Basic First Aid

How to assess the needs of someone who has been injured or is in physiological distress

BASIC first aid allows you to quickly determine a person’s physical condition and the correct course of treatment, whether the distress is due to to choking, heart attack, allergic reactions, drugs or alchohol or other medical emergencies. You should always seek professional medical help as soon as you are able. The following correct first aid procedures can be the difference between life and death:

1. Evaluate the situation.
Are there things that may put you at risk of harm? Are you or the victim threatened by fire, tosic smoke or gasses, an unstable building, live electrical wires and other dangers? Do not rush into a situation where you could end up as a victim yourself.

- If approaching the victim will endanger your life, seek professional help immediately; they have higher levels of training and know how to handle these situalions.

2. Remember the A,B,Cs of first aid which refer to the three critical things you need to look for.

- Airway - Does the person have as unobstructed airway?
- Breathing - Is the person breathing?
- Circulation - Does the person show a pulse at major pulse points (wrist, carotid artery, groin)?

3. Avoid moving the victim.
Avoid moving the victim unless they are in immediate danger. Moving a victim will often make injuries worse, especially in the case of spinal cord injuries.

4. Call Emergency Services.
Call for help or tell someone else (a specific person, if possible) to call for help as none as possible. If you are the only person on the scene, try to establish breathing before calling for help, and do sot leave the victim alone for an extensive amount of time.

5. Determine responsiveness. If a person is unconscious, try to rouse them by gently shaking and speaking to them.

6. If the person remains unresponsive, carefully roll them onto their back and open his airway.

- Keep head and neck aligned.
- Carefully roll them onto their back while holding his head.
- Open the airway by lifting the chin.

7. Look, listen and feel for signs of breathing.
Look for the victim’s chest to rise and fall, listen for sounds of breathing (place your ear near the nose and mouth, and feel for breath on your cheek

- If the victim is not breathing, see the section below.
- If the victim is breathing, but unconscious, roll them onto their side, keeping the head and neck aligned with the body. This will help drain the mouth and prevent the tongue or vomit from blocking the airway.

8. Check the victim’s circulation.
Look at the victim's colour and check their pulse (the carotid artery is a good option; it is located on either side of the neck below the jawbone). If the victim does not haves pulse, start CPR.

9. Treat bleeding, shock, and other problems as needed.- After you have established that the victim is breathing and has a pulse, your next priority should be to control any bleeding. Particularly in the case of trauma, you should take steps to control or prevent shock.

How to Stop Bleeding - Control of bleeding is one of the most important things you can do to save a trauma victim. Use direct pressure on a wound before trying any other method of managing bleeding.

How to Treat Shock - Shock, a loss of blood flow to the body, frequently  follows physical and occasionally psychological trauma. A person - in shock will frequently have cool, clammy skin, be agitated or have an altered mental status, and have pale color to the skin around the face and lips. Untreated, shock can be fatal. Anyone who has suffered a severe injury or life-threatening situation is at risk for shock.

How to Treats Burns - Treat first and second degree burns by immersing or fleshing with cool water (no ice). Don’t use creams, butter or other ointments, and do not pop blisters. Third degree burns should be covered with a damp cloth. Remove clothing and jewelry from the burn, but do not try to remove charred clothing that is stuck to burns.

Treat a Concussion - If the victim has suffered a blow to the head, look for signs of concussion. Common symptoms are: loss of consciousness following the injury, disorientation or memory impairment, vertigo, nausea, and lethargy.

How to Treat a Spinal Injury Victim - If you suspect a spinal injury, it is especially critical that you not move the victim’s head, neck or back(Unless they are in immediate danger). You also need to take special care when performing rescue breathing or CPR.

10. Stay with the victim until help arrives. Try to be a calming presence for the victim until assistance can arrive.

Source: News Straits Times - 1Klassifieds - Tuesday, October 26, 2010

Mobile phone should carry cancer warnings

Manufacturers should put labels on phones and packaging warning of the potential for brain cancer associated with electromagnetic radiation. The warnings should also warn that the most vulnerable users like children and pregnant women keep the devices away from their head and body.

