First Aid Facilities Research Articles

What brings people to government urban primary care facilities? A community-based study from Delhi, India

Introduction: Mohalla or Community Clinics of Delhi, India, provides free primary care services to the general population, with special focus on the underserved and marginalized. This study was conducted to analyze the perception and experience of target beneficiaries and to understand and document the determinants of people visiting these clinics. Material and Methods: A community-based study was conducted from October 2019 to April 2020. A semi-structured questionnaire was used for data collection. Correlation and comparative analysis were used. Thirty-seven Mohalla Clinics and their catchment areas were visited. A total of 391 respondents (including 35 health staff and 356 community members) were included. Results: Proximity of clinics, waiting times, age, perceived quality of treatment, and cleanliness at facilities were the factors that influenced the usage of clinics. Lack of first-aid facilities and long waiting time (at a few facilities) were identified challenges. There is a need for wider publicity and awareness about the clinics and regular analysis of data to determine an appropriate mid-course action to further increase utilization. Conclusion: Community Clinics of Delhi, India, have brought people back to government primary healthcare (PHC) facilities. The popularity of these clinics has encouraged a number of Indian states to set up similar facilities. The factors behind their success need to be studied in detail to derive lessons for making urban PHC accessible in other low- and middle-income countries.

Carrying rates of epinephrine devices in children with food-induced anaphylaxis.

BackgroundCarrying epinephrine can save lives in patients with anaphylaxis. The feature of epinephrine in prefilled syringe that commonly prescribed in Thailand may influence the willingness to carry. However, the rates of carrying prefilled syringe epinephrine are unknown in children with history of food-induced anaphylaxis.ObjectiveTo determine the rate of epinephrine carrying in children with history of food-induced anaphylaxis and factors influencing the decision to use the devices.MethodsA cross-sectional study was conducted by performing the structured interview in the parent(s) who were the main caregiver of the children with history of food-induced anaphylaxis.ResultsThe parents of 99 children (male, 50.5%) were interviewed. The median age of the child was 11 years old (range, 9 months to 18 years). Rate of carrying epinephrine was 84.7% (always 57.6%, some occasions 27.2%). The most common reason for not carrying was the thoughts that the children could avoid the food allergens. The first-aid facility at school was available in 48.3%. Rate of carrying epinephrine tended to be lesser in children attend the schools without first aid facility (p = 0.053). Forty-one patients had relapsing episodes, 34 (82.9%) had epinephrine carried, and 20 (58.8%) injected the epinephrine. The most common reason for not using epinephrine despite carrying was that they were afraid of getting injection (28.5%).ConclusionMost children with history of food-induced anaphylaxis carried epinephrine, but only half used it at the episodes. Interventions to promote epinephrine-carrying and injection training are needed in our setting.

First aid facilities in the school settings: Are schools able to manage adequately?

Background and Objective:Children spend most of their time in schools and are vulnerable to injuries and mild ailments, hence requiring first-aid care. School teacher can provide immediate first-aid care in the absence of any health professional. This study assesses first-aid facilities within school premises and assessment of teachers on first aid training.Methods:A cross sectional study was conducted from July-December 2017, participants were full time school teachers of both public and private sectors at both primary and secondary levels, having a minimum of one year experience. Questionnaire was filled on one to one basis by taking oral interview.Results:Out of 209 teachers, 72.7% were from private sector. Stomachache was the most common medical incident (82.29%) requiring first-aid care in schools. First aid box was available in all schools but its contents were not satisfactory. Sick bay was not found in any school. 68.42% of teachers were not trained in first-aid management because of lack of opportunity, however 56% were willing to enroll in any first aid training and majority (91.38%) considered it essential for their professional life.Conclusion:First aid facilities at various schools of Karachi and availability of trained teachers who can provide first aid care is unsatisfactory.

Medical control of mass gatherings: can paramedics perform without physicians on-site?

