FirstAid knowledge among industry workers in Greece. (41/156)

Occupational accidents cause serious consequences. Providing first aid (FA) in the workplace can reverse unpleasant results. Aim of our study was to evaluate the knowledge on FA of industry workers through a questionnaire. Our sample constituted of 236 workers, 40 (Group A) were trained on FA by a team of doctors authorised by the Hellenic National Centre of Emergency Help, while 196 had never have a formal training on FA (Group B). In Group A the mean value of correct answers (performance score) was higher than Group B (62.7 and 50.4 respectively), while the total sample of workers ranged from 21.1 to 84.2. Group A replied correctly about normal values (NVs) of pulse, arterial blood pressure (BP) and breaths at 67.5%, 35% and 47.5% respectively. Group B replied at 32.8%, 18.4% and 30.6% on the corresponding NVs. In Group A, 95% answered properly about the definition of Cardiopulmonary Rehabilitation (CPR) but only 25% were acquaint with the necessary number of chest compressions and 32.5% with the number of necessary mouth-to-mouth ventilations to practice in case of CPR. In Group B, the corresponding percentages were 72.4%, 26% and 36.7%. Only 5% from Group A and 1% from Group B answer correctly and simultaneously about estimation of vital signs and CPR practice. In conclusion, the vast majority of workers are unable to provide efficient FA as long as they can't estimate vital signs and provide satisfactory CPR.  (+info)

First-aid supplies for backpacking. (42/156)

A portable first-aid kit should be carried in the backpack of campers, hikers, and anyone who expects to spend time in a remote and unoccupied area. That is the recommendation found in lay texts dealing with medical care, in backpacking books, as well as in articles appearing in popular magazines. It goes without saying that it is far better to practise safety and prevention than to have to use first aid. However, many times medical problems occur which no amount of safety and forethought could have prevented. Information in this paper indicates that hikers are generally well prepared for the health-related problems they encounter. Hikers carry diverse supplies to meet health problems but there are some basic supplies with which hikers start their long-distance sojourn. Those supplies and their usage rates are discussed, as are attitudes toward using the supplies.  (+info)

Management of Irukandji syndrome in northern Australia. (43/156)

INTRODUCTION: Irukandji syndrome, a potentially life-threatening condition that follows the sting of small carybdeid jellyfish, occurs along the northern Australian coastline from Broome, Western Australia in the west to Rockhampton, Queensland in the east. Much of this area is classified rural or remote. Because correct patient management is essential to avoid unnecessary fatality, and stings are relatively uncommon in any specific location, it was considered important to document current approaches to Irukandji syndrome management throughout coastal northern Australia, comparing urban and more rural health facilities, and to assess the availability of management guidelines for health staff. METHODS: A telephone survey of the clinicians responsible for Irukandji syndrome patient management at 34 coastal northern Australian health facilities that might encounter this patient presentation was conducted during November and December 2003. Healthcare providers responsible for Irukandji syndrome management on the day of survey were interviewed using a structured, standardized questionnaire, which included a description of a hypothetical patient with Irukandji syndrome. This was used to stimulate a spontaneous description of the usual response of the particular health facility to such a patient presentation. Additional vignettes were used to investigate further specific aspects of patient management, including first aid, and pain and blood pressure management. Respondents were also asked about the existence of Irukandji treatment guidelines at their facility. RESULTS: All 34 facilities contacted agreed to participate. Five health facilities were in urban centres with a population of 50,000 or greater, four were within 50 km of such centres, 20 were more remote and five facilities were on islands. Basic clinical monitoring (blood pressure, pulse, respiratory rate and oxygen saturation) was generally adequately practised. Topical application of vinegar as a first aid measure was described by 79% of respondents, with spontaneous mention of vinegar significantly associated with increasing remoteness (p = 0.023). Other sting site management was variable, with uncertainty about the use of pressure immobilisation bandaging. Intravenous opiate analgesia was administered at 91% of facilities, and magnesium sulphate, a treatment that is still being evaluated for its role in Irukandji syndrome-related pain and hypertension, was mentioned by 12% of respondents for pain relief. Twelve different pharmacological treatments were used for syndrome-associated hypertension, with magnesium sulphate being mentioned by 21% of respondents. Of the 22 facilities with guidelines, 14 used either the Primary Clinical Care Manual or the Central Australian Rural Practitioners Association Standard Treatment Manual. The remaining guidelines were independently produced protocols. The availability of guidelines was associated with appropriate use of intravenous opiate for adequate pain relief (p = 0.037). Although all urban health centres and 75% of health facilities <50 km away had guidelines, only 56% of more remote or island facilities reported the availability of guidelines. CONCLUSIONS: Although monitoring and pain management of patients with Irukandji syndrome were generally appropriate, a variety of inappropriate first aid and hypertension management approaches were found. In general, appropriate practice was associated with the presence of guidelines but, unfortunately, guidelines were less often present in remote health facilities. This is particularly important because the majority of respondents who reported no experience of managing Irukandji syndrome were located in more remote settings. There is a need for uniform, evidence-based guidelines, and mechanisms for effective dissemination of these guidelines with training for all health staff who may be required to manage Irukandji syndrome, particularly in remote areas of northern Australia.  (+info)

