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PubMedDate not supplied

Lymphatic flow rates and first-aid in simulated peripheral snake or spider envenomation.

OBJECTIVES: To demonstrate and define normal lymphatic transit times by lymphoscintigraphy and to evaluate the efficacy of the currently recommended first-aid measures for the management of snake or spider envenomation. SETTING: The nuclear medicine department of a major teaching hospital. PARTICIPANTS AND DESIGN: Twenty-four subjects received either intradermal or subcutaneous injections of 99mtechnetium antimony sulfur colloid (0.1 mL) in both hands/forearms and feet/legs. This simulated a snake or spider bite. Fifteen of the subjects had first-aid in the form of firm bandages and splints applied to an upper and a lower limb immediately after injection. MAIN OUTCOME MEASURES: The progress of the radiotracer was followed with a large field of view gamma camera. If no egress of radiotracer was seen in the bandaged limbs, the subject walked until radioactivity was detected. RESULTS: The mean (+/- SEM) periphery-to-systemic circulation transit time after subcutaneous injection was 58 (+/- 7) minutes. The first-aid was found to be very effective when applied with bandage pressures ranging from 40 to 70 mmHg (5.3-9.3 kPa) in the upper limb and 55 to 70 mmHg (7.3-9.3 kPa) in the lower limb. Lower and higher bandage pressures were ineffective. However, despite first-aid measures, egress of radiotracer, even in the upper limbs, was seen in all subjects who walked for 10 minutes or more. CONCLUSIONS: Firm pressure bandaging is an effective means of restricting the lymphatic flow of toxins after envenomation, provided the bandage is applied within the defined pressure range. Strict limb immobilisation is necessary to minimise lymphatic flow, and walking after upper or lower limb envenomation will inevitably result in systemic envenomation despite first-aid measures.

Adult↗
PubMed2005

[Resuscitation by laypersons: lack of knowledge of first-aid measures in Germany].

BACKGROUND AND OBJECTIVE: Sudden cardiac death is a leading cause of death. In Germany, only 10% of patients will survive reanimation. The prognosis is mainly determined by the first-aid skills of accidental witnesses. METHODS: The reaction of 1007 German-speaking adults (462 males, 545 females, median age 39 years) was investigated in an emergency scenario with symptoms of sudden cardiac death in an acquaintance. Afterwards a self-assessment of their first-aid skills, such as cardiac compression and mouth-to-mouth ventilation was made. RESULTS: 94% of the interviewees would call professional aid at once. Diagnostic skills, as searching for pulse or checking for breath would be done by 26 and 21%, respectively. The most frequently mentioned therapeutic skill was positioning the victim in stable lateral position (37%), but very less frequently cardiac compression (6%) and mouth-to-mouth resuscitation (10%). When asked, 51 (81%) of those interviewed regarded their skills in cardiac compression and mouth-to-mouth resuscitation as adequate. To some extent there were differences in favor of young people and those from East Germany. CONCLUSION: These representative data suggest that (a) ABC-like first-aid rules are largely unknown among the population; (b) the value of a stable lateral position is overestimated and (c) first-aid skills of elderly persons are worst. A significant improvement of first-aid skills of the German population is mandatory in order to improve in future the outcome of sudden cardiac death.

Adolescent↗
PubMed1992

Generalized effects of a peer-delivered first aid program for students with moderate intellectual disabilities.

Peers with mild intellectual disabilities taught first aid skills to 4 students with moderate intellectual disabilities. A multiple probe design across participants was used to examine the effects of the peer teaching program during an acquisition and a partial sequential withdrawal phase. Generalization assessments were conducted in the participants' homes using novel, randomized simulated injuries. Results suggested that the peer teaching program resulted in acquisition of first aid skills, and the participants' skills generalized to the home, to novel simulated-injury locations, and to new trainers. Additionally, a more detailed analysis of the generalized responding suggested that when given a choice among first aid materials, participants treated burns using large adhesive bandages rather than the materials used in training. Participants also successfully treated injuries when novel instructional cues were used. The findings are discussed with respect to training issues, generalization and maintenance of the acquired skills, and the use of peer tutors with disabilities.