Over the last few decades, there has been rapid worldwide development of wireless technology, including increasing use of wireless telephones communication.

This has raised concerns about health risks, primarily increased risk for brain tumours, owing to the proximity of the brain to the radiation antenna with the potential for absorbing comparatively large amounts of electromagnetic energy.

Latest studies led by Professor Lennart Hardell of the University Hospital in Orebro, Sweden have shown that using mobile phones for 10 years or more significantly increases the risk of brain tumours.

 

Other significant findings by the Hardell group are that:

 

-- For every 100 hours of mobile phone use the risk of brain cancer increases by 5%.

 

-- For every year of mobile phone use the risk of brain cancer increases by 8%.

 

-- After 10 or more years of digital mobile phone use, there is a 280% greater risk of brain cancer.

 

According to a detailed report by the International EMF Collaborative, which reviewed Hardell’s research, their findings are precisely what would be expected if mobile phones lead to brain tumours, in particular:

 

-- The higher the cumulative hours of mobile phone use, the higher the risk.

 

-- The greater the number of years since first mobile phone use, the greater the risk.

 

-- The more power radiated from the mobile phone during use, the more the risk.

 

-- The greater the exposure (phone use on the same side of the head as the tumour), the greater the risk.

 

-- The younger the user, the higher the risk.

 

Studies have also found that young people today are 5 times more likely to get brain cancer if they are mobile phone users.

 

Children are especially vulnerable to radiation from mobile and cordless phones, Wi-Fi and other devices because their brains and nervous systems are still developing and since their heads are smaller and their skulls are thinner, the radiation penetrates deeper into the brain.
Professor Hardell says those who started using mobile phones young, were also 5 times more likely to get acoustic neuromas, which are benign but often disabling tumours of the auditory nerve, which usually cause deafness, whereas people who were in their 20s before using handsets were only 50% more likely to contract gliomas and just twice as likely to get acoustic neuromas.
In another earlier report, Mobile Phones and Health, Professor Sir William Stewart, chairman of the national Radiological Protection Board (NRPB), said that there are 4 studies which have caused concern. One 10-year study in Sweden suggested that heavy mobile users are more prone to non-malignant tumours in the ear, evidence of cell damage from fields typical of those of mobile phones and brain, while a Dutch study had suggested changes in cognitive function. A German study has hinted at an increase in cancer around base stations, while a project supported by the European Union had shown evidence of cell damage from fields typical of those of mobile phones.
A number of scientists have discovered that mobile phone radiation causes permanent damage to DNA, an undisputed cause of cancer.
According to one report, there is an obvious disturbance of communication between cells which is a prerequisite for the uninhibited proliferation of cells that is characteristic for cancer development occurs at mobile power levels just a few watts per metre.
Equally alarming, the report explains that these effects can take place within the brain. The body normally has a self protective mechanism to prevent toxins from entering the brain, but mounting evidence shows that mobile phone frequencies can cause the blood-brain barrier to break down. Besides cancer, mobile phones have been linked to a number of other health problems:

 

-- reduced sperm quality

-- memory impairment

-- weakened bones

-- autism

-- symptoms of electro sensitivity, such as tiredness, stress, headache, anxiety, concentration difficulties and sleep disturbances

 

In view of the dangers associated with mobile phones, CAP calls on the Government to:
-- require mobile phones to carry warnings that they increase the risks of brain cancer
-- issue a warning to parents to ban their children under the age of 12 years from using mobile phones
-- run campaigns to educate and warn the public of the dangers of radiation exposure from mobile phones
Meanwhile CAP reiterates its call to consumers to refrain from using mobile phones unless in an emergency and if you have to use it, use the speakerphone function so the phone is 20 cm away from the head. Use landlines wherever possible.
Read about how mobile phones fry your brain, raise brain cancer risks and damage your DNA in the CAP Guide, How Unsafe Is Your Mobile Phone

Chemicals linked to rising health problems

Toxic chemicals are linked to some cancers, birth defects and low birth weight, autism, and learning and behavioural disabilities. Many parts of the world today are seeing escalating health problems and more and more countries are linking this to the chemical legacy.
 