A national programme for on-site defibrillation by lay people in selected high risk areas: initial results. (44/156)

OBJECTIVE: To report on the effectiveness of an initiative to reduce deaths from sudden cardiac arrest occurring in busy public places. SETTING: 110 such places identified from ambulance service data as high risk sites. PATIENTS: 172 members of the public who developed cardiac arrest at these sites between April 2000 and March 2004. 20,592 defibrillator months' use is reported, representing one automated external defibrillator (AED) use every 120 months. INTERVENTION: 681 AEDs were installed; staff present at the sites were trained in basic life support and to use AEDs. MAIN OUTCOME MEASURES: Initial rhythm detected by AED, restoration of spontaneous circulation, survival to hospital discharge. RESULTS: 172 cases of cardiac arrest were treated by trained lay staff working at the site before the arrival of the emergency services during the period. A shockable rhythm was detected in 135 (78%), shocks being administered in 134 an estimated 3-5 minutes after collapse; 38 (28.3%) patients subsequently survived to hospital discharge. Spontaneous circulation was restored in five additional patients who received shocks but died later in hospital. In 37 cases no shock was initially indicated; one patient survived after subsequent treatment by paramedics, cardiopulmonary resuscitation having been given soon after collapse. Overall, irrespective of the initial rhythm, 39 patients (22.7%), were discharged alive from hospital. For witnessed arrests of presumed cardiac cause in ventricular fibrillation (an international Utstein comparator) survival was 37 of 124 (29.8%). CONCLUSIONS: The use of AEDs by lay people at sites where cardiac arrest commonly occurs is an effective strategy to reduce deaths at these sites.  (+info)

Experiences in applying skills learned in a Mental Health First Aid training course: a qualitative study of participants' stories. (45/156)

BACKGROUND: Given the high prevalence of mental disorders and the comparatively low rate of professional help-seeking, it is useful for members of the public to have some skills in how to assist people developing mental disorders. A Mental Health First Aid course has been developed to provide these skills. Two randomized controlled trials of this course have shown positive effects on participants' knowledge, attitudes and behavior. However, these trials have provided limited data on participants' subsequent experiences in providing first aid. To remedy this, a study was carried out gathering stories from participants in one of the trials, 19-21 months post-training. METHODS: Former course participants were contacted and sent a questionnaire either by post or via the internet. Responses were received from 94 out of the 131 trainees who were contacted. The questionnaire asked about whether the participant had experienced a post-training situation where someone appeared to have a mental health problem and, if so, asked questions about that experience. RESULTS: Post-training experiences were reported by 78% of respondents. Five key points emerged from the qualitative data: (1) the majority of respondents had had some direct experience of a situation where mental health issues were salient and the course enabled them to take steps that led to better effects than otherwise might have been the case; (2) positive effects were experienced in terms of increased empathy and confidence, as well as being better able to handle crises; (3) the positive effects were experienced by a wide range of people with varied expectations and needs; (4) there was no evidence of people over-reaching themselves because of over-confidence and (5) those who attended were able to identify quite specific benefits and many thought the course not only very useful, but were keen to see it repeated and extended. CONCLUSION: The qualitative data confirm that most members of the public who receive Mental Health First Aid training subsequently provide support to people with mental health problems and that this support generally has positive effects.  (+info)

