Search Results

DUBAI //The sudden change in temperature from extreme hot to cold can have a serious effect on people who have a history of cold-related disorders. Doctors say managers of malls, offices, public buildings, mosques and even hospitals, which sometimes record temperatures as low as 19°C, have a responsibility to ensure that the inside of their establishments is not unhealthy. "Extreme and sudden variance between outside and inside temperatures has adverse effect on body as it undergoes a certain amount of stress when it is forced to go from a boiling hot environment into an air-conditioned one", said Dr Aamerah Shah, a primary care specialist at the American Hospital Dubai. "It dries off your skin, the mucus membrane and the eyes. We see patients who say they went to the malls or their offices and it was extremely cold. Eye infections, respiratory infections and muscular spasms are caused by this change in temperature," Dr Shah said. She treats several patients each month for asthma attacks, runny noses, muscular pain, flu, pharyngitis, sinusitis, cold, sore throat, muscular aches and severe pains, all mostly the result of air conditioning. Dr Shah said the recommended temperature should be between 23°C and 25°C to prevent susceptibility to ailments and ensure healthy living. Another medical expert said low temperatures can exacerbate medical conditions of existing patients. "These extreme differences from outside to inside might affect the human body," said Dr Tarek Abdul Hadi Azeem, a professor and consultant of internal medicine at Al Noor Hospital in Abu Dhabi. "The change in temperature can exacerbate coronary heart diseases, vascular cardiac, vascular brain diseases and peripheral vascular [artery and vein] diseases. "The condition of people with respiratory diseases might also worsen. I always advise patients to switch their air conditioners off when possible and avoid being exposed to low temperatures." Another doctor said the hospital where she worked set the temperature sometimes as low as 19°C, which was unhealthy for patients and medical practitioners. A prominent hospital whose inside temperatures The National gauged with a thermometer recorded about 22.5°C at 11am on a Wednesday. "It is too cold for the patients," said the doctor. "It is something that all hospital administrations should look into. The temperatures of all buildings including hospitals should be monitored closely. If offices and hospitals are too cold, they should let the management know." Dr Azeem agreed: "Many patients are sick, they might fall more ill. Hospitals should pay attention as they are providing health care. They have a responsibility. Even mosques are so cold. No place should be very cold." PinnedOthers

Schools may administer their “spare” adrenaline auto-injector (AAI), obtained, without prescription, for use in emergencies, if available, but only to a pupil at risk of anaphylaxis, where both medical authorisation and written parental consent for use of the spare AAI has been provided.The school’s spare AAI can be administered to a pupil whose own prescribed AAI cannot be administered correctly without delay.AAIs can be used through clothes and should be injected into the upper outer thigh in line with the instructions provided by the manufacturer.If someone appears to be having a severe allergic reaction (anaphylaxis), you MUST call 999 without delay, even if they have already used their own AAI device, or a spare AAI.In the event of a possible severe allergic reaction in a pupil who does not meet these criteria, emergency services (999) should be contacted and advice sought from them as to whether administration of the spare emergency AAI is appropriate.