In Canada, for instance, the government has found that 12% of children there have asthma, possibly a 4-fold increase since the 1970s. Among young Canadian adults, aged 20-44, thyroid cancer has been rising at a rate of 4.2% in men and by 6.6% in women annually.
Non-Hodgkin’s lymphoma has risen by 3.5 and 4.2%, respectively; lung cancer by 1.9%; brain cancer by 2% in women; and testicular cancer by 1.7% (The Ottawa Citizen, 11.12.06).
By the Ontario Medical Association’s conservative tally, air pollution alone – ground-level ozone and fineparticle pollution – prematurely kills more than 5,800 people in the province every year, triggers more than 16,800 hospitals admissions, 60,000 emergency room visits and more than 29 million minor illness days at a combined price tag of $7.8 billion, estimated to increase to $12.9 billion by 2026.
In the US, scientists have found that US residents have the world’s highest levels of perfluorochemicals in their bodies. Perfluorochemicals are a family of manmade chemicals that have been used for decades to make products that resist heat, oil, stains, grease and water. Common uses include nonstick cookware, stain-resistant carpets and fabrics, as components of firefighting foam, and other industrial applications. It takes the body at least 8 years to rid itself of these chemicals.
The US is also seeing a rise in certain diseases and health problems. Over the past 50 years, as infectious childhood diseases like polio, smallpox, rheumatic fever, and diphtheria have largely been controlled, chronic conditions of less obvious origins have taken their place. Asthma, autism, attention deficit and hyperactivity disorders (ADD and ADHD), childhood brain cancer and acute lymphocytic leukaemia have all increased over the past 30 years.
In addition, 5-10% of American couples are infertile. Up to half of all pregnancies end in miscarriage. 3-5% of babies are born with birth defects.
Scientists cannot fully explain these increases, but early life exposure to environmental pollutants is a leading suspect.
And what will this lead to?
In the article, “Rejecting the Toxic Plague: War on Plastic”, author Jan Lundberg, says:
“Most North Americans urinate plastics. Sperm counts are at an historic per capita low. Cancer is an epidemic.
Birth deformities, sex organ abnormalities and eventual cancers are becoming more common – all traceable to certain Chemical exposures to the fetus. If the human race is not driven extinct by nuclear holocaust or complete distortion of the climate, it may happen through wonderful plastic and other petrochemicals.”
Hormonal hazards
In recent years, scientists and lawmakers have become more concerned about pollutants in the environment that appear to interfere with natural hormone systems.
Hormones play many critical roles in controlling growth and development in early life, such that any interference could have serious and irreversible effects on child development with consequences that may be felt throughout their later lives.
“There’s a lot of concern that a lot of chemicals to which we are exposed routinely, and without our knowledge, are interfering with the way hormones work,” said R. Thomas Zoeller, a professor of biology at the University of Massachusetts at Amherst.
Here are 2 of the most widely known examples, as cited in a Washington Post article (4.12.06):
Bisphenol - A (building block for plastics). Found in: Clear plastic bottles such as those used by hikers and infants, as well as resins used to line food and drink cans. Results of research: In animals, low doses have been linked to low sperm production, altered growth and behavioural changes. The chemical industry, however, says other studies show that the chemical is safe.
Phthatates -  (chemical additives that increase plastic’s flexibility). Found in: Flexible vinyl toys, wallpaper and electronic devices. Results of research: In animals, these chemicals affect the functioning of male brains and sex organs. In humans, one recent study found a correlation between mothers’ exposure and subtle developmental changes in baby boys.
The chemical industry, however, says that there is no proof that human health is at risk.