Child↗
PubMed2002

Realtime telemedicine for teaching a first-aid course.

We evaluated a realtime, distance-learning first-aid course at three schools. From September 1997 to January 1998, 180 students took the course (60 at each of three sites, one of which was the broadcast site). Self-administered questionnaires were distributed to students at the end of the course. The overall response rate was 86%. Sixty-three per cent of students at the remote sites and 83% of students at the broadcast site rated the programme as good or excellent. Students at the broadcast site had a significantly higher degree of satisfaction with the video (79% vs 30%) and audio (83% vs 44%) quality than those at the remote sites. Students at the broadcast site also had a significantly higher degree of satisfaction with slides (75% vs 43%) and transparencies (60% vs 44%) as teaching tools than those at remote sites. The three most important factors affecting the course at the remote sites were teaching aids (video, slides, transparencies), the teacher's body language and self-expression, and equipment stability. Satisfaction at the broadcast site was significantly lower when the course involved demonstrations or practice procedures such as cardiopulmonary resuscitation, dressing, bandaging or splinting. Teaching aids and equipment therefore appear to be important factors at remote sites for a first-aid telemedicine course. Limitations in teachers' movements during demonstration and practice were important at the broadcast site. The evaluation and selection of appropriate teaching models, teaching tools and methods are important when implementing these types of educational programme.

Adolescent↗
PubMed1999

"First aid for scalds" campaign: reaching Sydney's Chinese, Vietnamese, and Arabic speaking communities.

OBJECTIVES: As a serious yet preventable problem, scald injuries in children have been a priority for prevention in Australia and other developed countries. Not only can the occurrence of scalds be prevented, but immediate first aid treatment offers an effective method for secondary prevention, reducing the severity of scalds. Despite the success of scald prevention initiatives, local evidence suggested that first aid knowledge was lacking in some minority ethnic groups. To redress this gap, the "First Aid for Scalds" campaign for those from a non-English speaking background was specifically targeted to three ethnic groups (Vietnamese, Chinese, and Arabic), with the aim of increasing the proportions of parents and caregivers who had correct knowledge of first aid treatment for scalds. The primary strategy was a media campaign, including advertisements on ethnic radio and in ethnic newspapers. METHODS: The evaluation design included formative research and impact evaluation. The impact evaluation study involved random population based telephone surveys with each of the three language groups, before and after the campaign, to assess the reach and effectiveness of the campaign. RESULTS: After the campaign, there were significant increases in the proportion of people who knew the correct first aid treatment for scalds. There were substantial variations in campaign recall and knowledge between each of the three language groups. The largest improvement was found in the Vietnamese group. CONCLUSION: The association between campaign recall and increase in correct knowledge, and the absence of any similar interventions during the campaign period, give credence to the conclusion that the changes observed were a result of the campaign. The results demonstrate the value of community based injury prevention campaigns specifically targeting linguistically diverse communities.

Accident Prevention↗
PubMed1990

[The physician as an accident witness: emergency care and problems of failure to provide first aid].

As a witness of an accident the physician has always the duty to render first aid. At least he has to examine carefully whether his help is not or no more necessary. On account of his professional abilities the duty to first aid may concern him as the only person also among several participants, and he must always care to take the best possible measures for the prevention of dangers. In the other case he exposes himself the danger of culpability for not having performed first aid. Apart from a penal verdict also the possibility of a verdict by a professional court of justice for the same offence can be added. In the process before the professional court of justice is examined, whether or not the physician failed in his professional duty to protect and restore health as well as to reduce complaints (section 1, number 2 MBO).

Accidents↗
PubMed2002

Rock climbers' self-perceptions of first aid, safety, and rescue skills.