A new study suggests members of the public don’t know what defibrillators are, how to use them, or where to find them. It also suggests organizations don’t feel they should have one or feel unable to obtain one. COVENTRY, UK--A study led by the University of Warwick suggests that people are reluctant to use public access defibrillators to treat cardiac arrests. The analysis of existing international studies, which has been published in the European Heart Journal – Quality of Care and Clinical Outcomes, suggests that there are a number of factors that prevent members of the public from using them and potentially saving lives. The researchers’ study suggests that many members of the public don’t know what an automated external defibrillator (AED) is, where to find one, and how to use one. This is despite AEDs being suitable for use by untrained members of the public. Although studies suggest there is variation across the studies they analyzed in the number of people willing to use an AED, a lack of confidence and fear of harm are common themes. The research, “Barriers and facilitators to public access defibrillation in out-of-hospital cardiac arrest: a systematic review,” was conducted by Warwick Medical School, the University of Warwick; the Institute of Digital Healthcare, WMG, the University of Warwick; Heart of England NHS Trust, Birmingham; London Ambulance Service NHS Trust and Imperial College Neurotrauma Centre, St Mary’s Hospital, London. Gavin Perkins, Professor in Critical Care Medicine at Warwick Medical School said: “Public access defibrillation is very effective in certain cases of cardiac arrest outside of hospital. A study conducted in the US showed that the chance of survival was nearly double in the group that received CPR and were treated with a public access defibrillator compared to the group that received CPR alone. However the number of cases when a public access defibrillator is used is very low – just 0.15-4.3% of cardiac arrests that occur outside of hospitals.” Although only a minority of out of hospital cardiac arrests occur in locations where use of a defibrillator would help save a life, AEDs are often poorly accessible or have limited availability; often their location is not known to even emergency services or those running training schemes. They also found that although members of the public saw the value of AED training most hadn’t undergone training. Theo Arvanitis, Professor of e-Health Innovation and Head of Research at the Institute of Digital Healthcare, WMG, at the University of Warwick said: “Investment in more AEDs is great but it’s at least as important to maximize use of existing defibrillators. Many cardiac arrests that happen in public occur out of ‘normal business hours,’ therefore if an AED is kept in a building there is a good chance the building won’t be accessible. We would also like to see the message put out that these devices can be used without training. However our study found that those with training were more likely to use an AED so training is important too.” It was found that public-access AEDs were often acquired by donation or fundraising rather than private purchase, and donation was a predictor of AED acquisition among college athletic departments in one study. The research team also examined the reasons for not obtaining an AED. They were: cost; concerns about liability; not being considered necessary; lack of and/or attrition of responsible individuals; there was a good, local emergency service and there was a nearby hospital. One study reported that while 32% cited cost and 37% cited legal concerns as reasons not to obtain an AED, 55% thought affordability and 51% thought legal protection were good reasons to obtain an AED. They also highlighted that maintenance of AEDs was variable. One study reported that all but one of 206 AEDs were ‘operable’ and ready for use, but many AEDs were not maintained or had no formal plans in place for maintenance or replacement. The systematic review conducted by the research team consisted of an analysis of 68 English language articles. Many of these were observational, many collected data retrospectively or were surveys. Due to the nature of the articles surveyed the team recommend further research is needed before making policy proposals. SOURCE: University of Warwick

Abstract BACKGROUND: Automated external defibrillators can be life-saving in out-of-hospital cardiac arrest. OBJECTIVE: Our aim was to review our experience of prescribing automated external defibrillators for children at increased risk of sudden arrhythmic death. METHODS: We reviewed all automated external defibrillators issued by the Scottish Paediatric Cardiac Electrophysiology Service from 2005 to 2015. All parents were given resuscitation training according to the Paediatric Resuscitation Guidelines, including the use of the automated external defibrillator. RESULTS: A total of 36 automated external defibrillators were issued to 36 families for 44 children (27 male). The mean age at issue was 8.8 years. Diagnoses at issue included long QT syndrome (50%), broad complex tachycardia (14%), hypertrophic cardiomyopathy (11%), and catecholaminergic polymorphic ventricular tachycardia (9%). During the study period, the automated external defibrillator was used in four (9%) children, and in all four the automated external defibrillator correctly discriminated between a shockable rhythm - polymorphic ventricular tachycardia/ventricular fibrillation in three patients with one or more shocks delivered - and non-shockable rhythm - sinus rhythm in one patient. Of the three children, two of them who received one or more shocks for ventricular fibrillation/polymorphic ventricular tachycardia survived, but one died as a result of recurrent torsades de pointes. There were no other deaths. CONCLUSION: Parents can be taught to recognise cardiac arrest, apply resuscitation skills, and use an automated external defibrillator. Prescribing an automated external defibrillator should be considered for children at increased risk of sudden arrhythmic death, especially where the risk/benefit ratio of an implantable defibrillator is unclear or delay to defibrillator implantation is deemed necessary.

