by Tim Smith
One of the most frequent things onlookers say at the scene of an accident, according to Joshua Correia, is: “I didn’t know what to do.”
Correia, the training officer at St. John Ambulance Bermuda, says you can avoid that helpless situation by completing a first aid course to equip yourself with the knowledge and skills to deal with a crisis until emergency services arrives. This is never more important than during a hurricane, when it may be impossible for an ambulance to reach your home for hours.
“Basic skills save lives, certainly with regards to stemming blood and mouth-to-mouth resuscitation,” Correia says. “At some point you might be in a situation where your training can mean the difference between somebody surviving or somebody dying.”
Your first concern is to ensure the scene is safe for you to respond to the incident.“What I don’t want to happen is that one person needs help and then when somebody jumps in to help them, they need help as well,” Correia says. “Look for any hazard that is on the scene that is going to be a threat to your personal safety as the person giving help, such as electric wires or an unstable vehicle.”
It is also important not to panic. “Hopefully if you are ever in that situation, you take a moment, take that breath in, and say, ‘I know what to do here. I have been trained on this and I’m going to do what I learned,’” Correia says.
Here, he outlines potential medical situations arising from a storm and offers first aid tips on how they can be handled.
Unless you have shutters, there’s always a danger bulky items may smash your window during the height of a storm. If anybody gets injured by a shard of glass, your first priority is to stop the bleeding with a sterile dressing or clean cloth.
“Put direct pressure on the bleeding wound and hold it,” Correia says. “If it starts to bleed through, put something else on top of that. Never remove what you put on the wound to stop the bleeding.”
He tells people to resist the temptation to look at the wound to see if it’s stopped bleeding as the clot will begin to form with the pressure you provide.
“Depending on the situation and the severity of the cut, you might end up needing to go to the hospital for further care or evaluation. It might need stitches.”
If glass is embedded in a wound, do not remove it. “Bandage the embedded object in place with a bulky object so it can’t move around and cause additional injury,” Correia says.
Wear appropriate footwear to ensure you don’t get injured while helping the victim and sanitize your hands before and after giving treatment.
After a storm, you will often come across unexpected hazards in your yard which may cause you to trip and break a bone. Correia’s advice: “Immobilize. Keep it still. Every time you move it you risk causing more damage.”
He also says the first thing to do is get to safety without further complicating the injury. It might mean scooting along on the backside or enlisting the help of somebody else in the house.
“Once back in safety, you are then going to immobilize the extremity. Apply an ice pack on the area to help reduce the swelling and pain. If it doesn’t cause further aggravation to the area, you can try head to the emergency room when it is safe, but you may find a lengthy wait as other people show up with storm-related injuries.”
“First things first, if it’s not safe for you to enter the water, don’t get in the water. Rule number one,” Correia says. “If somebody is in the water and something has gone horribly wrong, and they have been safely removed from the water, check them for responsiveness.”
If the person is not breathing, start CPR, compressions and breathing.
“We have dealt with reports of people having heart attacks in the middle of a hurricane. It’s never ideal because time is very much the essence,” says Correia.
First, advise the victim to rest and stop whatever they are doing. “Try to reassure them. Keep as calm as possible,” he says.
A single 325mg Aspirin tablet, or four 81mg tablets, can help reduce the worst outcomes. Make sure that they are not allergic to Aspirin, that they are not already taking blood thinners, and do not have other conditions such as a stomach ulcer.
Correia says: “Chew the tablets to get them into the circulation as soon as possible. That’s not going to stop the heart attack, but it will get you a little bit more time to get to the emergency room for the appropriate attention.”
Symptoms include crushing chest pains radiating to the arms, and becoming pale and sweaty. Many women feel no pain at all, and diabetics can feel lower levels of pain. Other symptoms include fatigue, unexplained nausea and vomiting. For women, it can be pain in the back that radiates round to the front.
Stroke patients need to get to the emergency room as soon as the storm allows. “Help them stay calm as much as possible. As soon as you can, get on with 911. Time is very important. There’s a very strict time window for some stroke treatment, 3.5 to four hours from what’s called ‘last seen normal.’”
Record the last time the patient seemed normal and relay that information to the doctors.
Correia says: “They need to go to the emergency room for a CAT scan to determine what kind of stroke it is. Once that is determined, they get the care or treatment they need.”
Symptoms include facial droop, arm drift and slurring speech.
Of course, there may be times when your children get seriously sick and it is not safe for you to take them to the hospital. Reduce the likelihood of fever by ensuring young children only wear one more layer of clothes than you feel comfortable wearing. “Especially infants and young kids, their body’s ability to regulate the temperature has not yet fully developed,” he says.
Give your child anti-fever medication, such as children’s Tylenol. Measure the dose based on the weight of your child, not the age. You can give them Advil 30 or 40 minutes later because it is a different medication. “Give them a dose of each because they work very differently in the body to break the fever down,” Correia says.
A lukewarm sponge bath in their underwear or diaper can also help reduce their temperature.
“Seizures can be terrifying for a parent,” Correia says. “The child will go limp and might be convulsing heavily.”
The key at that point is to cool the child down and make sure their breathing is okay. “Once they come to, which can be relatively quickly, they tend to be a bit groggy and don’t want to wake up. A gentle shoulder tap or pinch can help wake them up. When they do start to come round, if they haven’t yet had medication, that would be the time to get a dose in.”
If you are very concerned, try to get to the emergency room if you can or call your paediatrician.
To sign up for a first aid training course at St. John Ambulance, visit www.sjabermuda.org/first-aid-training