July 7, 2010

West Kelowna First Aid 250.878.6690 First Aid West Kelowna Westbank BC

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Written by Helen Marshall, pharmacist

Many people using metered dose inhalers (MDIs) find them hard to use. This is because it can be difficult to coordinate breathing in and pressing the inhaler at the same time. A spacer is a device designed to make an MDI easier to use, thus delivering more medicine directly into the lungs where it is needed. This makes the medicine more effective and reduces the side effects that may occur from inhaling the medicine into the mouth or throat.

A spacer device is a large plastic container, usually in two halves that click together. At one end is a mouthpiece and at the other end is a hole for inserting the mouthpiece of an MDI.

The dose from your inhaler is sprayed into the spacer, from where it can be inhaled without needing to coordinate breathing and pushing down the inhaler canister. It is particularly useful for babies and small children who do not have this coordination. Paediatric spacers have a small mask that fits onto the mouthpiece of the spacer and is placed over the child’s nose and mouth.

There are several brands of spacer device available and they are all different (including Volumatic, Nebuhaler and Aerochamber). Each spacer device fits different inhalers and so it is important to get the right spacer device that fits your inhaler. The inhaler mouthpiece must fit snugly into the spacer hole. Spacers are available on prescription.

The National Institute for Health and Clinical Excellence (NICE) recommends that spacer devices are used for children with chronic asthma. For children aged under five years they recommend that a spacer (with a facemask if necessary) is used with a metered dose inhaler for administering both inhaled bronchodilators and corticosteroids. For children aged 5 to 15 years they recommend that inhaled corticosteroids are administered in this way.

How to use adult spacers

Sit up straight, or stand up, and lift the chin to open the airways.
Remove the cap from the mouthpiece of the inhaler and shake the inhaler vigorously.
If you haven’t used the inhaler for a week or more, or it is the first time you have used the inhaler, spray it into the air before using it to check that it works.
Insert the inhaler mouthpiece into the hole in the end of the spacer (the inhaler should fit snugly and without difficulty – see below).
Take some deep breaths and then put your teeth around the spacer mouthpiece (not in front of it and do not bite it), and seal your lips around the spacer mouthpiece, holding it between your lips.
Press down on the canister in the inhaler to spray one puff of medicine into the spacer.
Breathe in slowly and deeply, then hold your breath for 10 seconds or as long as is comfortably possible.
Breathe out, then breathe in deeply again through the mouthpiece of the spacer and hold your breath. It is best to take two deep-held breaths from the spacer for each puff from your inhaler. However, if you find it difficult to take deep breaths, breathing in and out of the mouthpiece several times is just as good.
If you need another dose, wait 30 seconds, shake your inhaler again then repeat steps 4 to 8.
Don’t spray more than one puff at a time into the spacer. This makes the droplets in the mist stick together and to the sides of the spacer, so you actually breathe in a smaller dose.

How to use paediatric spacers

Remove the cap from the mouthpiece of the inhaler and shake the inhaler vigorously.
If the inhaler has not been used for a week or more, or it is the first time the child has used the inhaler, spray it into the air before it is used to check that it is working.
Attach the mask to the mouthpiece of the spacer.
Insert the inhaler mouthpiece into the hole in the end of the spacer (the inhaler should fit snugly and without difficulty – see below).
Place the mask over the child’s nose and mouth so that it makes a seal with the face.
Press down on the inhaler canister to spray one puff of medicine into the spacer.
Hold the mask in place and allow the child to breathe in and out slowly for five breaths.
If you need to give another dose, wait 30 seconds, shake the inhaler again then repeat steps 4 to 7.
Don’t spray more than one puff at a time into the spacer. This makes the droplets in the mist stick together and to the sides of the spacer, so the child actually breathes in a smaller dose.
Using a mask and spacer with a baby can sometimes be tricky. Reassure the baby by cradling them in your arms or on your knee. Gently stroke the baby’s face with the mask so that they get used to it. Talk to the baby and smile – the baby will sense if you are anxious. You can hold the mask over the baby’s nose and mouth to give them a dose while they are sleeping, and babies will also breathe in the medicine while they are crying.

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June 26, 2010

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Sunburn treatment starts with prevention. Correctly using sunscreen will help prevent burns. Make sure you know sunscreen myths versus facts when out in the sun.