Over 300 chemicals are found in our bodies. Find out how you can reduce exposure to these toxic chemicals in the CAP Guides, Contaminated Humans, Chemical Hazards and Going Extinct

Risks from radiological & nuclear medicine examination

 

The basis of present day medicine is shared decision making between the doctor and the patient. Empowering a patient to make informed decisions about their treatment is a fundamental principle in medical professionalism. But is this principle translated into clinical practice in so far as radiological and nuclear medicine examinations are concerned?
In general, patients undergoing radiological and nuclear examinations receive no, very little, or inaccurate information regarding the risks involved. Take, for example, the CT Scans and X-rays. They are so common that they are used as if they don’t pose any risk.

The total number of imaging examinations (use of nuclear and X-rays), for instance, account for 2 billion per year. Angiograms are performed routinely by cardiologists; radioisotope studies are common; the use of contrast mediums like iodine is also routine and now we have the Helical CT Scans which carry a high risk of cancer or death.
 

As every examination of a radiological or nuclear medicine nature involves the administration of radiation, there is the inherent long-term risk of cancer and yet, the patient is rarely, if ever, informed of the associated risks.  
Currently, doctors tend to opt for 1 of 3 choices: no mention of risk; understatement of risk or full disclosure of risk.
No mention of risk
Some doctors choose not to mention any risks involved. These may be very real and quite substantial but they remain unsaid and unheard, the main reason being that radiologists are too busy too explain the risks and to get an informed consent. However, the patient’s rights are not just overshadowed by the factor of efficiency but also that of a paternalistic attitude of “doctor knows best”.
Understatement of risk
In nuclear medicine, the standard practice is to obtain a written informed consent. The only problem is that the quality of the information given to the patients is suspect. Doctors tend to give imprecise statements such as, “A nuclear medicine examination is safe, with an irradiation corresponding to a simple radiograph”.
The attitude is to suggest that the examinations are safe and simple. A patient might believe that a simple radiograph would be a chest X-ray, the simplest and commonest radiological examination.
In reality, the dose exposure could be very much higher. While the purpose of such imprecise statements might be to reassure or prevent unnecessary concern about an unavoidable risk, the fact remains that the associated risks are underestimated and the patient’s autonomy is eroded.
Full disclosure
Full disclosure involves informing the patient of any possible risk however small. It also means that the patient has clearly understood the benefits vs the risks involved in the radiological examination or procedure. He then makes an informed choice which means that the consent obtained is an informed one (informed consent). However, only a few doctors, if any, provide full disclosure.
Reasons for the failure to communicate the risks
It must be understood that failure to communicate the risks of radiological and nuclear medicine to patients is violating patient autonomy. There could be various reasons for this failure, but this is no excuse as the risks are real and may be substantial depending on the type of procedure carried out.

Some of the reasons for failing to communicate risks include:

1.    The practitioner has a morbid fear of losing his patient if he alarms him. A simple example is to label drugs scheduled as poisons with a poison label. Many doctors opt not to do so as this might scare the patient from consuming the drug. What more if you talk of cancers, leukaemia and death as a result of irradiation!

2.    Another factor in carrying out a hazardous procedure without a clear idea of the benefits is the fear that if you don’t carry out that procedure, another doctor would be willing to.  The following remark from a senior surgeon that if he didn’t remove the appendix from a patient complaining of abdominal pain, someone else would do it even though the appendix might not be the primary cause of the problem would serve to illustrate this point.

3.    The terminology used in radiation protection can be mind-boggling even to doctors and specialist in other fields. Terms like “megabecquerels”, “roentgen”, “millicuries”, “millirems”, “micro-sieverts”, “source-related dose cconstraints” and “co-efficient for stochastic effects” are employed in this branch of medicine which sets standards for the safe use of irradiation. The communication between doctors themselves is lost in this quagmire of gobbledygook. Unfortunately, the end result is that risks get ignored at the expense of the poor patients.

As it is essential to communicate risks to patients, one way out is to simplify the language such that the layman understands it and in so doing will be able to give an informed consent whether he wishes to undergo the procedure or not.

Leptospirosis-get rid of the rats

Consumers Association of Penang (CAP) views with concern the recent outbreak of leptospirosis at a detention camp for illegal immigrants in Bukit Mertajam.

