Introduction

DIABETES

All cells in the body need insulin in order to absorb and use sugar for energy. The pancreas produces insulin; however, in a person suffering from diabetes, this process is ineffective. The balance of sugar and insulin in the body is normally regulated without being aware of it, but in a diabetic person, this must be monitored and controlled. If there is not enough or too little insulin, then the person will very quickly show the effects.

Sugar levels in the blood can easily fall too low if the person:

1. Takes too much insulin
2. Experiences emotional stress
3. Does not eat appropriately
4. Exercises more than expected
5. Is dehydrated, vomits, or has diarrhea

A person suffering a diabetic incident may become:

1. Sweaty
2. Unsettled, panic
3. Tremors
4. Rapid pulse
5. Rapid breathing
6. Changed level of consciousness- aggressive confused, drowsy, dizzy

MANAGEMENT

1. If the casualty is able to respond to you and talk, offer the casualty a sweet, sugary drink, lollies, and fruit juice.
2. Follow up with a substantial carbohydrate meal (ham and salad sandwich on wholemeal bread).
3. If the casualty is unable to respond properly call for medical assistance. The casualty should respond quickly.
4. If there is no response from management, refer the casualty quickly to medical treatment.

STROKE

A stroke is caused by an interruption to the blood supply to the brain. This can be caused by a blockage or a bleed inside the brain. As a first aider, it is impossible to tell which has been the cause.

SIGNS AND SYMPTOMS

1. One-sided headache
2. Disorientation
3. Slurred speech
4. Weakness on one side
5. Numbness in one side
6. Unconsciousness
7. Altered conscious state

ASK THE CASUALTY TO SMILE, SAY A SHORT SENTENCE, AND SQUEEZE YOUR HANDS

MANAGEMENT

1. It is important that a casualty suffering a suspected stroke is seen by Medical Personnel as soon as possible.
2. If emergency treatment is begun quickly the chances of recovery are extremely good.
3. Monitor the ABC and comfort the casualty while you wait for an ambulance.
4. The casualty may have lost the ability to speak, but may still hear and understand what you are saying.

POISONING

INGESTED POISONS

Poisonings may be accidental or deliberate. Poisonous substances can be ingested, inhaled, injected, or absorbed through the skin. A wide range of symptoms and signs may occur including unconsciousness, nausea, vomiting, burning pain in the mouth or throat, headache, blurred vision, seizures, respiratory arrest, or cardiac arrest.

MANAGEMENT

1. RESUSCITATION MAY BE REQUIRED- FOLLOW DRABCD.
2.  AVOIDING MOUTH-TO-MOUTH CONTACT MAY BE APPROPRIATE.
3. If possible ascertain what poison or substance has been taken how much and when.
4. Obtain medical advice promptly 
5. If unable to get advice and waiting for help to arrive
6. Monitor casualty, especially airway, breathing, and circulation and manage appropriately
7. Arrange for the casualty to be taken to medical aid with samples of vomit and any container found near the casualty.

PREVENTION

AT HOME

1. Make a survey of your home and identify all poisonous substances
2. Remove poisons and medicines that are unwanted. Dispose of them safely.
3. Store poisonous substances in their original containers in locked or child-resistant cupboards or containers out of the reach of children
4. Use non-poisonous alternatives wherever possible
5. Keep the number of poisons in the home to a minimum
6. Ask for and use medicines in child-resistant packaging
7. Read the labels and use them according to the directions
8. Wear personal protective equipment when using toxic or caustic chemicals.

AT WORK

1. Have copies of MSDS
2. Keep a register of all chemicals used at work
3. Learn how to clean up chemical spills
4. Store chemicals safely

POISONING BY INHALATION

Inhalation of gases, vapors, and liquids may lead to a life-threatening situation

Symptoms and signs may be caused by:

1. Lack of oxygen in the immediate environment
2. Obstruction of the airway from spasms in the lower airway and outpouring of fluid into the lungs eg. By toxic fumes from ammonia, chlorine, or smoke
3. General toxic effects on the :
4. Brain (leading to unconsciousness eg carbon monoxide)
5. Heart (leading to cardiac arrest eg Glue sniffing)

RECOGNITION

In some circumstances, inhalation injury should be suspected even though there are no obvious symptoms and signs eg as smoke inhalation burns to the face and neck, or inhalation of fumes from burning synthetic material. The effects may be delayed, so all casualties need medical assessment.