Sunburns are caused by UV radiation rather than heat (ie, we get sunburns on cold, snowy days).

Sunburns destroy skin, which controls the amount of heat our bodies retain or release, holds in fluids, and protects us from infection.

Remember always, if you think a burn of any type is significant, do not hesitate to call 911 immediately.

Look for blisters. Blistering means the skin is completely damaged and complications are likely. If the area with blisters is bigger than one entire arm or the whole abdomen, seek medical attention by calling 911 or visiting the emergency department.

Take a cool shower or bath to soothe the pain. No more 1/10 th ebody should be cooled at once.

Apply aloe or another cooling agent with parental consent form. Whatever you use - DO NOT APPLY BUTTER OR OIL TO ANY BURN!

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June 25, 2010

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Donut Bandage

The Donut Bandage is used to put pressure around an impaled object without putting pressure on the object itself. Attach with roll or gauze or tap

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June 24, 2010

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What is heat rash?

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Heat rash (prickly heat ) is a red or pink rash usually found on body areas covered by clothing. It can develop when the sweat ducts become blocked and swell and often leads to discomfort and itching. Heat rash is most common in babies, but may affect adults in hot, humid climates.

What causes heat rash?

In babies, heat rash can be caused by well-meaning parents who dress their baby too warmly, but it can happen to any baby in very hot weather. A baby should be dressed as an adult would be to be comfortable at the same temperature and activity level. Babies’ hands and feet may feel cool to your touch but that does not mean they need to be dressed too warmly in hot weather.

What are the symptoms of heat rash?

Heat rash looks like dots or tiny pimples. In young children, heat rash can appear on the head, neck, and shoulders. The rash areas can get irritated by clothing or scratching, and, rarely, a secondary skin infection may develop.

How is heat rash diagnosed?

Heat rash can usually be identified by its appearance and does not usually require medical attention. However, if doesn’t go away after 3 or 4 days, or if it appears to be getting worse, or if your child develops a fever, contact your health professional right away.

When you or your child has a rash, it is important to watch for signs of infection, including:

Increased pain, swelling, redness, or warmth around the affected area.
Red streaks extending from the affected area.
Drainage of pus from the area.
Swollen lymph nodes in the neck, armpit, or groin.
Fever of 100° F (37.8° C) or higher, or chills with no other known cause.

If any of these symptoms develop, contact your health professional immediately.

What is the treatment for heat rash?

Most prickly heat rashes heal on their own. The following steps can help relieve symptoms.

Start by removing or loosening clothing and move him or her to a cool, shady spot.
Let the skin air-dry instead of using towels.
If your baby’s skin is irritable to touch, calamine lotion or hydrocortisone cream may be used with your health professional’s approval.
Avoid ointments or other lotions because they can irritate the skin.

The following tips can help prevent future episodes of the rash:

Dress your child in as few clothes as possible during hot weather.
Keep the skin cool and dry.
Keep the sleeping area cool.

After the rash is gone, gradually expose your child to warmer temperatures so that his or her skin can acclimate.

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June 21, 2010

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The abdomen contains so many different organs that isolating stomach discomfort can be difficult. A helpful guide, especially when you are talking to your doctor, is to pinpoint the pain in terms of quadrants or sections. If your pain is:

Anywhere in the chest, behind the breast bone or in the throat, it could be simple indigestion, cramp caused by shallow breathing, hiatal hernia, heartburn or reflex oesophagitis.Inflammation and pain around the breastbone and upper abdomen, it could be a viral infection, which can cause inflammation and pain in a condition known as Bornholm disease. Like other viral infections, it will clear up with rest, relaxation, plenty of fluid, nourishing soups, extra vitamin C and so on.

In the chest, it should be taken seriously as it could be angina or the early signs of a heart attack especially if accompanied by pain in the arms.

Behind the shoulder blades, it could mean gall bladder trouble. If it strikes the upper right quadrant, consider gastroenteritis, gastritis, gallstones, ulcer or hiatus hernia.

In the upper left or lower left quadrant, it may be diverticular disease, constipation, ulcerative colitis or irritable bowel syndrome. The pain of hiatal hernia may also radiate to the lower left or right side under the ribcage.