The disease is caused by the Leptospira spp. bacteria. Infection in humans is said to be rare and is usually through coming into contact with water, food or soil that has been contaminated by an infected animal’s urine. Rats and mice are common sources of infection.
Symptoms of leptospirosis include initial fever, headaches and chills and can follow with more serious effects such as meningitis, liver damage and renal failure, possibly ending in death.
Due to a wide range of symptoms the infection can possibly be wrongly diagnosed. This can mean that there may be more cases in the country than are actually detected.
Prevention of infections is through proper sanitation. Here in Penang, and also in other areas in the country, rats can be seen running freely around some open-air hawker centres and eateries. Drinking water and water used for washing dishes can become contaminated. Not much seems to be done to clean up and rid these places of rodents.
Crowded places such as detention camps, squatter settlements, prisons and other areas may also be sources of infection if cleanliness is not upheld.
People should play their part, but in many instances, either the “stick” is needed before things get moving, or else, certain segments of society need official assistance to improve their living or working environments.
CAP calls on the Health Ministry and the local councils to step up measures to ensure eateries and other places are not hotbeds for rodents and a source of serious infections like leptospirosis.
Letter to the Editor – 19 May, 2009

How to stop smoking

SMOKERS don't need to be told that their habit is disgusting, anti-social and will probably make them die earlier. The problem is how to give up, for most smokers would like to if they could.

IF you smoke, you're in the grip of a double addiction. First, there's the physical craving for nicotine -- and the more you smoke the more urgent the craving becomes. This is because nicotine passes very rapidly through the body, so you're continually having to "top up" your nicotine level to keep feeling its effects.
Then there's the psychological addiction. You come to rely on the stimulant effect of nicotine and feel you "need" a cigarette to work, to relax or to calm your nerves.
Hardly a week goes by without a new report on the dangers of tobacco addiction. Don't wait to give up smoking until you're stricken with lung cancer, heart disease, bronchitis or one of the many other smoking-related illnesses.
And you can't rely on switching to a lower tar brand to reduce your chances of getting these diseases. Most smokers on lower-tar brands actually smoke more to compensate for the tar reduction, so end up back where they started.
Mind over matter
TO STOP smoking, you have to conquer both addictions. If you manage to overcome only the physical craving, it's likely you'll reach for a cigarette in a crisis and undo all the hard work.
So you should start by asking yourself why you need a crutch like nicotine. It often helps to observe your habit carefully, even writing down every occasion during the day that you have a cigarette and identifying the reason why you wanted one then.
Thinking about it can help you to cut down, because it breaks the automatic pattern of reaching for the packet. But people who simply cut down almost always go back to their old level.
The only successful way to stop is to choose a time when you feel relatively free from stress, throw away your current packet, grit your teeth and prepare yourself for nicotine withdrawal symptoms.
Substitutes and support
MOST people use food as a substitute when they try to give up smoking and find they put on weight as a result. You also tend to eat more after stopping smoking because your palate, accustomed to being deadened by smoke and tar, becomes cleaner and more sensitive to taste.
If you want to give up smoking without gaining weight, eat fruit rather than sweets and make sure you have regular meals so you're less tempted to nibble.
You can also take up hobbies like knitting or carpentry that satisfy the urge to occupy your hands. And publicise your achievement by colouring in each new day without smoking on a giant wall calendar.
It helps, too, to enlist the support of friends and relatives. Don't let them offer you cigarettes; you can even ask them not to smoke in your home. Avoid places where you'll be tempted, especially pubs and clubs where the drink and the atmosphere will undermine your good resolutions. Head for the non-smoking areas on public transport.
If you find it hard to do it alone, group therapy centres can help by bringing you together with other addicts, to share the problems of addiction and give mutual support for those stopping, as well as expert medical and psychological advice.
There can't be many more rewarding projects than giving up smoking. Feel good about it. Enjoy the cleaner air of "No Smoking" zones in public places. Enjoy being able to get close to people without worrying about the smell of stale tobacco on your breath and body.
Enjoy knowing that you'll live longer, and enjoy the feeling that you're not forcing other people to tolerate your anti-social habit. And pamper yourself with some of the money you're no longer burning.