Efficiency in reducing lost-time injuries of a nurse-based and a first-aid-based on-site medical facility. (46/156)

OBJECTIVES: The purpose of the study was to evaluate the efficiency of two standards for on-site medical facilities in reducing lost-time injuries during the construction of the link across the Oresund sound between Sweden and Denmark. One medical facility employed licensed nurses, who had advanced medical assistance at their disposal. The other medical facility utilized first-aid-trained watchmen. The on-site medical facilities aimed both at providing immediate medical assistance to workers subjected to occupational injuries and at reducing lost worktime. METHODS: The distributions of injuries treated on-site (the worker resumed work after treatment) and injuries sent to hospitals or to specialists were compared for each type of injury and for each category of injured body part. RESULTS: The on-site medical facilities dealt, in particular, with the treatment of ocular injuries (21%), wounds (21%), and sprains or strains (15%). The study showed a statistically significant on-site treatment (and resume work) rate ratio of 3.3 between the nurse-based (76%) and the first-aid-based (23%) medical facility. CONCLUSIONS: The construction of the Oresund Link shows a need for on-site medical facilities, particularly at remote construction sites, and that it is essential that the medical personnel have both the qualifications and authorization to treat site-specific workplace injuries effectively in order to obtain high on-site treatment rates.  (+info)

Safety among foreign workers and impact on emergency medicine services in Singapore. (47/156)

INTRODUCTION: This article aims to study work-related injuries through the eyes of the foreign workers and correlate the findings with their perception of job safety and their level of training received. METHODS: A prospective questionnaire-based survey was conducted between April and October 2002 in the Emergency Department of a secondary level hospital. 285 consecutive foreign workers with work-related injuries were enrolled. RESULTS: The majority of the foreign workers were of Asian origin, male, and 20-30 years of age. 66 percent had prior working experience. 83 percent of those surveyed rated the safety training received as "just enough" or better. There was a positive correlation between job skills and safety training (rs equals 0.733). 82 percent said that safety equipment were available, though only one-half made use of them. 67 percent of the injured received some form of first aid at scene, mainly bandaging. 17 percent did not receive any first aid because of lack of equipment or first aid training. The two most common injuries were wounds to the limbs (33.2 percent) and foreign body (FB) entry into the eyes (17.7 percent). Correspondingly, toilet and suture and removal of FB in the eye were the two most common procedures done. CONCLUSION: In this study, the foreign workers generally felt that the safety and work skills training were adequate. However, there are some problems that still need to be addressed.  (+info)

Prehospital pediatric trauma classification (PHPTC) as a tool for optimizing trauma care resources in the city of Sao Paulo, Brazil. (48/156)

PURPOSE: To evaluate the pediatric prehospital care in Sao Paulo, the databases from basic life support units (BLSU) and ALSU, and to propose a simple and effective method for evaluating trauma severity in children at the prehospital phase. METHODS: A single firemen headquarter coordinates all prehospital trauma care in Sao Paulo city. Two databases were analyzed for children from 0 to 18 years old between 1998 and 2001: one from the Basic Life Support Units (BLSU-firemen) and one from the Advanced Life Support Units (ALSU-doctor and firemen). During this period, advanced life support units provided medical reports from 604 victims, while firemen provided 12.761 reports (BLSU+ALSU). Pre-Hospital Pediatric Trauma Classification is based on physiological status, trauma mechanism and anatomic injuries suggesting high energy transfer. In order to evaluate the proposed classification, it was compared to the Glasgow Coma Score and to the Revised Trauma Score. RESULTS: There was a male predominance in both databases and the most common trauma mechanism was transport related, followed by falls. Mortality was 1.6% in basic life support units and 9.6% in ALSU. There was association among the proposed score, the Glasgow Coma Score and to the Revised Trauma Score (p<0.0001). CONCLUSION: Pre-Hospital Pediatric Trauma Classification is a simple and reliable method for assessment, triage and recruitment of pediatric trauma resources.  (+info)