In the lower right area of the abdomen, sharp pain could mean appendicitis whilst groaning discomfort could be Crohn’s disease or ulcerative colitis.

In the lower back or lower abdomen, it may indicate kidney problems, cystitis, diverticulis, pelvic inflammatory disease or period pains.

The pressure of trapped wind, it can be excruciating and deceiving. Not only does the discomfort move around, it can also be an amazing mimic, aping the pain of gallstones, appendicitis and a heart attack all within the space of an hour or two.

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June 19, 2010

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Helmet Basics

Bicycle helmet use should not be optional for anyone in your family, no matter where you are or how short the ride. In many states it’s the law.

Here’s why: Most bike accidents involve a head injury, so a crash could mean permanent brain damage or death for someone who doesn’t wear one while riding. In fact, each year in the United States, about half a million kids are seriously injured in bicycle-related accidents, and most of those injuries could have been avoided if a helmet was worn.

Here are some things to keep in mind when buying a helmet:

Pick bright colors that are visible to drivers and other cyclists.
Look for a helmet that’s well ventilated.
Make sure that the helmet has a CPSC or Snell sticker inside. These indicate that the helmet meets standards set by the Consumer Product Safety Commission (CPSC) or the Snell Memorial Foundation, a nonprofit group that tests helmet safety.
Make sure your child’s helmet fits correctly and can be adjusted.

P_helmet-fit You should be able to get help finding a well-fitting helmet and adjusting it properly at any bicycle store.

When kids wear a helmet, make sure that the straps are fastened. Also make sure they don’t wear any other hat underneath it.

Be sure to replace any helmet made before 1999. If your child hits any surface hard while wearing a helmet, replace it — helmets lose their capacity to absorb shock after taking serious hits.

A few bike helmets can be used as protection for other activities, but in general, they’re best suited to biking. Most helmets are made for one specific type of activity — for example, special helmets also are made for inline skating, baseball, and snowmobiling.

Kids should not wear any helmet when they’re on a playground or climbing a tree — there is a risk of strangulation from the chin strap during these types of activities.

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June 18, 2010

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Signs and Symptoms of Anaphylaxic shock

St john Amvulance Kelowna

with other allergies, anaphylaxis can trigger symptoms in any of these four body systems:

skin
gastrointestinal system
respiratory system
cardiovascular system

An allergic reaction may be a medical emergency if it happens in two or more of these systems — hives on the skin, for example, together with stomach pain.

The most common signs that a child who has been exposed to an allergen might have anaphylaxis are:

difficulty breathing
tightness in the throat or feeling like the throat or airways are closing
hoarseness or trouble speaking
wheezing
nasal stuffiness or coughing
nausea, abdominal pain, or vomiting
fast heartbeat or pulse
skin itching, tingling, redness, or swelling

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June 17, 2010

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What are the different kinds of casts?

A cast, which keeps a bone from moving so it can heal, is essentially a big bandage that has two layers — a soft cotton layer that rests against the skin and a hard outer layer that prevents the broken bone from moving.

These days, casts are made of either:

plaster of paris: a heavy white powder that forms a thick paste that hardens quickly when mixed with water. Plaster of paris casts are heavier than fiberglass casts and don’t hold up as well in water.
synthetic (fiberglass) material: made out of fiberglass, a kind of moldable plastic, these casts come in many bright colors and are lighter and cooler. The covering (fiberglass) on synthetic casts is water-resistant, but the padding underneath is not. You can, however, get a waterproof liner. The doctor putting on your child’s cast will decide whether a fiberglass cast with a waterproof lining is appropriate.

How is a cast put on?

First, several layers of soft cotton are wrapped around the injured area. Next, the plaster or fiberglass outer layer is soaked in water. The doctor wraps the plaster or fiberglass around the soft first layer. The outer layer is wet but will dry to a hard, protective covering. Doctors sometimes make tiny cuts in the sides of a cast to allow room for swelling.

Can plaster of paris casts get wet?

Absolutely not! A wet cast may not hold the bone in place because the cast could start to dissolve in the water and could irritate the skin underneath it, possibly leading to infection. So your child shouldn’t swim and should use a plastic bag or special sleeve (available online or sometimes at pharmacies) to protect the cast from water. And instead of a shower, your child may need to take a sponge bath.

