Carrying the torch for first aiders

There are thousands upon thousands of St John Ambulance volunteers up and down the country providing first aid to those in need; developing young people and equipping them with the skills they need for the future; or carrying out countless other charitable acts in order to serve their local communities.

With the Olympics taking place next year, the organisers are looking for 8,000 truly inspirational people to carry the Olympic flame around the United Kingdom between the 19th May and the 27th July. Reflecting on that, I could instantly think of several volunteers I know who have been an inspiration to me and others, people who would fit the bill perfectly.

People who have given up so much of their own time to help save lives in their local community; who ease the suffering of those who become ill, injured or in pain; who just provide comfort to those in need.

People who pass on the skills and knowledge they have learnt to those around them so many more people can save lives, ensuring that everyone who needs it could receive first aid from those around them and no one should suffer for the lack of trained first aider.

People who encourage their fellow volunteers to be the best they can be and give them the confidence they need to go out and make the difference between a life lost and a life saved.

People who recognise the importance that youth have in our society and so give their time to helping those young people to grow in themselves, building upon their knowledge, skills and experience.

People who, despite the pressures of school and the many distractions that exist outside of school, choose to become a cadet in order to learn more, to better themselves and most importantly to help other people.

There are so many volunteers in St John Ambulance who are an inspiration so let's get nominating them. Wouldn't this be such a great way to acknowledge all that these volunteers have achieved and what they have done for others.

To nominate someone (thet must be over 12 year old) visit the London 2012 website and complete the form by the 29th June.

Let them eat cake!

I’ve found it to be a common misconception that people with diabetes are not allowed to consume sugar as their body is unable to deal with it.  Is this right?  What exactly is diabetes that apparently causes it to be so cake-limiting?

Diabetes is a result of the pancreas not producing sufficient insulin, the chemical the body uses to regulate the blood sugar level.  There are two main types, imaginatively named type 1 and type 2.

Type 1 diabetes is insulin dependent and is often diagnosed at an early age.  People with type 1 don’t produce enough insulin in the body so require regular injections to top them up.

Type 2 diabetes normally develops later on in life and is often linked to obesity or just an unhealthy lifestyle.  People with type 2 either don’t produce enough insulin or the body does not use the insulin it does produce effectively.  In this case insulin injections may be required but in most cases it is controlled by having a healthy diet and taking regular exercise.

So diabetes is not about the body not being allowed sugar.  You can let them eat cake, it’s just that the blood sugar level needs to be managed.  The two consequences of not managing it properly are either hypoglycaemia or hyperglycaemia.

When the body’s blood sugar level gets too low this is known as hypoglycaemia and is usually something that occurs fairly rapidly and perhaps as a result of missing a meal, consuming too much alcohol, taking too much exercise or just the body starting to overheat.

When the body’s blood sugar level gets too high this is known as hyperglycaemia and this tends to occur over a period of time, even over a period of days.  This condition is a lot more serious and requires urgent medical attention.  Hyperglycaemia tends to be more acute so there are usually some warning signs - needing the wee more often (leading to dehydration), increased thirst (due to the fluid loss and dehydration) and weight loss.  The symptoms that the first aider is likely to recognise in cases of hypoglycaemia and hyperglycaemia are:

Of course the biggest clue as to whether a patient is diabetic and therefore likely to be hypoglycaemic or hyperglycaemic is to talk to them.  Patients are remarkably adept at knowing what illness they have and how to deal with it.  There may be other clues such as a medic alert tag.

So how would you treat someone who is either hypoglycaemic or hyperglycaemic?  If it is the latter then it is a medical emergency.  Phone 999 and request an ambulance.  Place the patient in a comfortable position and take some observations – pulse, resps etc.  If it is the former then give them a sugary drink or perhaps a chocolate bar in order to get some sugar in them.  If they start to improve then give them a bit more to eat or drink and encourage them to have a full meal as soon as they can, ideally something with plenty carbohydrates.  Also encourage them to seek medical attention.

In either case if the patient has impaired consciousness then do not give them, anything to eat or drink as this could affect their treatment later on.  If their condition worsens then be prepared to put them in the recovery position, maintain the airway and even perform CPR if things get really bad.

If you’re not sure whether it is hypoglycaemia or hyperglycaemia, merge both treatments.  Phone 999 and give them something sugary to eat or drink.

Phoning 999 won’t be a problem even if you get it wrong.  I’m sure ambulance crews would much rather be called to a non-emergency than not be called to an emergency.