OBJECTIVE: Rock climbing is a challenging and demanding sport that requires specialized equipment and training. One significant area of training involves being familiar with first aid and rescue skills. This study reports climbers' self-perceptions of their first aid, safety, and rescue skill competencies. Actual technical skills were not measured. METHODS: Data were collected through a World Wide Web (WWW)-based questionnaire administered over a 15-month period. The questionnaire requested information on respondents' climbing history, first aid training, personal safety practices, and partner and self-rescue skills. RESULTS: Two hundred forty-one climbers completed the Web-based survey. Findings showed that the majority of climbers reported receiving some form of first aid training, were attentive to personal safety practices, and perceived themselves to be confident in partner and self-rescue techniques. CONCLUSIONS: On the basis of the results obtained in this study, it appears that training and specialized skills are considered by rock climbers to be important components of managing risk.

Adolescent↗
PubMed2002

An audit of first aid qualifications and knowledge among team officials in two English youth football leagues: a preliminary study.

OBJECTIVES: To determine if youth football officials responsible for dealing with injuries have appropriate first aid qualifications and knowledge? METHODS: Information was collected from two youth football leagues by questionnaire. First aiders were asked to provide details of their qualifications and their response from a list of alternatives to an injury scenario. RESULTS: Fifty two of 86 respondents did not have a current first aid qualification. Only 12% and 38% respectively gave the correct response to the injury scenarios "player choking" and "player unconscious". Health and injury records for the players were kept by 40% and 19% of teams. Written parental consent to emergency treatment was obtained by 30%. CONCLUSION: This preliminary study shows an obligation on teams who do not possess a qualified first aider to evaluate their legal and moral responsibilities to their players. The Football Association and Health and Safety Executive should produce a list of recommended equipment, facilities, and first aid qualified personnel to which teams should have access at games and training sessions. Providers of first aid training should reassess their teaching of the management of the choking and unconscious casualty.

Athletic Injuries↗
PubMed1982

Retarding the uptake of "mock venom" in humans: comparison of three first-aid treatments.

We compared, for the first time in human subjects, first-aid measures to treat bites from Australian snakes using a "mock venom" (congruent to 0.2 mL of Na 131I at 7.4 kBq or 11.1 kBq (0.2 muCi/kg or 0.3 muCi/kg)) as a subcutaneous injection in the lateral aspect of the leg. After application of either a full-length lower-limb airsplint (inflated to 7.3 +/- 0.7 kPa (55 +/- 5 mmHg) pressure) or the currently recommended treatment (elastic bandages at 7.3 +/- 0.7 kPa (55 +/- 5 mmHg) pressure and supporting splint) the rate of appearance of the Na 131I in the peripheral blood was approximately the same as the ratio for the untreated controls. However, application of a large firm pad over the injection site and its immediate surrounds, retained by a non-elastic bandage (at least 9.3 kPa (70 mmHg) pressure over the injection site), completely prevented "mock venom" uptake until the pad was removed. Further investigations are proceeding.

Adult↗
PubMedDate not supplied

[First aid].

Particular safety measures are suggested that a victim alone at home can practice self-applied first aid without provoking further injury. Mild wound injuries necessitate medical advice in order to determine the necessity of a tetanus shot. A physician should also inspect if the bandaging and medication was properly applied. If only one rescurer is available, there are general criteria which indicate that first aid be given in certain cases while other emergency situations necessitate urgent care. Various examples of emergency situations are illustrated which differentiate between life-threatening situation and less critical emergencies. An immediate evaluation of the severity of the victim's condition with corresponding type of treatment can save the victim's life. Drugs and medications should always be kept in a fixed place which is easily accessible to family members and eventually to medical personnel. We include a list of all necessary first aid materials, and their possible substitution in case they are not available. Fundamental regulations regarding gas leak-related accidents are listed. We advise not ringing the doorbell, electric lights should not be used, the windows and doors should be opened wide and the victim should be dragged away as far as possible. General indications are given in order to slow or decrease external bleeding.

Accidents, Home↗
PubMed1987

[Use of diagnostic tests in problems of internal medicine. Analysis of 1,667 ambulatory patients attending the first aid unit of a general hospital].