Here is a great study on epinephrine pens and storage . Abstract BACKGROUND: Epinephrine is a lifesaving drug in the treatment of anaphylaxis and cardiac resuscitation. Current US storage recommendations are for controlled room temperature (20°C-25°C), with excursions permitted from 15°C to 30°C. Maintaining epinephrine within this required range is challenging, particularly for patients carrying autoinjectors and during storage in emergency vehicles. OBJECTIVE: To study epinephrine degradation with extreme temperature exposure for epinephrine concentrations used in anaphylaxis and cardiac resuscitation. METHODS: We searched the literature for all studies of epinephrine in sealed syringes, vials, or ampules in concentrations between 1:1,000 and 1:10,000, that measured epinephrine in samples exposed to temperatures above and/or below the recommended storage temperature compared with control samples. RESULTS: Nine studies were included. Heat exposure resulted in epinephrine degradation but only with prolonged exposure. Constant heat resulted in more degradation. None of the studies that evaluated epinephrine exposure to extreme cold found significant degradation. None of the studies evaluating the effects of real-world temperature fluctuations detected significant degradation. Only 2 small studies (1 evaluating heat and 1 freezing) involved autoinjectors, and all 40 devices tested fired correctly. CONCLUSION: Temperature excursions in real-world conditions may be less detrimental than previously suggested. Freezing and limited heat excursions did not result in epinephrine degradation. Refrigeration of epinephrine appears to reduce degradation. However, the effect of extreme temperatures, particularly freezing, on autoinjectors is not sufficiently well established. More research in needed at clinically relevant high temperatures, with limited exposure to heat, and involving autoinjector devices. Copyright © 2016 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved. #epipens #Allergies #Allergicreaction #Firstaid #Anaphylaxis #Anaphylacticreaction

Here is an interesting one. Recently during the course a site manager was stood listening at the back of the room. During the session he heard me say that when we lose a pint of blood in trauma it is replaced normally within 24 to 48 hours (plasma) and fully back up and replaced after 4 to 6 weeks. On his recent First Aid Course he raised this with his instructor who corrected him sternly that this was rubbish and it takes 3 months minimum. That student decided not to argue but did decide he wouldnt get involved in the session with more questions for fear of a repeat embarrassment. Today he took me to one side to reassure him he had heard me correctly during my session. So for that site manager and for the first aid trainer. How long will it take to replenish the pint of blood I donate? The plasma from your donation is replaced within about 24 hours. Red cells need about four to six weeks for complete replacement. That’s why at least eight weeks are required between whole blood donations. If you want the link for this question and answer email me. Sad that by answering the question with admonishment and embarrassment he lost that student.

It isn't prohibited but it is generally accepted not to use wound closures (steri-strip) on paediatric wounds as you must make sure the wound is clean and the environment is sterile. Also if the wound is deep or longer than 4-5cm  it should really be referred to the ED to be cleaned, glued and stitched (be it sutures or steri-strip) by a health care professionals so as to reduce scar tissue. Remember if you do use strips the wound must be clean. Hope this helps. I have included the NHS guide for wound closures below for you if you do choose to use them. Common health questions How do I apply butterfly stitches? Butterfly stitches, called Steristrips, are narrow adhesive strips that help to close the edges of a small wound and encourage the skin to heal. They can be applied to "v"-flap cuts on thin skin on the legs of the elderly, and to some cuts on children. They should not be used in areas where the skin moves a lot (for example, joints) or on oily, moist, or hairy areas. If the wound is shallow, (less than 5cm long), clean and uninfected, and you are sure that there is nothing embedded in it, butterfly strips can be used. Make sure the skin around the wound is also clean and dry. It's not always necessary to use the full length of the strips, and you can cut them to a more appropriate length. Leave about 3mm between each strip. Carefully line up the edges of the wound. Push them together, and, starting at the middle of the wound, apply the strips to keep the edges closed. Place half of the strip on one side of the wound, bring the edges together by gently bringing the other side towards it, and then pass the strip over. Place strips alternately above and below the first strip – this helps to match up the edges and keeps the skin tension equal. To anchor the rows of strips in place, put two strips across the rows (one on each side of the wound). A protective dressing is not usually necessary, but the wound must be kept dry until the strips are removed (around three to five days if on the head, or 10-14 days for cuts over the joints). If the strips are difficult to remove, it may help to moisten them with warm water for around 10 minutes. If the wound does not stop bleeding once the strips have been applied, this is a sign that butterfly stitches are not suitable. You should seek medical advice, as another method of treating the wound may be required.