As for giving them something sugary, it may sound odd giving sugar to someone whose blood sugar level is already too high but it won’t harm them.  It will however help someone whose blood sugar level is too low.  Remember that hypoglycaemia develops rapidly so can also be resolved fairly quickly.  Hypoglycaemia on the other hand would have built up over time so won’t be resolved as quickly, topping the patient up with a bit more sugar won’t cause any more harm in the short term.

For more information on diabetes visit the St John Ambulance web site.

Keep your finger on the pulse

It’s Heart Rhythm Week, a period of action organised by the heart charity Arrhythmia Alliance and dedicated to the notion that everyone should know their pulse, the beat of the heart as it pumps blood around the body.  Knowing your pulse is vital as it could indicate an arrhythmia, a disturbance in the normal heartbeat.
 

600,000 people in the UK diagnosed with Atrial Fibrillation (AF), the most common form of arrhythmia in the UK, and this figure is rising by 200,000 each year.  Conditions such as AF can lead to further complications such as heart failure or a stroke but early detection could help alleviate this.

 

Everyone is different and it would be impossible to say exactly what someone’s pulse should be as there are a number of determining factors – age, fitness, medical condition, caffeine intake and smoking to name just a few.  Activities performed will also have an affect – being busy at work, being stuck in traffic or participating in exercise all have the potential to raise the heart rate.  The table below gives an indication of what the pulse and respiratory rates should be.

Certainly many people could have a pulse or respiratory rate much higher than these or even lower.  It is perhaps important to emphasise that these are only to be seen as a rough guide.  They do however give an idea of what a normal healthy person’s pulse and respiratory rate should be at rest.
 

In order to get a baseline of what your pulse is at rest, try taking it when you wake in the morning and before going to bed.  It is often a good idea to take your pulse at various points throughout the day, particularly if you are participating in exercise or doing something that you could consider stressful.
 

The pulse can be taken at several places on the body – neck, elbow, groin, knee, ankle etc. – but the easiest pulse to take is the radial pulse, on the wrist just below the joint of the thumb.

Before you start make sure you can see a clock or a watch that has a second hand.  Using your index and middle finger on one hand, feel the wrist of the other at the base of the thumb until you detect the beat of the pulse.  Apply sufficient pressure to feel the pulse but not so much as to cut it off.  Ideally you should count for a minute, but failing that count for thirty seconds and then multiply your count by two to get the beats per minute.
 

So what does this tell you?  If your pulse is constantly too fast or too slow then you should consider seeking medical attention by arranging to see your GP.  The pulse should have a relatively constant beat so lookout for any irregularities such as an extra beat or a missed beat.  Again if you are concerned then arrange to see your GP.

As if a heart attack wasn't bad enough

One of the suggested ways of identifying whether someone is having a heart attack and perhaps one of the most memorable entries in the first aid manual is the reference to a “sense of impending doom” the patient may have.   Is it just me or does this make anyone else think of Private Frazer in Dad’s Army proclaiming “we’re doomed, I say, doomed” in his dour Scottish accent?
 
Joking aside it seems that this sense of impending doom is actually more relevant to the condition than previously thought.  It's certainly relevant to the long term health of the patient.  Researchers writing in the European Heart Journal have now theorised that this sense of impending doom, this fear of dying, can actually cause more damage to the patient and ultimately reduce their chances of making a full recovery.
 
The gist of the research was that an increased level of fear can cause a change in chemical levels within the body potentially causing problems in the future.  As if having a heart attack wasn’t bad enough, the stress caused by having a heart attack can be even more damaging.
 
So, if you do happen to be having a heart attack then chin up, try not to be too gloomy.  Perhaps you could try singing ‘always look on the bright side of life’ out loud.  You never know, it could be a life-saver.
 
If you’re not personally having a heart attack but someone else is, in reality there’s very little you can do to treat the physical aspects of a heart attack.  Place the patient in a comfortable position, offer them a 300mg aspirin tablet to chew (as long as they’re not allergic to aspirin) and perhaps provide oxygen if able to do so.  Other than, all you can do is wait until the paramedic arrives.
 
Although, as the evidence suggests, that is not all you can do.  You can talk to the patient, provide reassurance and not only make them comfortable physically, but make them comfortable emotionally.  Give the patient something to feel confident about and this could help lessen their sense of impending doom.
 
For further information on heart attacks, or any other condition, please look at the St John Ambulance web site.