Immediate symptoms vary with the contaminant and the level of exposure. There may be no warning symptoms and signs. The casualty may lose consciousness unexpectedly.

SIGNS AND SYMPTOMS

1. Wheezing
2. Shortness of breath
3. A choking sensation
4. Disorientation

MANAGEMENT

Warning: IN A CONFINED SPACE RESCUE MAY BE HAZARDOUS WITHOUT SPECIAL PRECAUTIONS

1. Ensure it is safe to carry out the rescue
2. Remove the casualty from the contaminated environment
3. Smoking and naked flames should be prohibited
4. The treatment consists of assessment and emergency care of the casualty following DRABCD
5. Additional measures include
6. Removal of contaminated clothing if appropriate
7. Flushing of contaminants from eyes and skin

NOTE: Toxic gases can be colorless, odorless, tasteless, and non-irritant.

ANGINA

Angina is a condition where there is inadequate blood flow to the heart usually caused by the narrowing of the blood vessels leading to the heart.

This condition causes severe central chest pain usually on exertion or emotional stress.

A casualty who has been diagnosed with Angina will have prescription medication to relieve symptoms.

This medication comes in the form of small pills that are placed under the tongue, not swallowed.The medication is absorbed through the lining of the mouth and symptoms should be relieved within a few minutes. If the pain continues, it must not be ignored. The pain of angina is very similar to that of a heart attack. If chest pain continues for more than 10 minutes seek medical aid urgently.

MANAGEMENT

1. Make the casualty comfortable and reassure.
2. Assist with prescribed medication.
3. If no improvement in 10 minutes calls for medical assistance. Be prepared to give CPR

ANAPHYLAXIS

Anaphylaxis is an acute, severe allergic reaction that can be triggered by a variety of substances and can be life-threatening.

These reactions usually appear rapidly- within seconds or minutes after exposure to the substance (allergen).

1. The most common allergens are
2. Foods ( especially peanuts, nuts, eggs, shellfish, and seafood)
3. Certain drugs (penicillin, aspirin)
4. The venom of some stinging insects (bees, wasps, ants)

Allergies to latex-containing products are a serious problem, especially among health care workers.

People with DIAGNOSED allergies that may lead to anaphylaxis should have a readily accessible emergency plan and medical alert device.

WHEREVER POSSIBLE THIS INFORMATION SHOULD BE SOUGHT AND IMPLEMENTED

These people often have prescribed medication in the form of injectable adrenaline (Epipen). The injection of adrenaline is often critical in life-threatening anaphylaxis.

1. Injection of Adrenaline is the recommended first aid management for diagnosed anaphylaxis.
2. RECOGNITION
3. Symptoms of anaphylaxis which usually occur within minutes of exposure to the allergen may include:
4. Swelling of the throat and tongue leads to difficulty swallowing and breathing
5. Hoarseness
6. Itching hives or general redness of the skin
7. A strange metallic taste in the mouth
8. A sudden feeling of weakness
9. A sense of impending doom
10. Increased heart rate (tachycardia)
11. Abdominal cramps and nausea
12. Collapse and unconsciousness

MANAGEMENT

1. Assist the casualty to lie down
2. Call for an ambulance
3. If the casualty has an emergency action plan follow it
4. If the casualty has an Epipen it should be injected into the thigh
5. If breathing stops follow DRABCD
6. BITES and STINGS

FAINTING

Fainting is the term used to describe the condition of sudden, brief loss of consciousness with the potential for a full recovery. Loss of consciousness from fainting (syncope) is usually brief, from seconds to one or two minutes, providing the casualty lies down. Prior to the loss of consciousness the casualty usually feels light-headed, anxious, pale, and maybe nauseous. There can be serious health consequences if the casualty is left supported upright in a chair or supported upright.

CAUSES:

1. Standing for long periods in hot weather or a hot shower
2. Sight of blood
3. Pain
4. The sight of a needle, particularly prior to or just following an injection

MANAGEMENT:

1. Follow the DRABCD
2. If the person is in a chair, assist them into a horizontal position
3. Lie the casualty flat
4. Raise the legs if feasible
5. A pregnant woman should be turned onto the left side
6. Assess the casualty for any injury resulting from the fall
7. If the casualty does not regain consciousness turn onto the side into the recovery position.

NEVER SIT THE CASUALTY IN A CHAIR AND PUT THE HEAD BETWEEN THE KNEES