Herpetic whitlow (whitlow finger) Introduction A herpetic whitlow, or whitlow finger, is an abscess of the end of the finger caused by infection with the herpes simplex virus (the "cold sore virus"). It usually affects the fleshy area of the fingertip. What are the symptoms? The fingertip suddenly becomes red, swollen and extremely painful. Small white blisters develop underneath the skin of the finger, which may break to release fluid, eventually crusting over. What's the cause? There are two types of herpes simplex virus (HSV), type 1 and type 2. Both HSV-1 and HSV-2 can cause a herpetic whitlow. These viruses can also cause cold sores and genital herpes. A herpetic whitlow can develop as a secondary infection if you already have a cold sore or genital herpes and you touch the sore area of skin, transferring the virus from your mouth or genitals to your finger. It can also develop if you touch the sore or blister of another infected person. You're at greater risk of becoming infected if you have a weakened immune system. How is it treated? Antivirals A herpetic whitlow may be treated with an antiviral drug such as aciclovir. You may be prescribed a five or seven day course of 200mg aciclovir to take five times a day or 400mg to take three times a day. But this is only worth taking if you start the treatment within 48 hours of symptoms starting. Using an antiviral after this initial period is unlikely to have any effect. Antiviral drugs may help to heal a herpetic whitlow, but they do not get rid of the herpes simplex virus or prevent future outbreaks of herpes simplex viral infection. A whitlow will heal without an antiviral drug within two to three weeks. Antiviral treatment may: reduce the time taken for the abscess to heal reduce your risk of a secondary bacterial infection reduce your risk of the herpes simplex virus spreading to other parts of the body Caring for the whitlow at home You should cover the whitlow with a light dressing so the infection doesn't spread any further. Avoid wearing contact lenses until the infection has healed, to stop the virus spreading to your eyes. You can take an over-the-counter painkiller such as paracetamol or ibuprofen for pain relief. Do not attempt to drain the fluid, as this may cause the virus to spread or cause a bacterial infection. Will it come back? The herpes virus remains dormant (inactive) in nerve cells and may reactivate at a later date, sometimes following stress or an illness. This can result in another whitlow at the same site as the first one If a whitlow does return, it can be treated in the same way, with an antiviral drug. If the whitlow returns often, the antiviral drug can be given for long periods of time (years) to reduce the number of times it comes back. This suppressive antiviral treatment will also reduce both the severity of the whitlow and the length of time it takes to heal. #communicablediseases #Herpes #childcare

Important update on the life saving adrenaline in schools campaign The plans for an amendment to legislation which will allow all state schools to hold a spare adrenaline injector for use in case of emergencies continues to progress positively. We have been informed today by the Department of Health that this change is to come into effect in October of this year. In the meantime, there will be a public consultation and the development of a robust training programme for school staff. Background This campaign’s objective is for a change in the law to allow schools, pre-schools and nurseries to hold generic adrenaline auto-injectors, and ensure they have sufficient trained staff to operate the device in case of an emergency. There are currently three brands of adrenaline auto-injector available in the UK – Emerade, EpiPen and Jext. They are prescribed for the emergency treatment of anaphylaxis. In the UK, up to 6% of children and young people have a food allergy. Children and young people diagnosed with allergy are frequently prescribed adrenaline auto-injector devices in case of a potentially life-threatening anaphylactic reaction. Although the majority of children with anaphylaxis respond to a single adrenaline auto-injector, some children may require a further dose and it is possible that devices may misfire or be used incorrectly. Therefore, within schools, children at risk of anaphylaxis should have access to two adrenaline auto-injectors at all times. This campaign is being led by the Anaphylaxis Campaign alongside Allergy UK, The British Society for Allergy & Clinical Immunology (BSACI), British Paediatric Allergy Immunity and Infection Group (BPAIIG) and is supported by the Royal College of Paediatrics and Child Health. #allergy #allergicReaction #anaphylaxis #Epipen #JextPen

