First Aid Care Research Articles

Rabies Immunization of Travelers in a Canine Rabies Endemic Area

Travelers to countries where rabies is endemic may be at risk of rabies exposure. We assessed rabies immunization of travelers attending a travel clinic in Thailand. The medical charts of international travelers who came for preexposure (PrEP) or postexposure (PEP) rabies prophylaxis at the Queen Saovabha Memorial Institute (QSMI), Bangkok, Thailand between 2001 and 2011 were retrospectively reviewed. A total of 782 travelers, including 188 patients who presented with mammal-associated injuries and possible rabies exposures and 594 persons who came requesting PrEP, were studied. Of the travelers who received PEP, only 27 (14.3%) had been previously immunized against rabies and 141 (75.0%) cases experienced high-risk WHO category III exposure. Most of the incidents were unprovoked. Although promptly seeking medical services after the injuries, 114 (60.7%) travelers did not undertake any first-aid care for their wounds. Of these travelers, 19 (10.3%) received intradermal rabies vaccination as they could complete the series here. Rabies immunoglobulin was given to 118 of 121 (97.5%) patients. About one fourth of recipients could accomplish the full schedule at QSMI. Among visitors who requested PrEP, 454 (76.4%) persons had just started their first dose. Among all visitors, 263 (44.3%) were Japanese. The number of Japanese asking for PrEP was higher in 2006, the year when cases of imported human rabies to Japan were reported. This trend has sustained since then. Two (0.3%) travelers were bitten by suspected rabid dogs before they completed their PrEP program. Rabies prophylaxis is an important decision for each traveler. It should be made before visiting endemic areas.

Utilisation de l’adrénaline dans le traitement de l’anaphylaxie : nécessité d’autorisation d’emploi par les secouristes

Anaphylaxis is the most serious form of the IgE-dependent food allergy, with lethal risk. The incidence is sharply rising. Analysis of the actual management of anaphylaxis, searching for the appropriateness with the International Guidelines highlighting the absolute need of epinephrine, and further suggestions for the improvement of treatment. A general review of international studies stemming from Emergency Departments (ED), Paediatric, Resuscitation, Cardiologic or Allergy Departments over 1999-2012, as well of International Guidelines about the management of anaphylaxis. The self-injectable epinephrine by the patients is under-used. Treatment by epinephrine in ED has a low concordance with recommended guidelines. The discharge prescriptions of self-injectable epinephrine and referral to allergy testing are quite insufficient. The actual management of anaphylaxis does not fit with the International Guidelines. Anaphylaxis treatment protocols according to the international criteria should be applied in ED. Risk reduction strategies cannot rely only on the self-administration of epinephrine by the patient and should put forward a better efficiency of all first-aid care providers. A targeted educational intervention should be developed to improve the care of emergency medical services providers. They should have self-injectable-epinephrine available and should be coached to use it properly.

Zinc phosphide toxicities among patients of the University of Benin Teaching Hospital, Benin city, Nigeria: A 10 year experience

Background: Due to the poor success rate associated with zinc phosphide ingestion, it became necessary to assess the incidence. Objective: To assess the incidence of zinc phosphide toxicities reported between June 2000 and June 2009 in the University of Benin Teaching Hospital, Benin City, Nigeria. Material and Method : Data were sourced from the archives of casualties of zinc phosphide poisoning. These were entered into a generated case data form after obtaining an ethical permission. Results: All the ages of the 23 casualties reported were within 37.74±13.20 years. The male-female ratio was 4.75:1. Nineteen [78.26%] died after reporting 13.52±11.34 hours following single ingestion. Twenty cases were due to suicidal tendencies; the most common reason given was because of frustration in life related to marital affairs. Among the three unintentional, two were accidental while the other was due to assassination. Postmortem was refused in all the patients that died. One attempted herbal medication. Oil and milk were the most frequent solvents used at home as first-aid care therapy. Three were unintentional. Nine came with empty sachets and containers brought by relatives. Sodium chloride intravenous infusion was the most frequently used. Duration of hospitalization was 13.38±15.60 hours. Intravenous ciprofloxacin and metronidazole were the most common antibiotics used. Oxygen was instituted in 78.26% of the victims during respiratory distress. One ate meal prepared from poisoned rodent and died after reporting. One had alcohol along with the Zinc Phosphide ingestion. Nine were reported at the drug and poison information centre. Conclusion: Attention is needed by all for proper regulation in the handling of poisons and related substances to reduce burden minimally.

