​Heat Exhaustion is downright horrible and Heat Stroke is life threatening.

​It is best of course to stay out of the sun but this isn’t always enough for some of us! This morning in the sun just west of Brisbane it was 37.9ºc at 10:30am.

​Sometime just being in a hot environment can cause heat absorption, also the body produces a lot of heat when there is increased activity but even, in this heat, that is not always a must. Especially for the very young, those who are pregnant & the older ones among us, but also for those working in an environment where there is lack of ventilation such as a shed or factory, not to mention those having to work outside or in protective clothing.
Some people may be affected quicker due to infection, or a viral illness, those taking medications that affect the way the body regulates the bodies heat or lack of hydration from a few possibilities such as alcohol (as this dehydrates the body) & lack of fluid intake. This is certainly not an extensive list, just some ideas!

Prevention is the key!

• Keep Cool (Air conditioning/fan/water)
• Stay in the shade
• Try and stay in well-ventilated areas
• Lots of fluid intake
• Dress to the conditions
• Wear a hat
• Seek medical attention or call 000 if concerned

 
For the difference between Heat Exhaustion & Heat Stroke check out our blog post
 
https://www.b-readyfirstaid.com.au/blog/whats-the-difference-between-heat-exhaustion-heat-stroke

 Yes, I think you might have a clue from the picture, that this relates primarily to those carrying a child & typically in the last trimester of pregnancy or when visually pregnant.

Specifically speaking about the inferior vena cava as it is the largest vein in the body and carries de-oxygenated blood from the lower part of the body back to the heart & lungs to be re-oxygenated. The blood enters back into the heart through the right atrium of the heart. It also has valves to stop blood flowing, in a downward direction with gravity. Isn’t the body marvellously made!

​A vein is not like an artery that, which has thicker vessel walls. Therefore, this large diameter vein actually has very thin walls and can be put under pressure causing the blood traveling back to the heart to be either restricted or even completely stopped.
It lies to the right side of the vertebral column in the abdominal cavity.

​Why do we think of this for those mum’s to be? Imagine if the blood flow is limited to both mum and bub during a first aid emergency. If CPR is required start straight away don’t delay and if there is something you can utilize available, chock up her right hip at approximately 15-30 ◦. We suggest something such as a rolled-up towel, jumper, her handbag, pillow or cushion. This will move the baby and fluid etc to her left off the uterus and off the right side where this major vein is located. This is not to compromise the quality of compression's so it is best if their shoulders remain flat. 

​If your casualty is unconscious and breathing normally then there is no need to commence CPR, PHEW! However, they still need to be placed into the recovery position and guess which side that should be!

​This is stated in the Australian Resuscitation Council ANZCOR Guideline 6- Compression's ‘There are no published studies of optimum positioning in pregnant women undergoing cardiopulmonary resuscitation (CPR) so recommendations to date are extrapolated from manikin studies or studies of pregnant women who are not in cardiac arrest.’ 

This is a small cartilaginous extension of the lower part of the sternum or breastbone, just below where the ribs meet at the bottom tip. It is the smallest & lowest part of the sternum. At birth it is a thin and roughly a triangular shape which hardens in adult hood and fuses to the sternum, approximately between 15 and 29 years of age. It even flexes if you press it gently. It is a vital attachment point for several major muscles such as the diaphragm.   

In teaching CPR, we direct students to find the ribs, work your fingers up to where they meet, place a finger there and then place the heal of the hand above the finger position, towards the casualty's head. You can see just how close to the Xiphoid process that is. Much care should be given not to apply pressure as it is unsupported and can be injured, fractured, dislocate or even break away causing damage to various organs. This could puncture or lacerate the diaphragm or the liver, which as you can imagine is not helpful to a person who also requires CPR. Do take care but remember,

This is one of those topics that always creates a big discussion especially for certain industries that are at potential high risks for injuries, but in general there will be a level of anxiety for this potential situation.

Crush injury  

• When a force is applied to the body or a part of the body is trapped, pinched or jammed between or under something and tissue, skin, muscle, nerves or bone is injured.

Compartment syndrome -

• When there is a decrease of fluid to the tissues or even organs via the circulatory or lymphatic systems due to the applied pressure & this can lead to tissue necrosis (death of the tissue), permanent damage or even escalate to crush syndrome  

Crush syndrome

• When the applied pressure is extended in time & pressure causing a systemic condition with multiple problems including disruption of the body's chemistry and can affect the kidneys & heart from the build-up of toxins, enzymes & potassium, to name a few. It occurs most commonly to the legs but also the limbs or where there is a larger muscle impacted. 

High risk workplaces are especially prone to these injuries. 
Some possible things that could cause a crush injury are, forklifts, machinery, sheets of glass or metal, falling objects on a building site, girders, train accidents, being hit by a car or even trapped in one, trucks, semi-trailers,  when natural disasters happen, such as building collapses and mud or earth slides, even someone's own body weight when unconscious, in the farming industry, motor bikes & Quad bikes, brick walls, trenches, crowds & this list could go on & on but I'm sure you got the idea. 

