Dislocation

Introduction :

A dislocation is an injury in which the ends of your bones are forced from their normal positions. The cause is usually trauma, such as a blow or fall, but dislocation can be caused by an underlying disease, such as rheumatoid arthritis.

[Broken Ankle]

Dislocations are common injuries in contact sports, such as football and hockey, and in sports that may involve falls, such as downhill skiing and volleyball. Dislocations may occur in major joints, such as your shoulder, hip, knee, elbow or ankle or in smaller joints, such as your finger, thumb or toe.

The injury will temporarily deform and immobilize your joint and may result in sudden and severe pain and swelling. A dislocation requires prompt medical attention to return your bones to their proper positions.

Symptoms :

• Pain

• Tenderness

• Difficulty to move injured part

• Swelling

• Discoloration.

Treatment :

• Call medical help as soon as possible

• Do not move the joint or try to place it back

• Place ice to control swelling

• If skin is cut, clean gently and bandage with sterile gauze

• Sling or splint the injury in its original position

• If injury is serious, check for breathing

• If not breathing, provide Cardio pulmonary resuscitation (CPR)
  Elevate the feet up to 12 inches

• Cover the patient with a blanket.

Mind it :

1. Don't delay medical care,
2. Don't move the joint,
3. Put ice on the injured joint.

Prevention :

• Wear protective gear while sporting

• Make home environment safe

• Teach safe habits to children

• Do not stand on chairs or other unstable objects

• Exercise care while using bath oils

• Make use of hand rails while using the stairs.

Stroke

INTRODUCTION :

A stroke occurs when there's bleeding into your brain or when normal blood flow to your brain is blocked. Within minutes of being deprived of essential nutrients, brain cells start dying — a process that may continue over the next several hours.

A stroke is a true emergency. The sooner treatment is given, the more likely it is that damage can be minimized. Every moment counts.

Some Points :

• Stroke is also called 'Cerebrovascular Accident'

• It is an acute neurological injury

• It may be due to blood clot (ischemic) or bleeding (hemorrhagic)

• Leads to stoppage of blood supply to a part of brain

• Oxygen supply is decreased

• This initiates 'ischemic cascade'-causes brain cell death/damage

• This results in a cerebral stroke.

Risk factors :

• High blood pressure
• Having a history of previous stroke
• Smoking
• Diabetes mellitus (DM)
• Having heart disease
• Age.

Signs and symptoms :

• Sudden weakness or numbness in your face, arm or leg on one side of your body
• Sudden dimness, blurring or loss of vision, particularly in one eye
• Loss of speech, trouble talking or understanding speech
• Sudden, severe headache — a bolt out of the blue — with no apparent cause
• Unexplained dizziness, unsteadiness or a sudden fall, especially if accompanied by any of the other signs or symptoms.

Follow the DRABC action plan :

St John Ambulance Australia recommends you follow the ‘DRABC Action Plan’ in every emergency. It helps you determine whether someone has a life-threatening condition and what first aid is needed.

The following plan assumes you have at least one other person to assist you. If you are alone with the casualty, work down the plan to ‘breathing’, check for breathing and turn the person into recovery position (see below) before calling an ambulance. Then resume the plan, starting mouth-to-mouth breathing if necessary.

D - Check for DANGER

• To you.
• To others.
• To the affected person.

R - Check RESPONSE

Ask the person their name. If someone has had a stroke, they may not be able to talk, so grasp both their hands and ask them to squeeze — they may respond by squeezing one of your hands.

Does the person respond? If so, they are conscious: follow the directions at the end of the page while you wait for help to arrive.

If the person does not respond, they are probably unconscious. Make sure someone has dialled 000 for an ambulance, then continue.

A- Check AIRWAY

• Is the airway clear of objects?
• Is the airway open?

If the airway is not clear, turn the person into recovery position.

• Kneel beside the person.
• Put their arm that’s farthest from you out at right angles to their body.
• Place their nearer arm across their chest.
• Bend their nearer leg up at the knee; the other leg should be straight.
• While supporting their head and neck, roll the person away from you.
• When they are on their side, keep their top leg bent at the knee, with the knee touching the ground.

Then tilt the head slightly backwards and downwards to let anything that’s in the airway (such as vomit) drain out, and clear the airway with your fingers.