Effect of combined antihypertensive and cholesterol lowering treatment on the arterial elasticity in middle-old-aged hypertension patients

Objective: To explore the prehospital first-aid mode of acute cardiovascular events, management and patient prognosis. Methods: 378 patients with acute cardiovascular diseases were continuously registered at the emergency department. The patients were divided into two groups according to the different ways of prehospital care, one group included 194 patients who received first-aid care after calling ‘120’, another was a self-aid group consisting of 184 patients whom were taken to hospital by their relatives. The proportion of subjects had higher than high school education level and better knowledge for cardiovascular disease in first-aid group was higher than self-aid group (51.3 vs 28.6%, 81.0 vs 58.7%, both Pb0.05). Firstaid group received a variety of prehospital treatment, but self-aid group not. At hospital two groups were treated according to our standard procedure, then registered, and a questionnaire was taken. All patients were followed up at the end of first and third months. Results: The major cardiovascular events was myocardial infarction (58.8%) among 378 patients, there were statistically significant differences between twogroups in self-aid response time, first disposal time and prehospital rescuing time, respectively [(31.5±5.4) min vs (87.6±8.5) min, (46.1±6.9) min vs (153.9±13.4) min, (61.5±80) min vs (1539±13.4) min, all Pb0.01], but no difference in-hospital rescuing time [(29.5±5.1)min vs (32.7±4.6)min, PN0.05]. Mortality rate was lower in first-aid group than self-aid group at the end of first and thirdmonths (2.6 vs 7.6%, 4.6 vs 9.2%, both Pb0.05). Conclusion:A perfect prehospital emergency management and process can significantly reduce initial disposal time and out-hospital rescuing time of cardiovascular events, and improved the prognosis. The educational level and health knowledge of patients and their families are related to the treatment mode.

Application of emergency management path in emergency operation nursing

Objective To apply emergency management path to improve the qualities of first aid care and the level of emergency operation care.Methods Through the investigation and analysis of related risks factors in operating room emergency care, a scientific emergency management path was made, a special emergency management was started up, the quality of emergency care was observed and evaluated.Results After the implementation and application of various emergency management paths, the awareness of first aid was improved,strain capacity was strengthened in emergency, the quality of emergency care was evidently raised.Conclusions The implementation of emergency management path is helpful to improve the quality of emergency care. Key words: Emergency management path; Operating room; Emergency care

CONCERNS OF DISASTER MEDICAL ASSISTANCE TEAM (DMAT) MEMBERS ABOUT TROUBLES AT THE NUCLEAR POWER PLANT: EXPERIENCE FROM THE NIIGATA CHUETSU-OKI EARTHQUAKE, 16 JULY 2007, IN JAPAN

An earthquake measuring 6.8 on the Richter scale struck the Niigata-Chuetsu region of Japan at 10:13 on 16 July 2007. The earthquake was followed by the sustained occurrence of numerous aftershocks, delaying the reconstruction of community lifelines. The earthquake affected the Kashiwazaki-Kariwa nuclear power plants (NPPs), the biggest NPP site in the world. The earthquake caused damage to NPPs, resulting in a small amount of radioactive materials being released into the air and the sea. However, no significant effects were detected in the public and the environment. As medical response to this earthquake, 42 Disaster Medical Assistance Teams (DMATs) were sent to hospitals and first-aid care centers at the NPP site. In order to evaluate the perceptions of the deployed DMAT personnel regarding concerns about the health effects of radiation and information about the damage to NPPs, questionnaires were sent to 40 facilities that dispatched DMATs to the earthquake area. Most of them were concerned with the effects of radiation, and adequate information about the problems at the NPPs was not communicated to them. This preliminary study suggests that communication of information is extremely important for DMAT members in the case of disasters, in particular if there exists a possibility of radiation exposure, since radiation cannot be detected by our senses. DMAT members are critical to any mass casualty incident, whether caused by humans or nature. We have learned from this earthquake that there is urgent need for an all-hazards approach, including a "combined disaster" strategy, which should be emphasized for current disaster planning and response. This is the first report on DMATs deployed to an earthquake site with damage to NPPs.