Asbestos: The deadly, silent killer

In recent weeks, concerns over asbestos poisoning have been raised in our local print media. And rightly so! This naturally occurring fibrous mineral, with fire and heat resistant properties, has been recognised as a serious threat to life in the Western countries and where possible, its use is avoided.

People who work with asbestos are at serious risk of developing lung cancer, asbestosis, mesothelioma and fatal respiratory illnesses. The International Labour Organisation (ILO) conservatively estimates that 100,000 workers die each year from asbestos-related diseases. Thousands more perish from environmental exposures.

 

Asbestos fibres are exceptionally strong and commonly found in ceiling tiles, flooring, water pipes and vehicle brakes. Asbestos was once heralded as the greatest building material, but is today recognised as one of the biggest workplace killers.
Asbestos also includes chrysotile, amosite, crocidolite, tremolite asbestos, anthophyllite asbestos, actinolite asbestos, and any of these materials that have been chemically treated and/or altered.
Asbestos only becomes a danger when it is disturbed, causing the fibres to become airborne. This is commonly referred to as friable asbestos, while intact asbestos is referred to as non-friable asbestos.
Airborne friable asbestos is sucked into the lungs of people exposed to it. Until today, research has yet to determine a safe level of exposure to asbestos, but one thing is for certain – the more prolonged the exposure, the greater the risk becomes for developing an asbestos-related disease. This is why asbestos poisoning is often called an occupational hazard disease, because the people who commonly work with the material are most at risk for developing an asbestos-related disease.
Health officials have warned that widespread asbestos exposure will result in epidemics of mesothelioma, lung cancer and asbestosis. Besides these debilitating fatal diseases, a panel of 27 experts convened by the World Health Organisation’s (WHO) International Agency for Research on Cancer (IARC) reported new evidence that asbestos causes cancer of the larynx and the ovary.
Of concern is a forecast by Dr James Leigh, retired director of the Centre for Occupational and Environmental Health, Sydney School of Public Health, Australia, that there will be 5 to 10 million deaths from asbestos-related cancers by 2030.
It is also alarming that international health agencies such as the WHO, ILO and IARC agree that there is no safe level of asbestos exposure. Despite this, asbestos roofing materials, asbestos cement pipes and other asbestos-containing products are still being widely used worldwide, including in Malaysia.
What is of great concern to consumers is that there does not seem to be any concern for their health in being supplied with water through asbestos cement pipes. Malaysia does not have any programme to specifically replace asbestos cement pipes. Even if there is little evidence of the carcinogenicity of ingested asbestos, precaution must be taken by replacing old asbestos-cement pipes with safer substitutes.
Acknowledging the dangers of asbestos, 54 countries worldwide have imposed bans, restrictions or exemptions for minor uses of asbestos. In Malaysia, only crocidolite (blue asbestos) has been prohibited, but the use of chrysotile (white asbestos), amosite (brown asbestos), tremolite, anthophyllite and actinolite are allowed.
In view of the importance of safeguarding the health of the public and workers handling asbestos, CAP has been calling for a complete ban on the material. We understand that the Malaysian government is in the midst of studying the implementation of a ban, but our concern is that this process is taking too long.  
Besides imposing a ban on asbestos, the Malaysian government must make available a national registry for asbestosis and mesothelioma, early diagnosis of asbestos-related diseases and implement a workers’ compensation scheme.
The government must also embark on an asbestos awareness and education programme to impart the message to the public, contractors, mechanics, plumbers and workers in general about the hazards of asbestos and to encourage compliance with regulations and safe asbestos management practices. We also need knowledgeable and skilled labour for safe removal and disposal of asbestos-containing products.
CAP reiterates our call to the government to expedite an outright ban on asbestos and ensure that the necessary measures are taken to safeguard the health of all Malaysians.
Letter to the Editor - 9 October 2010

Basic Life Support - CPR