Often the first thought is for the casualty & a quick response time but you also need to make sure that you & others will be safe. Ensuring that there is no risk is imperative & the consequential management or elimination of those dangers. Call for help 000/112 asap. Now this is where most people start to get twitchy. If it is safe & is physically possible, get that crush object removed as quickly & safely as possible. Of cause some things are just not going to be possible to remove unfortunately. When the casualty has a weight affecting their head, neck, chest or abdomen this can affect their breathing & as we always say in first aid "No Air No Life" so this must be removed as promptly as you can. Manage any bleeding that also might be associated & keep monitoring their vital signs, keeping them as calm as possible, especially watching for shock as this is inevitable at some degree after such a traumatic event. Never leave them or use a tourniquet for the management of a crush injury as this can exacerbate their condition. A casualty who has been involved in a crush situation may not even complain of pain or there might not even be any external signs of the injury however anyone subjected to a crush injury should be assessed by professionals in a hospital setting for ongoing reassessment or deterioration. Also consider the casualties' chances of sustaining some sort of spinal injury where it is essential to minimize or even immobilize as much as possible to reduce the chances of further damage to the spinal cord & vertebrae. 

If the casualty is unresponsive (unconscious & not breathing normally) at any time then of course we would initiate CPR irrespective of injuries or suspected spinal condition otherwise they have no hope at all. :(
​ 

Oh, there are some scary looking animals around that can give quite a horrible bite or sting, but unless someone suffers an allergic reaction or anaphylaxis, they may not even require medical assistance. 
Usually Ticks, wasps, ants, scorpions & centipedes can cause immediate and intense local pain around the bite or sting area, as well as localized redness and swelling. 

​If bites or stings occur around the face or neck area even if they are not allergic to the animal, this can cause difficulty breathing and require immediate first aid and medical attention.

Heat Exhaustion & heat stroke are a great concern especially over the summer months as the temperatures are on the rise, especially over the next few days in Brisbane. The most at risk groups are our little ones and those who are older. Did you know that once you are over 40 years in age that your body does not recognize you are dehydrated as early as it used to, therefore if you are thirsty you will require more fluids (water) than you realize to re-hydrate. 

Most of us when we get hot start to sweat, this is the normal mechanism to cool the bodies core temperature, but when this process is not functioning properly, that evaporation technique is not always adequate.

Often heat exhaustion can begin with thirst and a headache leading onto nausea, dizziness which can lead to collapse. Just feeling lousy, unwell and maybe even discomfort.The body temperature is less than 40 deg C , will appear red & still be sweating in an attempt to cool down. 

This is worse than heat exhaustion as the core body temperature is rising and is above 40 deg C now, which is life threatening as now the bodies organs are being affected and it can cause unconsciousness and death. 

As this is a progression on from heat exhaustion you can expect all those signs and symptoms to also be present but with some possible changes. Their skin may now become dry, will still appear red though as the body is in preservation mode and is trying to keep available fluid for the essential organs to function. There are some people though that can profusely sweat at this stage.

Heat Exhaustion it is all about cooling their body and reducing the temperature, reasonably slowly. Assist them into a shaded or cooler environment if you can, remove any extra clothing and moisten their skin with a dampened cloth or even a spray bottle. Gently fanning with sips of water if they are fully conscious. Always keep them under observation as if they are not responding reasonably quickly it is best to call for an ambulance.
Heat Stroke is serious and requires treatment as soon as possible, call for an ambulance, get them into a cool place if possible again you can cool the skin surface with the wet cloth and fan vigorously,  even placing some wrapped ice packs to the back of the neck and armpits and always monitor just in case they become unresponsive or even stop breathing. 

Prevention is always the best practice as the temps begin to climb again. Keeping well hydrated is a great start and trying to stay in cool environments that have plenty of ventilation or are air conditioned. This can be so difficult for those who work outdoors or in restricted hot sheds or buildings and environments that also may have radiant heat sources etc. Workplaces will have specific guidelines for each environment or work area that are relevant to occupational health and should be followed to protect employees.
Fluid is essential to hydration and we often leave that too late, start as early in the day as you can with cool water, ice blocks etc. Even using hydrolyte, as directed, can make a big difference. If possible, restrict activities in the hottest parts of the day and keep a watchful eye on those who are ill, young or older in our communities.

​First aid is the assistance provided for a sick or injured person sometime before professional help even arrives, that critical first care. It is not a difficult thing to learn and has been reviewed and tweaked over the years to allow us all to gain the confidence and skills to assist more appropriately and succinctly. Are they vital skills you may ask? Many would argue yes and that is me! I have seen, as you might have, how it can be the difference between life and death, a serious injury or lessening a problem, supporting someone at need weather that be a colleague, a family member or someone in the general public.

