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PubMed1993

[Normobaric oxygenation as a first-aid measure in decompression sickness].

Most divers and diving medicine specialists know that application of normobaric oxygen as first aid after a bubble disease incident is highly effective. However, as yet technical difficulties acted as a deterrent to using normobaric oxygen at the diving site. This can now be overcome by a newer technique. To be efficient, any therapy of bubble disease should follow three main principles: maximal partial pressure of inhaled oxygen (i.e. 100 kpa in normobaric, and 280 kpa in hyperbaric conditions); minimal partial pressure of inhaled nitrogen, which should ideally be near zero; immediate start of therapy, if possible at the diving site, but not later than 2 hours after the onset of the first symptoms. However, it has to be borne in mind that for an efficient normobaric oxygenation (100%), the standard apparatus design without oxygen reservoir is obsolete, for it offers at most 40% oxygen to the lungs. Currently the following technical approaches for an efficient normobaric oxygenation are available: open one-way systems with tightly fitting mask and oxygen reservoir bag (type Ambu or Leardal, etc.); open systems with on-demand regulation and tightly fitting mouth piece (type SCUBA, or Bird-respirator); closed systems with CO2 absorber (type oxygen rebreathing diving gear). The closed system is a genuine technical advance, because it needs 15 times less oxygen than open systems (about 90 liters oxygen for a 3-hours oxygenation run). Such an apparatus is thus of light weight, far less cumbersome, and nevertheless highly efficient. The therapy should start immediately at the site of the mishap and be maintained during the transport to the next HBO-unit (usually 3 to 6 hours).(ABSTRACT TRUNCATED AT 250 WORDS)

Atmospheric Pressure↗
PubMed1994

The effects of first aid training on public awareness of the management of a seriously injured patient.

Members of the public were questioned regarding previous first aid training and whether they believed that they would be able to manage a seriously injured person adequately. They were then assessed as to their awareness of basic principles of dealing with such a person. It was found that, whilst confidence as an independent variable was not associated with better knowledge, those who had some form of training were significantly more confident about their own abilities and also performed better in the assessment. However there remained a minority who would be unwilling to become involved in the initial treatment of a seriously injured person and training did not appear to reduce this tendency.

Educational Status↗
PubMed2000

Field trial of efficacy of local compression immobilization first-aid technique in Russell's viper (Daboia russelii siamensis) bite patients.

A field trial of efficacy of local compression immobilization first-aid technique in 42 Russell's viper bite cases was studied and only 19 were envenomed. Proper immobilization was carried out in 3/13 immobilized cases. The average time of application of the pad was 1.12 hours (range 5 minutes to 7 hours) and the total duration of the pad application was 3 hours 40 minutes (range 30 minutes to 9 hours). Venom levels measured at the hospital before and at 15 and 30 minutes after release of the pad (n=10) showed a rise of 5 to 30 ng/ml of venom following release. Movement of venom antigen was found to be retarded in all cases (n=9) whose venom levels were measured at 15 and 30 minutes with the pad in place. Sixteen out of 19 cases had systemic envenoming, indicating that pad or immobilization alone is not effective in delaying spread of venom. The incidence of local necrosis 3/42 (8%) following use of the pad was comparable to that of the systemic cases without the pad. No ill effects were observed following its application for as long as 9 hours. Local blackening seen in 4/36 (10%) cases was likely to be result of a local venom effect.

Adolescent↗
PubMedDate not supplied

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.

Codes of Ethics↗
PubMedDate not supplied

Recommendations for Life-Supporting First-Aid training of the lay public for disaster preparedness.

In catastrophic disasters such as major earthquakes in densely populated regions, effective Life-Supporting First-Aid (LSFA) and basic rescue can be administered to the injured by previously trained, uninjured survivors (co-victims). Administration of LSFA immediately after disaster strikes can add to the overall medical response and help to diminish the morbidity and mortality that result from these events. Widespread training of the lay public also may improve bystander responses in everyday emergencies. However, for this scheme to be effective, a significant percentage of the lay population must learn in eight basic steps of LSFA. These have been developed by the International Resuscitation Research Center in collaboration with the World Association for Emergency and Disaster Medicine, the City of Pittsburgh Department of Public Safety, and the American Red Cross (Pennsylvania chapter). They include: 1) scene survey; 2) airway control; 3) rescue breathing (mouth-to-mouth); 4) circulation (chest compressions; may be omitted for disasters, but should be retained for everyday bystander response); 5) abdominal thrusts for choking (may be omitted for disasters, but retained for everyday bystander response); 6) control of external bleeding; 7) positioning for shock; and 8) call for help.