Educational intervention for preventing bloodborne infection among medical students in China

Although medical students are known to be at risk for bloodborne infections, there have been no systematic studies, effective intervention programmes, or guidelines for them in China. We developed prevention guidelines, implemented an intervention, and evaluated the effectiveness of knowledge among medical students. This study was designed as a cluster randomised controlled trial. All those who completed a consent form were randomly assigned either to an intervention or to a control group. The intervention group underwent an educational intervention programme consisting of a series of lectures and videos following a baseline survey. The control group completed the same intervention programme after the study was completed. A questionnaire of 25 items was sent to participants three months and nine months after the initial intervention programme. Outcomes measured before and after intervention included knowledge of transmission route, first-aid care, and post-exposure prophylaxis. Pearson's chi(2)-test was used, and the efficacy of students was analysed to control for bias. Intervention in the form of a one-time bloodborne pathogen educational prevention programme for Chinese medical students had little effect on knowledge.

The strategy and process of out-hospital emergency care of acute cardiovascular events

To study the strategy and process of out-hospital emergency care of acute cardiovascular events. One hundred and eighty-three patients in the Second Affiliated Hospital of Baotou Medical College were prospectively studied. The patients were divided into two groups according to the different ways of out-hospital care, one group consisted of patients who received first-aid care after calling "120" (94 cases), another was self-aid group consisting of patients sent to hospital by relatives (89 cases). The proportion of persons with higher than high school education and better knowledge for emergency care of patients with heart disease in first-aid group was higher than self-aid group (50.0% vs. 29.2%, 83.0% vs. 60.7%, both P<0.05). When the patients were brought to the emergency room, they were all treated according to our standard procedure and then registered. All patients were followed up at the end of first and third month after illness. Cardiovascular events were mainly myocardial infarction (61.7%) among 183 patients. There were statistically significant differences between two groups in self-aid response time, first disposal time and out-hospital rescuing time [(32.3+/-5.6) minutes vs. (89.6+/- 8.4) minutes, (47.3+/-7.3) minutes vs. (149.8+/-13.5) minutes, (61.7+/-8.3) minutes vs. [(149.8+/- 13.5) minutes, all P<0.01], but no difference was found in in-hospital rescuing time [(29.9+/-5.3) minutes vs. (31.1+/-4.5) minutes, P>0.05]. Morbidity rate was lower in first-aid group than self-aid group in 1st and 3rd month, respectively (2.1% vs. 9.0%, 4.2% vs. 12.4%, both P<0.05). Excellent emergency system and procedure can shorten initial disposal time and out-hospital rescuing time, thus improve patients' prognosis. The education level and health knowledge of patients and their relatives directly affect their mode of arriving hospital and prognosis.

Knowledge of firefighters with special paramedic training of the emergency management of avulsed teeth

Immediate replantation into the socket is the ideal procedure in cases of accidental avulsion of permanent teeth. In Brazil, firefighters with special paramedic training are in charge of providing first-aid care to victims of road accidents and might have to deal with tooth avulsions. This study assessed the knowledge of firefighters regarding the emergency management of avulsed teeth. Information was collected from a questionnaire submitted to 110 volunteer firefighters in seven cities in the São Paulo State (Brazil). The results revealed that 70.9% of the respondents did not know what tooth avulsion was; 53.6% did not know what tooth replantation was or defined it incorrectly; 60% would not act properly in tooth avulsion cases; 20.9% did not consider replantation of the avulsed tooth into the socket as a treatment option; the ideal time interval for tooth replantation was unknown to 40% of the interviewees; 90% of the participants answered that they would not be able to perform tooth replantation. Among those who considered themselves unable to perform tooth replantation, 47.3% chose saline as the best storage medium for an avulsed tooth, 21.8% chose milk, 3.6% chose the patient's mouth and 20% reported not knowing where to store the tooth; 81.8% of the firefighters reported not to have ever received any specific directions on tooth replantation and 100% of them considered this knowledge a requirement for first-aid care to accident victims. In conclusion, the knowledge of the surveyed firefighters regarding emergency management after tooth avulsion was unsatisfactory in several aspects that are important for the success of replantation procedures. Firefighters with special paramedic training should be educated on how to proceed in cases of dentoalveolar traumas and tooth avulsions in order to improve treatment prognosis and increase the survival rate of replanted teeth.