Can synthetic (fiberglass) casts get wet?

Although the fiberglass itself is waterproof, the padding inside a fiberglass cast is not. So it’s still important to try to keep a fiberglass cast from getting wet. If this is a problem, talk to the doctor about getting a waterproof liner. Fiberglass casts with waterproof liners let kids continue bathing or even go swimming during the healing process. Although the liner allows for evaporation of water and sweat, it’s still fragile. Also, only certain types of breaks can be treated with this type of cast. Your doctor will determine if the fracture may be safely treated with a waterproof cast.

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The common fall is more dangerous than it may seem. While the majority leave behind no more than a few bumps, bruises, or scratches others can be the injury behind a concussion, broken bone, seizure and other unpleasant situations.

When a person falls, the first thing to do is make sure there are no serious and obvious injuries- no broken bones, heavy bleeding, seizures, and that the person is conscious. If the fall was ‘bad’ do not allow them to move until you are sure no injuries have been done to their head, neck, back, or hips.

If there seems to be a serious injury, like any of the ones listed above and more, call 911 for aid. Also call if you see any of these signs

Unconsciousness- even if it is very brief (concussion)

Becomes very sleepy or is difficult to wake up (concussion)

Walking in an abnormal fashion- off balance, dizzy (concussion)

Difficulty breathing

No breathing -begin CPR

Clear fluid or bleeding coming from nose, ears or mouth.

Complains of intense or increasing pain

Vomiting

Deep or large wounds

Trouble focusing eyesight, distorted vision. (concussion)

Odd behavior or symptoms

Irritable and oddly moody, nonstop crying.

If the fall does not seem to be an emergency, but the child is young, keep watch over them closely for the next 24 or so hours, to make certain that no symptoms of injury or strange behavior develop. If you fear a concussion, due to a fall involving the head, even if there are no symptoms always go see a doctor.

Prevention

Preventing falls, especially with young children is tough, but it there are ways to minimize risks. With very young children or infants, always trap them securely into strollers, car seats, high chairs, and onto changing tables. Discourage children from playing on furniture or jumping on beds. Active children should be taught to wear helmets and other safety pads when biking, skating, skiing, and climbing.

*** Before administering any first aid to anyone outside your family, be aware of your rights and responsibilities: The Good Samaritan Law. ***

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June 16, 2010

Kelowna First Aid Westbank First Aid West Kelowna First Aid Penticton First Aid Vernon First Aid

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Seizures

A seizure is a sudden “episode” caused by an electrical problem in the brain. With a seizure, a person has change in awareness, body movements, or sensation

Signs & Symptoms

There are many types of seizures. Common types are:

A Generalized Tonic Clonic Seizure. This is also called a grand mal seizure. A convulsion occurs with this type. Signs of a convulsion include:

Brief loss of consciousness. Falling down.

The arms and legs stiffen, jerk, and twitch.

This type usually lasts 1 to 2 minutes. When it ends, the person’s muscles relax. He or she may lose bladder control, be confused, have a headache, and fall asleep. This is the type most people think of with the word “seizure”.

An Absence Seizure. This is also called a petit mal seizure. A convulsion does not occur with this type. Signs of an absence seizure include:

Blank stares. It looks like the person is daydreaming or not paying attention.

Lip smacking. Repeated blinking, chewing or hand movements.

This type of seizure usually lasts only a few seconds, but can occur many times a day. When the seizure ends, the person is not confused, but is not aware that the seizure occurred.

Absence seizures are common in children and can result in learning problems.

A Fever (Febrile) Seizure. This type is brought on by a high fever in infants and small children. High fevers cause most seizures in children aged 6 months to 5 years. Signs are ones of a convulsion listed in the left column. Most febrile seizures last 1 to 2 minutes, but can last longer. Seeing a child have a febrile seizure causes alarm. In general, these seizures are harmless.

Causes

Causes include epilepsy (a brain disorder), infections that cause a high fever, heat stroke, and electric shock. Head injury, stroke, and toxic substances can also cause a seizure. Sometimes the cause of a seizure is not known.

Treatment

Seizure disorders are treated with medication. Other medical treatments may be needed.

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