Evaluate the experience of paramedic personnel at mass gatherings in the absence of on-site physicians. Retrospective review of patients evaluated by paramedics with emergency medical services (EMS) medical control. First-aid facility operated by paramedics at an outdoor amphitheater involving 32 (predominantly rock music) concerts in accordance with the Chicago EMS System, June through September 1990. A total of 438 patients (< or = 0.1% on-site population) were evaluated. Presentations to the first-aid facility were viewed as if the patient was presenting to an ambulance. Transportation to an emergency department was strongly recommended for all encounters. Time from presentation to the first-aid facility until disposition was limited to 30 minutes in the absence of on-line [direct] medical control. Refusal of care was accepted. On-line [direct] medical control with the EMS resource hospital was initiated as needed. Off-line [indirect] medical control consisted of weekly reviews of all patients records and periodic site visits. Of the 438 patients, 366 (84%) refused further care, including 31 patients (7%) who refused advanced life support (ALS) level care. Seventy-two patients (16%) were transported; 37 by ALS and 35 by basic life support (BLS) units. On-line [direct] medical control was initiated in all ALS patients that were transported as well as for those who refused care. No known deaths or adverse outcomes occurred, based on lack of inquiries or complaints from the local EMS system, emergency departments receiving transported patients, law enforcement agencies, 9-1-1 emergency response providers, venue management, or security. No request for medical records from law firms have occurred. Problems noted initially were poor documentation and a tendency not to document all encounters (e.g., dispensing band-aids, tampons, earplugs, etc.). Concerns noted included: initial and subsequent vital signs, times of arrival, interventions, dispositions, and patient conditions of refusal. Specific problems with documentation of refusals at disposition included: appropriate mental status, speech, and gait; release with an accompanying family member or friend; and parental notification and approval of care for minors. There also was an initial tendency not to establish on-line [direct] medical control for ALS refusal or BLS medicolegal issues. The medical system configuration modeled after practices of prehospital care, demonstrates physicians did not need to be on-site when adequate EMS medical control existed with less than 30 minutes on-scene time.

Appendix 4: First-aid boxes and first-aid facilities

Appendix 4: First-aid boxes and first-aid facilities

Appendix 4: First-aid boxes and first-aid facilities

Appendix 4: First-aid boxes and first-aid facilities

Ice-Skating injuries to the hand

166 patients with injuries due to ice-skating were seen in the local accident and emergency department over a six-month period; 60% of these involved the upper limb. 28 of the upper limb injuries were closed fractures and 24 were lacerations, almost all to the dorsum of the hand. The use of protective gloves would help to prevent these potentially avoidable injuries. “On-site” first-aid facilities help to reduce the demand on the local accident service.

Ice-Skating Injuries to the Hand

166 patients with injuries due to ice-skating were seen in the local accident and emergency department over a six-month period; 60% of these involved the upper limb. 28 of the upper limb injuries were closed fractures and 24 were lacerations, almost all to the dorsum of the hand. The use of protective gloves would help to prevent these potentially avoidable injuries. "On-site" first-aid facilities help to reduce the demand on the local accident service.

Medical planning for a major event: the Pope's visit to Coventry Airport, 30 May 1982.

The five-hour day visit by the Pope to Coventry Airport on 30 May 1982 required a major exercise in medical planning. First- and second-line first-aid facilities were provided by the British Red Cross Society and the St John Ambulance Association. Hospital facilities were provided in a 30-bed Territorial Army field hospital. The visit attracted a crowd of 350,000; 1424 casualties were seen at first-aid stations and 152 at the field hospital. Twenty patients required transfer to NHS hospitals for further treatment, and one woman died. Most ailments experienced were headaches and effects of heat, blisters, and abdominal symptoms. The field hospital treated a wide range of conditions including cardiac conditions, fractures, premature labour, and acute abdominal emergencies.

The place of medicine in the American prison: ethical issues in the treatment of offenders.