​Isn’t it important that we all help each other out when things go wrong and they do! No one should die because they needed first aid and didn’t get it.  

​Often situations can be stressful and distressing to both the casualty and the rescuer knowing what and why you are doing something will be enabling and reassuring. Remember that “Any help is better than none” Right! You can’t make things any worse, for someone, who is unconscious and not breathing by doing CPR. Accidents always happen, being that person who is trained, is known to increase bystander CPR outcomes for a casualty. 

​We encourage the process of the ‘Chain of Survival’ for the overriding directive at a scene, Early access, early CPR, Early Defibrillation = Early Advanced Care…Keeping these as close together as possible, like links in a chain, means the best chances for a casualty.

​With the ‘Action Plan’ that you learn during the CPR component of training. being your step by step guide to work through the incident.  
DRSABCD, Danger, what is around the incident or could impact further and how could it be best managed, Response, is the casualty conscious or unconscious as this impacts considerably to what you do next, Sending for Help, making that 000 call as quickly as it is possible or as soon as it is realised they are required, Airways, checking for obstructions clearing if necessary and then tilting the head back for an adult or child (such an important part as no air no life), Breathing, are they breathing normally or not at all and deciding on what action is next, Compression's if they are unconscious and not breathing normally and finally, Defibrillation if there is access to one should always be used ASAP if CPR has commenced.. All of these steps are set in place to protect all those involved during an incident, how to respond and when.  

Every minute counts in an emergency and the way you respond to that is best done calmly and with good intent and direction. Training will promote your safety as it’s always better to be safe than sorry. It should raise your awareness to issues that could concern you in your industry or home life etc. Also helping you to avoid or even prevent a situation becoming worse. 

​The earlier that CPR commences on a casualty that is unconscious and not breathing normally means that you are circulating vital blood which carries oxygen, glucose and nutrients to vital organs, heart, lungs and the brain to mention a few. This can sustain the casualty so that when the professionals arrive the time delay has hopefully not seen them deteriorate beyond hope. Techniques learnt regarding how many compression's to breaths (30-2), if breaths are possible, the rate of compression's (100-120 per minute), how deep to compress the chest, when to apply a defibrillator, is there one available or even when to stop CPR say when someone vomits and even how to change over CPR operators so that there is very limited down time for the casualty, is imperative knowledge and skills you can apply from training.  

​Sometimes there is very little we can actually do, apart from call 000/112, such as heart attacks, stroke and some other medical conditions, monitor and reassure them while watching their vital signs and taking note of changes. Find out information if possible, from them or someone that might know them. Such things as allergies, medications they might be on or just taken, including any natural products, Past medical history, if they have just eaten and even what might have lead up to the incident or sometimes known as the mechanics of the injury. The acronym ‘AMPLE’ is something you might recall, assisting with this info you might need to pass on to the 000 operators or even to the paramedics when they arrive. 

​YES YES YES!!! First Aider's make a difference.
Consider training Before you wished you had!

​B-Ready, B-Trained and B-The difference!

I have changed my career a few times over the years & have always thought I wonder if I really do make a difference to someone, anyone's life. Connecting on social media has allowed me to hear some feedback over the recent years (all positive) & gee I'm so grateful for people taking the time to let me know.  
I celebrated 9 years at the beginning of this year (2017) training CPR & First Aid skills to thousands of people. I strive for continual improvement & really love my job & feel so blessed to be in the industry. 

I know what I do but sometimes it really hits you like a ton of bricks especially when you hear from students & businesses that what you taught them made such a difference. Let me share one of those stories.  

I have been to this business before to train and they are such a great bunch of guys. Helpful, fun & always interacting in discussions. Not shy to ask why & understand in depth the topics we cover. I had the opportunity to speak with Paul (names changed for confidentiality) recently & he looked me straight in the eye & said, "You know we had an accident, here, didn't you?" I had not heard, Paul continued to say that "what you taught us all kick into gear & I could hear your voice going through the steps". Paul & three other workmates responded first to their colleague (Mark) being in a serious situation. Paul's training kicks in, as he leads the team to rescue their mate. He started CPR & yelled for the AED (Automated External Defibrillator) before the 000 operator was even able to tell him what to do. With the commencement of CPR & the AED, shocking a few times before the ambulance arrived. The four colleagues changed roles as needed & Mark finally shows signs of life. Mark has survived this horrific ordeal due to his workmates, he is on the road to recovery, which will take some time. He was crushed & among other injuries damaged vertebrae leaving him in a wheelchair. ​

I was stunned after our discussion, shaking my head & even shed a few tears of happiness, when someone told me,
​'But that is what you do, teach others to save lives, it's important and makes a difference'
Simply Awesome!
Have you Made a Difference? Share your story below!