Patients with problems of internal medicine presenting at first-aid units of city hospitals represent a considerable work load. 1667 patients of this type have been examined retrospectively. The most numerous group had cardiocirculatory (22%) and nervous system (21%) problems, 9% had problems linked to their mental state and 11% dermatology complaints in general. 1047 patients underwent further investigation and/or specialist examination (247 neurological and 166 cardiological). Patients with jaundice, diabetes mellitus and cardiac decompensation underwent the highest number of laboratory examinations. The highest percentage of X-rays was done on patients suffering from chronic bronchitis during an acute episode, the highest percentage of ECGs in patients with prethoracic pain or cardiopalmus. In first aid also, some tests seem to be carried out as routine or for legal medicine purposes while for problems where tests are less easy or harder to understand (e.g. loss of consciousness episodes), a specialist is frequently brought in. The work load on the first-aid out-patients structure can be reduced by promoting greater awareness of the problem on the part of the internist and by rerouting users to non-hospital structures.

Cardiovascular Diseases↗
PubMed2005

How to become an under 11 rescuer: a practical method to teach first aid to primary schoolchildren.

It has been calculated that, on average, 20% of the population should be trained to provide first aid, if a significant reduction of mortality is to be achieved. However, wide dissemination of the principles of emergency care poses a series of difficulties. As a partial solution, we have designed a first aid training course for children aged 8-11 years in their last three courses at primary school. According to the Italian school system, classes in primary school are indicated as I through V, from start to ending. The course addresses three issues: the broken tooth, nose bleeding and paediatric basic life support (PBLS). The course is divided into 17 didactic modules: each module contains a theoretical lecture, a practical demonstration by the trainer and a session for the trainees to practice under supervision. The aim of the study was to evaluate the benefit of teaching emergency procedures including practical sessions for pupils in primary schools. Four hundred and sixty-nine children were enrolled: the evaluation consisted of a 13 question multiple-choice written test taken at the end of the theoretical session and a semi-structured test at one month. Two hundred and seventy-one children attended to the theoretical lesson only, without going through the practical session (Group A), while the remaining 189 children completed the practical training (Group B). The outcome of the evaluation demonstrates that older children (in their V school class) score better than those in their IV and III class (p < 0.001). However, when comparing Group A and Group B in each class, the children that had also been exposed to the practical training (Group B) scored significantly better (V(B) versus V(A) p < 0.001; IV(B) versus IV(A) p < 0.001; III(B) versus III(A) p < 0.01). In conclusion, this proposed method of teaching emergency first aid could be successful in training primary school children. The permanent integration of the subject into the core curriculum of primary schools, and extended to higher school levels, could help in disseminating the culture of emergency care in the general population.

Child↗
PubMed2005

Mental health first aid responses of the public: results from an Australian national survey.

BACKGROUND: The prevalence of mental disorders is so high that members of the public will commonly have contact with someone affected. How they respond to that person (the mental health first aid response) may affect outcomes. However, there is no information on what members of the public might do in such circumstances. METHODS: In a national survey of 3998 Australian adults, respondents were presented with one of four case vignettes and asked what they would do if that person was someone they had known for a long time and cared about. There were four types of vignette: depression, depression with suicidal thoughts, early schizophrenia, and chronic schizophrenia. Verbatim responses to the open-ended question were coded into categories. RESULTS: The most common responses to all vignettes were to encourage professional help-seeking and to listen to and support the person. However, a significant minority did not give these responses. Much less common responses were to assess the problem or risk of harm, to give or seek information, to encourage self-help, or to support the family. Few respondents mentioned contacting a professional on the person's behalf or accompanying them to a professional. First aid responses were generally more appropriate in women, those with less stigmatizing attitudes, and those who correctly identified the disorder in the vignette. CONCLUSIONS: There is room for improving the range of mental health first aid responses in the community. Lack of knowledge of mental disorders and stigmatizing attitudes are important barriers to effective first aid.

Adolescent↗