Cardiopulmonary Resuscitation↗
PubMedDate not supplied

Legal aspects of first aid and emergency care: 2.

The first article in this series examined the nurse's duty to act at the scene of an accident. This article explores this theme further by looking at the legal implications and the four arenas of accountability.

Emergency Medical Services↗
PubMedDate not supplied

Legal aspects of first aid and emergency care: 3.

The first and second articles in this series considered whether there was a duty in law to volunteer help when there was no pre-existing duty to do so and discussed the standard of care that should be followed. This article examines the volunteer's rights if he/she is injured while assisting at an accident.

Emergency Medical Services↗
PubMed1980

First aid in disasters.

If you are first on the scene of a disaster, approach safely and liaise with police and ambulance officers. Carry out triage, identifying those victims who need urgent treatment and those who do not--because they are not ill enough, too ill or dead. Establish priorities of treatment within the urgent group in the airway (A), breathing (B), circulation (C) sequence. Record assessment and treatment given.

Adult↗
PubMed2001

Corneal foreign bodies--first aid, treatment, and outcomes. Skills review for an occupational health setting.

Eye injuries from foreign body incidents remain prevalent in the workplace setting. Often the professional nurse provides the first line of treatment. The informal class presented at the authors' facility offered a comprehensive, organized presentation of a common injury encountered in the practice of occupational health nursing. Strenghts of the presentation included handouts demonstrating eye eversion technique and a flip chart summarizing the content to be placed in each medical station as quick reference. One challenge involved presenting the information to all nurses. The site encompasses four locations and some nurses function as the only staff in the plant for a given shift. With the support of administration and some creative scheduling, 10 of 17 nurses attended one of three classes offered in one morning, and the remaining 7 were able to view the class on videotape. Videotaping the presentation also provided material for future orientation, as well as an opportunity for review. Overall analysis found this a worthwhile offering relevant to practice. A brief formal written evaluation indicated the objectives for the class were achieved and elicited subjects for future topics. Informal chart reviews to check for documentation of visual acuity testing and eversion of the upper lid for foreign body injuries is another outcome measure currently in progress. In addition, a performance improvement project could be accomplished easily by retrospective chart review of assessment and treatment documentation, and tracking of revisits and referrals. Knowledge of current standards in the assessment, first aid, and treatment of eye injuries is every occupational health nurse's responsibility. However, prevention of foreign body injuries is far superior to any treatment modality available. As highly visible leaders within the occupational setting, nurses can be advocates and role models for safe work practices. Occupational health nurses may promote safe eye practices by actively seeking collaboration with safety departments to continuously monitor and improve eye injury and outcome statistics and use of protective eye-wear. By consistently wearing proper safety eyewear, such as approved goggles or prescription safety glasses with side sheilds, during each and every venture into the work area, occupational health nurses provide a strong role model and have the opportunity to educate employees and encourage safe work practices. It is important to encourage shared responsibility and awareness between workers and management for prevention of foreign body incidents and prompt, accurate treatment when necessary to promote optimal outcome.

Cornea↗
PubMed2002

Is epinephrine administration by sublingual tablet feasible for the first-aid treatment of anaphylaxis? A proof-of-concept study.

PURPOSE: In order to explore the feasibility of sublingual administration of epinephrine tablets as a non-invasive first-aid treatment for anaphylaxis, we studied epinephrine absorption from this dosage form in an animal model. METHODS: In a prospective, randomized, four-way crossover study, six rabbits received epinephrine 2.5 or 10 mg as a sublingual tablet, epinephrine 0.03 mg (0.3 ml) by intramuscular (IM) injection (positive control), and 0.9% NaCl (0.3 ml) IM (negative control). Pre- and post-dose blood samples were obtained for measurement of plasma epinephrine concentrations by HPLC-EC. RESULTS: After administration of epinephrine 2.5 mg as a sublingual tablet, the mean (+/-SEM) C(max) was 2369+/-392 pg/ml, and the t(max) was 20.8+/-5.7 min. After administration of epinephrine 10 mg sublingually, the C(max) was 10836+/-2234 pg/ml, and the t(max) was 21.7+/-5.4 min. After IM epinephrine, the C(max) was 6445+/-4233 pg/ml, and the t(max) was 15.8+/-4.7 min. After IM 0.9% NaCl, the C(max) (endogenous epinephrine) was 518+/-142 pg/ml. The t(max) after both of the sublingual epinephrine tablet doses did not differ significantly from the t(max) after IM epinephrine, and the C(max) after the 10 mg sublingual epinephrine tablet dose did not differ significantly from the C(max) after IM epinephrine. CONCLUSIONS: In this proof-of-concept study, administration of epinephrine as a sublingual tablet formulation resulted in rapid achievement of peak plasma epinephrine concentrations. Absorption studies in humans are needed. DEFINITIONS: HPLC-high performance liquid chromatography; EC - electrochemical detection; C(max) - maximum plasma epinephrine concentration after dosing; t(max) - time of maximum plasma epinephrine concentration.