Severe Fracture of the Maxillary Alveolar Process Associated with Extrusive Luxation and Tooth Avulsion: A Case Report

The aim of this report is to present a case of severe fracture of the maxillary anterior alveolar process with substantial bone dislodgement associated with extrusive tooth luxation and avulsion. Dentoalveolar trauma is a challenge to dentistry, especially in young patients, for it can lead to early tooth loss which compromises oral function, esthetics, self-esteem, and alter the long-term plan of care for the victim. A 12-year-old girl with severe dentoalveolar trauma to the maxillary anterior region presented for emergency care for her injury. Treatment consisted of fracture reduction of the alveolar process, repositioning of the teeth that had suffered extrusive luxation, placement of a semi-rigid splint, and suturing of soft tissue lacerations. The traumatized teeth presented with pulpal necrosis and were treated endodontically. After 24 months of follow up, the fracture of the alveolar process was completely healed and the displaced teeth presented no signs of ankylosis or root resorption. First-aid care contributed remarkably to this case allowing the re-establishment of esthetics, function, and patient's self-esteem. In spite of trauma extension the treatment outcomes were favorable. Cases of dentoalveolar trauma should be evaluated on an individual basis. However, early emergency management and adequate follow-up can prevent further complications and contribute to treatment success.

The use and cost of first aid in the food and drink manufacturing industry.

The Health & Safety (First Aid) Regulations 1981 require all companies to consider the provision of first-aid care at work. Information was obtained by postal questionnaires returned by 36 food and drink manufacturing companies on the provision and cost of the first-aid care they provide, as well as the types of treatment that their first aiders administer. Almost all of the companies complied with the legislation by providing trained first aiders and adequate treatment equipment and facilities. The average cost of first-aid provision was 16.00 pounds per worker per year. The majority (93%) of the first-aid treatment provided was of a minor nature. The study demonstrates that first aiders only infrequently use their specialist knowledge and skills for the management of serious or life-threatening medical emergencies. Based on the results of the study, and on the results of previous studies concerning the provision of first-aid care and the training requirements for first aiders, it is concluded that the present emphasis on the provision of minor treatment and the current first-aid training system have resulted in first aiders not being adequately trained to save life, the main objective of first-aid care. A case is made for first-aid training to be reduced in content, but undertaken more frequently, to ensure that first aiders can adequately manage an acute, life-threatening medical emergency.

Ethical implications of first aid.

Nurses have a moral duty to act when faced with emergency situations. Fear of legal recourse is no excuse for failing to provide first-aid care. This article considers the ethical implications for the nurse, midwife and health visitor at the scene of an accident.

Recommendations for improving emergency medical services.

<h3>EMERGENCY FIRST AID AND MEDICAL CARE</h3><h3>First Aid</h3> Extension of basic and advanced first aid training to greater numbers of the lay population. Preparation of nationally acceptable texts, training aids, and courses of instruction for rescue squad personnel, policemen, firemen, and ambulance attendants. Adoption at the state level of general policies and regulations pertaining to ambulance services. Adoption at district, county, and municipal levels of ways and means of providing ambulance services applicable to the conditions of the locality, control and surveillance of ambulance services, and coordination of ambulance services with health departments, hospitals, traffic authorities, and communication services. Pilot programs to determine the efficacy of providing physician-staffed ambulances for care at the site of injury and during transportation. Initiation of pilot programs to evaluate automotive and helicopter ambulance services in sparsely populated areas and in regions where many communities lack hospital facilities adequate to care for seriously injured persons.

Modern Guidelines for First-Aid and Initial Care of Accident Victims

Modern Guidelines for First-Aid and Initial Care of Accident Victims

Instruction in First-Aid Care

Instruction in First-Aid Care