In Britain doctors and others concerned with the treatment of offenders in prison may consult the Butler Report (see Focus, pp 157) and specialist journals, but these sources are concerned with the system in Britain only. In America the situation is different, both in organization and in certain attitudes. Dr Peter L Sissons has therefore provided a companion article to that of Dr Paul Bowden (page 163) describing the various medical issues in prisons. The main difference between the treatment of offenders in prisons in America and in Britain lies in the nature of the federal system which means that each state may operate a different system in a variety of prisons and prison medical services are as various. Nationally, the prison systems are 'structured to treat and cure the offender'. Therefore it follows that the prison medical officer is only one of the professionals concerned with this 'cure' of the offender. This principle also applies to any form of research: medical research in prisons is part of a programme which covers a wide field of social and judicial research. The prison medical officer (where there is one) has of course to look after sick prisoners, and the American idea of 'cure' is also expressed in the need for more corrective surgery where, for example, it is necessary to remove physical impediments to social rehabilitation. But a doctor is only found on the staff of those institutions which are large: in the smaller prisons there may be only first-aid facilities, and no specially appointed doctor in the community. Moreover medicines are often dispensed by medical auxiliaries who are sometimes prisoners themselves. Finally, in America prisoners are regularly invited to volunteer as subjects for medical and social research for which they are paid. In short, although it is hoped to 'cure' a prisoner he is a criminal first and a patient second.

The changing complexity of fire and health protection problems in vegetable‐oil processing plants

w HEN my subject was first mentioned to me, it seemed that fire and health protect ion problems had grown more complex with the years. Af te r f u r t he r thought I realized tha t this was not necessarily so. Therefore I shall discuss changes and lack of changes, ra ther than increases, in the complexity of our problems. As addit ional clarification, it should be explained that most of my experience with vegetable-oil fire and health protection problems has been in the crudeprocessing end of the business so what I say is bound to be slanted in the direction of crude milling. Many years ago, when I first had anyth ing to do with a vegetable-oil processing plant, a crude mill was a mult is toried affair, often of brick or stone with wooden floors and roof. Near ly a lways there was a basement that contained the main lineshafts, which in tu rn were driven by a steam engine located somewhere near the middle of the building. The main mill building l i terally was j ammed full of machinery driven by lineshafts and counter shafts. The work spaee between machines usual ly was dark and inadequate. Auxi l ia ry buildings, for seedand products-storage, often were of wood, and many of them were fire traps. Machinery in auxi l iary buildings f requent ly was driven f rom the main engine by means of lineshafts s tretching across the mill yard. As well as I can remember, a great m a n y of our fires were caused by hot bearings, by the rubbing of belts on wood, and by sparks produced by scrap iron passing through machinery. Processing machines, conveyors, and elevators often contained m a n y wooden par ts and l i terally added fuel to the fires. As far as injuries to personnel were concerned, men were hur t by falls, by get t ing caught on line shafts, pulleys, and belts, and by being crushed in the process of handl ing heavy objects by hand. Infections were common because m a n y things were handled by hand and because locker-room and firstaid facilities were poor. In the bull/ handl ing of slow-flowing materials like cottonseed and cottonseed hulls, men often were covered up by caving materials. Regre t tab ly this problem has not been conquered and may even be worse in these days of bulk storage tanks and houses with high side-walls. Although we often feel tha t we have not made much progress in our industry, today ' s crude mills have changed much more than one may think. Most of the older mills that still operate have been electrified and now use group and individual drives. Newer mills have been built on one level and may not have any line shaft ing or open drives at all. Also the new plants general ly are of fire-proof construction. In almost all cases the l ighting and cleanliness have great ly improved; and the men have more and better work-space, locker rooms, and first-aid facilities. The danger of fire a n d / i n j u r y f rom screw conveyors and f rom material e t e ~ t o r s has been great ly reduced by the replacement of the wooden housings with t ight and substantial steel housings. Fires