Administration, Sublingual↗
PubMed2000

Life supporting first aid (LSFA) teaching to Brazilians by television spots.

Accidents in developing countries are frequent and have high mortality and morbidity rates. In Brazil, in 1995-1996, the year of this study, life supporting first aid (LSFA), which includes cardiopulmonary resuscitation (CPR) basic life support (BLS) was not taught in schools. With the population of 165 million, the only way to teach the adult population on a large scale would be by television (TV), that is widely viewed. This study compares two groups of factory employees - 86 controls without TV exposure to LSFA and 116 exposed to brief LSFA skill demonstrations on TV. Their ability to acquire eight LSFA skills was evaluated: external hemorrhage control; immobilization of a suspected forearm fracture; treatment of a skin burn by cold flush; body alignment after a fall; positioning for shock and coma; airway control by backward tilt of the head; and CPR (steps A-B-C). Simulated skill performance on the evaluating nurse or manikin was tested at 1 week, 1 month, and 13 months. In the control group, 1-31% performed individual skills correctly; as compared to 9-96% of the television group (P<0.001). There was excellent retention over 13 months. Over 50% of the television group performed correctly five of the eight skills, including positioning and hemorrhage control. Television viewing increased correct airway control performance from 5 to 25% of trainees, while it remained at 3% in the control group. CPR-ABC performance, however, was very poor in both groups. We conclude that a significant proportion of factory workers can acquire simple LSFA skills through television viewing alone, except for the skill acquisition of CPR steps B (mouth-to-mouth ventilation) and C (external chest compressions) which need coached manikin practice.

Adult↗
PubMed1979

Health education for the preadolescent: basic first aid.

Accidents are the leading cause of death and disability in the preadolescent age group. For this population, the State of California now recommends specific accident and emergency health education. This article discusses the American Red Cross' self-paced Basic First Aid course which can meet the needs of the student as suggested and integrate the student-teacher-nurse in a health education experience profitable for all.

California↗
PubMed2026

A systematic review of the impact of Mental Health First Aid on medical, nursing and allied healthcare professional students.

BACKGROUND: Healthcare professional (HCP) students are at high risk of mental health problems, but stigma and fear of career repercussions often deter them from seeking help. Mental Health First Aid (MHFA) is a globally disseminated course teaching the public to identify and respond to people experiencing mental health problems. MHFA training may address some of the challenges faced by HCP students, by improving mental health knowledge and by enhancing well-being and peer support. AIMS: To systematically review the available literature regarding the impact of MHFA training on HCP students' mental health literacy, confidence and intentions to provide help, stigma, peer support and self-care. METHOD: Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines (International Prospective Register of Systematic Reviews ID: CRD42024589509), five databases were searched. Primary studies evaluating the above outcome measures in HCP students were included. Two authors independently screened references and extracted data. Quality was assessed using the Modified Medical Education Research Study Quality Instrument and Cochrane Risk of Bias tools. A narrative synthesis was performed. RESULTS: Of 2367 records screened, 26 met inclusion criteria. Confidence in supporting others and mental health literacy showed the most consistent improvements following MHFA training, whereas evidence for changes in stigma was mixed. Peer support, self-care and student well-being were infrequently examined, although qualitative data suggested that MHFA had improved openness to help-seeking. CONCLUSIONS: MHFA shows promise in enhancing mental health literacy, confidence and intentions, and in reducing stigma, particularly when supplemented with experiential learning. HCP students may benefit from tailoring of such courses to their specific needs, fostering a culture of peer support, enhancing well-being and introducing basic concepts in mental health.

MHFA↗