B - Check for BREATHING

• Tilt the head back.
• Is the person’s chest rising and falling?
• Can you hear the person breathing?
• Can you feel their breath on your cheek?

If the person is not breathing:

• turn the casualty onto their back;
• tilt their head backwards;
• lift the chin, pinch the nose closed and give 2 initial mouth-to-mouth breaths;
• make sure the chest rises and falls with each breath; and
• if breathing does not return and there are no signs of life, go to the next step (step C).

If the person is breathing, follow steps below under ‘while waiting for help’.

C - Give CPR

• Kneeling beside the person, give 30 chest compressions on the lower half of the breastbone. Use 2 hands with the fingers interlocked.
• Then tilt the head backwards, tilt the chin and give 2 mouth-to-mouth breaths while pinching the nose shut.
• Keep alternating between 30 compressions and 2 breaths until the person shows signs of life or medical help arrives.

While waiting for help :

If the person is conscious:

• lie the person down with their head and shoulders raised and supported (use pillows or cushions);
• keep them at a comfortable temperature;
• loosen any tight clothing;
• wipe away any secretions from the mouth;
• make sure the airway is clear and open;
• assure the person that help is on the way (they may be able to communicate by squeezing your hands if they can’t speak) and;
• do not give them anything to eat or drink.

If the affected person becomes unconscious, put them in the recovery position as described above to prevent anything (blood, saliva, or their tongue) from blocking the windpipe and choking them. Continue to monitor their airway and breathing, and be ready to resume the DRABC plan as necessary.

Even if the symptoms are short-lived — a ‘mini-stroke’ or transient ischaemic attack (TIA) — ensure the person seeks immediate medical help, as these symptoms can be a warning sign of a future stroke.

Steps To Avoid :

• Never give a suspected stroke victim anything to eat/drink

• Do not permit the victim to move.

Prevention :

• Do regular checkups for BP

• Eat food with less salt

• Exercise regularly

• Eat a balanced, healthy diet

• Take the BP pills regularly.

Heart Attack

Introduction :

A heart attack occurs when an artery supplying your heart with blood and oxygen becomes partially or completely blocked. This loss of blood flow injures or destroys part of your heart muscle. A heart attack generally causes chest pain for more than 15 minutes, but it can also have no symptoms at all.

Many people who experience a heart attack have warning symptoms hours, days or weeks in advance. The earliest warning sign of an attack may be ongoing episodes of chest pain that start when you're physically active, but are relieved by rest.

Some points :

• Occurs when blood supply to vital organs gets blocked

• >50years / menopausal women at greater risk

• Occurs with / without chest pain

• Sudden arrest of breathing / heart function

• May result in cardiopulmonary arrest

• Clot in the arteries blocks blood supply

• Occurs due to:

  a. Deposits of calcium / cholesterol
  b. Hereditary factors
  c. Tobacco
  d. Obesity
  e. High blood pressure
  f. Emotional stress
  g. Inflammatory disease of arteries
  h. Trauma / disease of heart

Symptoms :

The classic symptoms are:

· Chest pain

· Pressure, heaviness or tightness in the chest

· Pain or pressure in the neck or jaw

· Pain or pressure in one or both arms (especially the left)

· Shortness of breath

· Sweating

· Nausea

· Pain or throbbing between the shoulder blades.

What help is needed?

• If possible, raise the legs up 12 to 18 inches to allow more blood to flow towards the heart
• Immediately place the palm of your hand flat on the patient's chest just over the lower part of the sternum (breast bone) and press your hand in a pumping motion once or twice by using the other hand. This may make the heart beat again.

If these actions do not restore a pulse or if the subject doesn't begin to breathe again:

• call for help, stating that the casualty is having a cardiac arrest but stay with the patient.
• find out if any one else present knows CPR.
• provide artificial respiration immediately (see below).
• begin CPR immediately (see below).

How to give artificial respiration :

• Tilt the head back and lift up the chin.
• Pinch the nostrils shut with two fingers to prevent leakage of air.
• Take a deep breath and seal your own mouth over the person's mouth.
• Breathe slowly into the person's mouth - it should take about two seconds to adequately inflate the chest.
• Do this twice.
• Check to see if the chest rises as you breathe into the patient.
• If it does, enough air is being blown in.
• If there is resistance, try to hold the head back further and lift the chin again.
• Repeat this procedure until help arrives or the person starts breathing again.

