usually from a few minutes to several hours. The usual symptoms are like those of a full-fledged stroke, except that the symptoms of a TIA are temporary, lasting 24 hours or less. In fact, people who have had TIAs are 9.5 times more likely to have a stroke than people of the same age and sex who have not had a TIA.

Treatment of Stroke

Treating a stroke depends on where the stroke occurred in your brain and whether it's ischemic or hemorrhagic. The doctor may use a magnetic resonance imaging (MRI) scan, computed tomography (CT) imaging or angiography (injecting dye through a catheter inserted into the suspected blocked blood vessel and taking x-rays of the vessels) to determine the stroke type and location.

Time is critical. Until a few years ago, strokes were regarded as untreatable. Brain cells were thought to die within minutes after a stroke began, so stroke treatment was believed useless. The only onsite medical treatment is stabilization and "wait and see." Now researchers have discovered that some brain cells die immediately after a stroke, but others can survive for as long as several days. It is now clear that treatment following a stroke, especially if begun within three hours of onset, can help preserve brain tissue.

Prevention of Stroke

Strokes may be prevented by lowering your blood pressure, quitting smoking, beginning or increasing exercise, controlling medical problems with medications (i.e., atrial fibrillation requires anticoagulants), maintaining optimal weight, and eating a diet high in fruits and vegetables.

If you have a blocked carotid artery your doctor may suggest a carotid endarterectomy to remove the fatty deposits.

Convulsions

Convulsions are when a person's body shakes rapidly and uncontrollably. During convulsions, the person's muscles contract and relax repeatedly.

The term "convulsion" is often used interchangeably with "seizure," although there are many types of seizures, some of which have subtle or mild symptoms instead of convulsions. Seizures of all types are caused by disorganized and sudden electrical activity in the brain.

Symptoms:

Brief blackout followed by period of confusion

Drooling or frothing at the mouth

Eye movements

Grunting and snorting

Loss of bladder or bowel control

Sudden falling

Teeth clenching

Temporary halt in breathing

Uncontrollable muscle spasms with twitching and jerking limbs

Unusual behavior like sudden anger, sudden laughter, or picking at one's clothing

The person may have warning symptoms before the attack, which may consist of:

Fear or anxiety

Nausea

Vertigo

Visual symptoms (such as flashing bright lights, spots, or wavy lines before the eyes)

Prevention:

People with epilepsy should always take any prescribed medication and wear a medical

alert tag.

Keep fevers under control, especially in children.

First Aid:

1. When a seizure occurs, the main goal is to protect the person from injury. Try to prevent

a fall. Lay the person on the ground in a safe area. Clear the area of furniture or other

sharp objects.

2. Cushion the person's head.

3. Loosen tight clothing, especially around the person's neck.

4. Turn the person on his or her side. If vomiting occurs, this helps make sure that the vomit

is not inhaled into the lungs.

5. Look for a medical I.D. bracelet with seizure instructions.

6. Stay with the person until he or she recovers, or until you have professional medical help.

Meanwhile, monitor the person's vital signs (pulse, rate of breathing).

In an infant or child, if the seizure occurs with a high fever, cool the child gradually with tepid

water. You can give the child acetaminophen (Tylenol) once he or she is awake, especially if the

child has had fever convulsions before. DO NOT immerse the child in a cold bath. See fever

convulsions.

Shock:

Shock is a life-threatening condition that occurs when the body is not getting enough

blood flow. This can damage multiple organs. Shock requires immediate medical treatment and

can get worse very rapidly.

Symptoms:

A person in shock has extremely low blood pressure. Depending on the specific cause and

type of shock, symptoms will include one or more of the following:

Anxiety  or agitation/restlessness

Bluish lips and fingernails

Chest pain

Confusion

Dizziness , light-headedness, or faintness

Pale, cool, clammy skin

Low or no urine output

Profuse sweating , moist skin

Rapid but weak pulse

Shallow breathing

Unconsciousness

First Aid:

Call 911 for immediate medical help.

Check the person's airway, breathing, and circulation. If necessary, begin rescue breathing

and CPR.

Even if the person is able to breathe on his or her own, continue to check rate of breathing at

least every 5 minutes until help arrives.

If the person is conscious and does NOT have an injury to the head, leg, neck, or spine, place

the person in the shock position. Lay the person on the back and elevate the legs about 12

inches. Do NOT elevate the head. If raising the legs will cause pain or potential harm, leave

the person lying flat.

Give appropriate first aid for any wounds, injuries, or illnesses.

Keep the person warm and comfortable. Loosen tight clothing.

IF THE PERSON VOMITS OR DROOLS

Turn the head to one side so he or she will not choke. Do this as long as there is no suspicion

of spinal injury.

If a spinal injury is suspected, "log roll" him or her instead. Keep the person's head, neck, and

back in line, and roll him or her as a unit.

Do Not:

Do NOT give the person anything by mouth, including anything to eat or drink.

Do NOT move the person with a known or suspected spinal injury.

Do NOT wait for milder shock symptoms to worsen before calling for emergency medical

help.

Call immediately for emergency medical assistance if:

Call 911 any time a person has symptoms of shock. Stay with the person and follow the

first aid steps until medical help arrives.

Prevention:

Learn ways to prevent heart disease, falls, injuries, dehydration, and other causes of

shock. If you have a known allergy (for example, to insect bites or stings), carry an epinephrine

pen. Your doctor will teach you how and when to use it.

Once someone is already in shock, the sooner shock is treated, the less damage there may

be to the person's vital organs (such as the kidney, liver, and brain). Early first aid and

emergency medical help can save a life.