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[Australian method of first aid for European snake bites. Spreading its use in Italy].

Antiquated first-aid procedures, such as the incision and sucking of the wound and the application of a tourniquet, are still used in Italy consequent to the bite of vipers. The A. hope that such procedures will be finally abandoned, since they are ineffective, impractical, painful and can furthermore produce invalidating or disfiguring permanent outcomes. In this report they extensively describe Australian first-aid measures consequent to snakebites, constituted by a compressive bandage and by immobilization of the bitten limb by splinting. They hope therefore that the divulgation of this procedure in Italian will bring about, within a short period of time, its extensive use in Italy consequent to viper bites, as it is very effective, practical and easy to carry out.

Australia

[First aid measures in emergency pediatric surgery (author's transl)].

The type of first aid given to patients requiring emergency pediatric surgery is decisive for the prognosis in many cases. With this aspect in mind, individual disease pictures from the group of connatal deformities (esophageal atresia, intestinal atresia, gastroschisis, diaphragmatic hernia and defect, myelomeningocele), from emergency surgical situations beyond the neonatal stage (acute abdomen and ileus, esophageal varices, pneumothorax), and accident injuries (blunt abdominal trauma, cranio-cerebral trauma, burns) are selected and the most important first aid measures described. But for all diseases, the general rule for the treatment of all seriously ill children applies: provision of a safe venous access, readiness to intubate, adequate oxygenation and control of the acid-base, water and electrolyte balances.

Abdomen, Acute

First aid on the ski slopes.

In administering first aid on ski slopes, the principles followed are basic ones: arrest of hemorrhage, adequate immobilization of fractures, prevention of shock, and relief of pain. Respiratory and circulatory complications must of course be given priority, but in my experience such situations have not arisen.

Athletic Injuries

First aid for shark attack victims.

A first-aid kit designed for the treatment of shark attack victims is presented. Emphasis is placed on the control of massive haemorrhage, the restoration of plasma volume and the transfer of the patient to hospital after initial shoch has been treated on the beach.

Animals

Recognizing acute health effects of substitute fungicides: are first-aid reports effective?

Recently, many British Columbia sawmills stopped using traditional chlorophenate anti-sapstain fungicides and substituted 2-(thiocyanomethylthio) benzothiazole (TCMTB) and copper-8-quinolinolate (Copper 8). We conducted a cross-sectional study with two aims: to ascertain which acute health effects, if any, were associated with the use of the substitute fungicides; and to determine the effectiveness of first-aid records as a means of detecting acute health outcomes. Workers in five coastal sawmills were asked to complete a self-administered questionnaire about symptoms considered potentially related and unrelated to fungicide exposure, and about injuries commonly reported in sawmills. In addition, we collected first-aid records from the mills, and asked senior workers to estimate the duration of exposure to fungicides for each job. Symptoms found to be consistently elevated in TCMTB mills included dry skin around the eyes, blood-stained mucus from the nose, nose bleed, peeling skin, burning or itching skin, and skin redness or rash. No symptoms were consistently elevated in the Copper 8 mills. Symptoms related to TCMTB exposure were recorded only 12 times in first-aid logs during the study period (versus 335 questionnaire self-reports). This low symptom-recording frequency may be a function of established patterns of first-aid use in which illness symptoms are reported less frequently than injuries.

Acute Disease

First aid treatment of burns.

A burn refers to the damage caused to the skin, and sometimes deeper structures, by heat (flame, scald, contact, electricity), chemical agents or radiation. Methods of first-aid treatment of burns are varied, imprecise and sometimes harmful. This article deals with the major principles involved in first-aid, which when implemented will limit the damage created by the burn. The medical profession must be aware of what can be achieved and the necessary steps in the initial treatment of the burn. The profession is called upon to offer first-aid, to give advice and to lecture on accidents in our community, so it is necessary to have a clear plan of treatment.

Analgesics

The efficacy of Polysporin First Aid Antibiotic Spray (polymyxin B sulfate and bacitracin zinc) against clinical burn wound isolates.

Polysporin First Aid Antibiotic Spray (Burroughs Wellcome Co., Research Triangle Park, N.C.) is a dry spray containing 200,000 units Aerosporin (polymyxin B sulfate) and 10,000 units bacitracin zinc, along with a propellant. Each 1-second spray delivers approximately 2300 units of polymyxin B sulfate and 115 units of bacitracin zinc. This study was designed to evaluate the efficacy of Polysporin Spray against various clinical isolates. Blood agar plates were inoculated with a pure culture of each isolate. Polysporin was then sprayed in an area approximately 30 mm in diameter. The area of inhibition was measured and recorded after 18 to 24 hours of incubation. A clear zone at least 20 mm in diameter with surrounding edges of growth indicated sensitivity. A zone less than 20 mm in diameter or growth over the whole plate indicated resistance. Three hundred fifty-three clinical isolates (202 gram positive and 151 gram negative) were tested. The results show that Polysporin inhibits the growth of all the gram-positive organisms, including methicillin-resistant strains of Staphylococcus. The gram-negative organisms were also sensitive to Polysporin Spray, with the exception of Serratia marcescens, Morganella morganii, and Proteus mirabilis. This study suggests that Polysporin First Aid Antibiotic Spray may be effective for wounds contaminated with gram-positive and some gram-negative organisms.

Administration, Topical

Safety warnings and first aid instructions on consumer and pharmaceutical products in Nigeria: are they adequate?