How do I perform CPR (cardiopulmonary resuscitation) :

See if there is breathing. If not, start artificial respiration as described above. Checking for a pulse in the neck (carotid artery) may waste valuable time if the rescuer is inexperienced in this check. The procedure is:

• place your fingers in the groove between the windpipe and the muscles of the side of the neck. Press backwards here to check for a pulse.

If there is no pulse, or if you are unsure, then proceed without delay thus:

• look at the person's chest and find the 'upside-down V' shaped notch that is made by the lower edge of the ribcage. Place your middle finger in this notch and then place your index finger beside it, resting on the breastbone. Take the heel of your other hand and slide it down the breastbone until it is touching this index finger. The heel of your hand should now be positioned on the middle of the lower half of the breastbone.
• now place the heel of your other hand on top of the first. Keep your fingers off the chest, by locking them together. Your pressure should be applied through the heels of the hands only.
• keep your elbows straight, and bring your body weight over your hands to make it easier to press down.
• press down firmly and quickly to achieve a downwards movement of 4 to 5cm, then relax and repeat the compression.
• do this 15 times, then give artificial respiration twice, and continue this 15:2 procedure until help arrives.
• aim for a rate of compression of about 100 per minute. You can help your timing and counting by saying out loud 'one and two and three and four ...' etc.

Artificial respiration and CPR should both be performed at the same time :

• If possible, get someone else to help - one person to perform artificial respiration and the other to perform CPR. (This is not easily done without prior practice and it is well worth attending sessions on CPR training to become familiar with the technique.)
• The ratio of chest compressions to breaths is 15:2 for both one-person and two-person CPR.
• Continue until the ambulance arrives or the patient gets a pulse and starts to breathe again.
• If the pulse returns and breathing begins but the person remains unconscious, roll them gently onto their side into the recovery position. This way mucus or vomit can get out of the mouth and will not obstruct the patient's breathing. It also prevents the tongue from falling back and blocking the air passage.

Make sure the patient continues breathing and has a pulse until the ambulance arrives :

• If you succeed in resuscitating the person who has been taken ill, he or she may be confused and alarmed by all the commotion. Keep the patient warm and calm by quietly, but clearly, telling them what has happened.

Again, it needs to be emphasised that the only way to provide proper first aid and resuscitation is through learning the technique, then regular practice and guidance.

Mind it :

• Call emergency medical number. Don't tough out the symptoms of a heart attack for more than five minutes. If you don't have access to emergency medical services, have a neighbor or a friend drive you to the nearest hospital. Drive yourself only as a last resort, if there are absolutely no other options, and realize that it places you and others at risk when you drive under these circumstances.
• Chew and swallow an aspirin, unless you're allergic to aspirin or have been told by your doctor never to take aspirin. But seek emergency help first.
• Take nitroglycerin, if prescribed. If you think you're having a heart attack and your doctor has previously prescribed nitroglycerin for you, take it as directed. Do not take anyone else's nitroglycerin, because that could put you in more danger.
• Begin CPR.

What's the Difference Between a Heart Attack and a Stroke?

Answer: Heart attack refers to damage to the muscle of the heart, usually from a lack of blood flow. Most of the time, a blood clot forms in one of the arteries that supplies the heart muscle with blood, blocking the flow of blood. As the heart muscle starves, it begins to die, causing chest pain and other heart attack symptoms.

A stroke is a similar blockage in an artery that supplies blood to the brain. When a clot forms in one of those arteries and stops blood flow, a section of the brain begins to die. Stroke symptoms often don't include any pain or discomfort, and are more likely associated with losing feeling or the ability to move. Much of the time, strokes affect only one side of the body.

These two terms are so often misunderstood that some in the medical community are attempting to do away with stroke and replace it with the term brain attack.

Prevention :

• Routine health check-up

• Avoid stress

• Quit smoking / alcohol

• Eat sensibly

• Control blood pressure / diabetes

• Control weight.

Want to know more about heart attack : MY MEDICAL COLLECTIONS