Important update on the life saving adrenaline in schools campaign The plans for an amendment to legislation which will allow all state schools to hold a spare adrenaline injector for use in case of emergencies continues to progress positively. We have been informed today by the Department of Health that this change is to come into effect in October of this year. In the meantime, there will be a public consultation and the development of a robust training programme for school staff. Background This campaign’s objective is for a change in the law to allow schools, pre-schools and nurseries to hold generic adrenaline auto-injectors, and ensure they have sufficient trained staff to operate the device in case of an emergency. There are currently three brands of adrenaline auto-injector available in the UK – Emerade, EpiPen and Jext. They are prescribed for the emergency treatment of anaphylaxis. In the UK, up to 6% of children and young people have a food allergy. Children and young people diagnosed with allergy are frequently prescribed adrenaline auto-injector devices in case of a potentially life-threatening anaphylactic reaction. Although the majority of children with anaphylaxis respond to a single adrenaline auto-injector, some children may require a further dose and it is possible that devices may misfire or be used incorrectly. Therefore, within schools, children at risk of anaphylaxis should have access to two adrenaline auto-injectors at all times. This campaign is being led by the Anaphylaxis Campaign alongside Allergy UK, The British Society for Allergy & Clinical Immunology (BSACI), British Paediatric Allergy Immunity and Infection Group (BPAIIG) and is supported by the Royal College of Paediatrics and Child Health.

DfE Clarification on medicines in early years settings foundationyears.org.uk/2016/10/dfe-clarification-on-medicines-in-early-years-settings/ Foundation Years Team This article seeks to clarify the current guidance on administering medicines in early years settings. Paragraph 3.45 of the EYFS states that ‘medicines must not usually be administered unless they have been prescribed’. This means that it must not be usual practice for an early years provider to administer medicines without permission to do so and not that all medicines, both prescription and non-prescription have to have been prescribed for a child by a doctor, dentist, nurse of pharmacist. For example, a provider cannot decide for themselves that a particular child needs to have a pain or fever reliever. Both prescription and non-prescription medicines can only be administered where written permission has been obtained from the child’s parent or carer. Providers should not expect parents to make unnecessary appointments with their child’s doctor to obtain prescriptions for medicines (other than for medicines containing aspirin) that can normally be obtained directly from a chemist. When the EYFS is next amended the DfE will use the opportunity to clarify the section on medicines so that this is clear. In addition the next EYFS will include a link to guidance published by Public Health England specifically for schools and childcare settings on infection control for various conditions (including conjunctivitis) which sets out when and for how long children need to be excluded, when treatment/medication is required and where to get further advice. This useful guidance can be found here.

Training on Defibrillators to be included on the EFAW and FAW Syllabus Training on Defibrillators to be included on the EFAW and FAW Syllabus All workplace first aiders to receive AED training, from 31st December 2016 Changes to Resuscitation Council UK guidelines on cardiopulmonary resuscitation (CPR) in October 2015 mean that HSE will now be revising the Emergency First Aid and First Aid at Work syllabuses. The revision will require all workplace first aiders to be trained in the use of an automated external defibrillator (AED) from the 31 December 2016, as the Resuscitation Council UK guidelines now state that the management of a casualty requiring CPR is to request an AED. It is sensible to ensure that EFAW and FAW first aiders are trained in AED use as they are now available within many workplaces and public spaces. There is good evidence that the early use of an AED has a far more beneficial outcome for the casualty than if that intervention is delayed. For employers this does not mean you have to purchase a defibrillator for your workplace as the requirement for a defibrillator is still dependent on your needs assessment. Neither do you have to retrain all your existing first aiders as they will be updated in this skill when they requalify. For those who deliver EFAW and FAW training the change means that you should ensure that students are trained and assessed on how to use an AED from the 31 December 2016 within the existing timeframe allowed for the delivery of either EFAW or FAW training. HSE has no objection if training providers wish to adopt this change before the 31 December. What are the Resuscitation Council
UK guidelines? With effect from 31st December 2016, the revised guidelines will require all first aiders to receive instruction on the use of an automated external defibrillator (AED). Do I have to buy a defibrillator? No. You will not need to buy a defibrillator unless the risk needs assessment at your workplace has identified one as a requirement. Do I need to retrain? Existing first aiders with a valid certificate will be trained when their refresher course falls due. New first aiders, or those with recertification due soon, should consider using a trainer that includes this skill in their course portfolio.