An investigation into the adequacy of safety warnings and first aid instruction on 357 consumer and pharmaceutical product labels was carried out. The results show that 23% of the products carried correct and appropriate information while 34% had neither warning nor first aid instructions. About 15% had copiously written instructions and/or warnings and 15% showed partially correct instructions. Only about 4% of the products described warning signs and gave directions for the full treatment of poisoning and 3% recommended calling a health professional in the case of poisoning.

Consumer Product Safety

First aid training: an appraisal. The soldier's longest journey.

A two part study was carried out to identify the most cost-effective way of enhancing first aid in the British Army. There is a lack of co-ordination between a variety of training programmes for paramedical non-RAMC personnel. Questionnaires were used to ascertain the views of users and experts were asked their views on the requirement for first aid at point of wounding on the battlefield. Skills needed in addition to those currently taught to all soldiers were identified. These include the setting up of intravenous infusions, administration of analgesia and antibiotics and the recognition and treatment of battleshock.

Evaluation Studies as Topic

[Emergencies in childhood. Experience at a Pediatric First Aid Unit in a regional hospital].

During 1989 4445 children, divided into four different age groups, were treated in the First Aid Unit of Carate Brianza Hospital. The paper analyses the types of pathology and reasons for using the First Aid Unit. The statistical incidence of accidents involving children, above all cranial and other injuries and the accidental swallowing of toxic substances or drugs, was assessed in an attempt to prevent the causes. The type of accident was also correlated to age group. The paper confirms the affirmation made by other researchers that the inappropriate use of emergency services is linked to the lack of relationship between the family and local pediatrician rather than the lack of primary care.

Adolescent

Dental injuries: "first aid" knowledge of Southampton teachers of physical education.

A total of 66 teachers of physical education within the Southampton telephone area responded to a postal questionnaire related to their knowledge of the first aid treatment of dental injuries. In a case study investigating tooth fracture, 64% gave an appropriate answer. In a second case study relating to avulsion (loss) of a permanent tooth, 43% gave an appropriate answer. There was an unclear relationship between the point in their careers at which teachers had received first aid training and the accuracy of their responses. There is a need for further information in this area.

Adolescent

First-aid reports of acute chlorine gassing among pulpmill workers as predictors of lung health consequences.

Workers in pulpmills can be exposed to a multitude of gases hazardous to respiratory function, the most common of which is chlorine gas. First-aid reports of acute gas overexposure incidents ("gassings") over an 8 year period were used to generate exposure data on a group of pulpmill workers whose respiratory function had been studied cross-sectionally in 1981 and 1988. Three hundred forty-eight incidents representing 174 workers were identified, 78% of these being treated solely by the first-aid attendant with the administration of O2 and cough suppression medication. Among 316 workers tested during a 1988 respiratory health survey, 78 had at least one chlorine or chlorine dioxide "gassing" incident. There was a significant decrease in the FEV1/FVC ratio (p less than .05) as well as increased risk for workplace associated chest symptoms in this group with at least one "gassing" incident. In an age- and smoking-matched analysis, among workers tested both in 1981 and 1988, there was a greater decline in FEV2/FVC ratio and MMF (p less than .05) in the "gassed" group than in the nonexposed group over the 7 year period of observation. These results emphasize the need for worker protection against accidental chlorine gas exposures.

Analysis of Variance

First aid and general principles of treatment of urethral injuries accompanying pelvic fractures.

Adequate first aid and operation done in due time with participation of an urologist enables the successful primary repair of urethral injuries accompanying pelvic fractures. Suprapubic cystostomy, drainage of the pre- and subvesical space towards the perineum, splinting of the urethra with an ureteral catheter and ureteral or at least paraureteral sutures done through a perineal incision are the principal requirements. Avoidance of catheterization, but eventually emptying of the bladder through a suprapubic puncture in the preoperative period and treating the urethra with greatest gentleness in time of repair should prevent additional injury to the urethra, in most cases only partially torn. Further development shall lead to giving up the theory of two-stage operations of urethral injuries.

Diagnosis, Differential

[Contribution to the treatment of children in the first aid medical service of the stomatological department].

At the first aid medical service of the stomatological department of a type II hospital with policlinic in the course of the calendar year a total of 1,761 children from 2-15 years were treated. During this period the staff treater 1,718 teeth and 43 times they treater soft tissues of the oral cavity. Most frequently periodontitis of the decidual teeth was treated, resorption of the root of a decidual tooth, pulpitis and caries. As to therapy, extractions were most frequent, followed by trepanation of the pulp cavity and treatment of the tooth by a provisional filling. The author draws attention to unsuitable therapeutic procedures such as trepanation of the pulp cavity in case of periodonititis of a decidual tooth and application of cobalt in pulpitis of a decidual tooth after the age of seven years. She emphasizes also the necessity to use local anaesthesia in extraction of decidual teeth.

Adolescent

[Psychiatric emergency and first level intervention. Analysis of a series of attempted suicides at a Turin First Aid station].

The present study was carried out in a Turin Hospital and considers interventions for attempted suicide in the period March-May 1988, examining psychopathological and social characteristics. No epidemiological evaluation was made of the problem but rather an analysis of the specialist and general assistance given to these patients in First Aid structures, the therapeutic protocols that preceded the attempted suicide, motivations and modalities involved. In addition, a three-month follow-up looked at the therapeutic destiny of the cases. In the last analysis, an attempt was made to evaluate the therapeutic interaction between local psychiatric services and the First Aid facility of a general hospital: in fact, according to the health service reform law and the application of Law 180, the DEA, as a hospital structure, forms part of the structures delegated to the treatment of mental disturbances.

Adolescent