Nosebleed

Bleeding from nose happens when tiny blood vessels inside the nostrils are rupture. This can happen as a result of a blow to the nose, sneezing, picking or blowing of nose. Nosebleeds may also occur as a result of high blood pressure.

Nosebleed can be dangerous when the casualty loses a lot of blood. If nosebleed is caused by head injury, the blood is usually watery and thin. The latter is a very serious sign as it indicated that the skull is fractured and fluid is leaking from around the brain.

Treatment

1. Ask the casualty to sit down and tilt her head forward to allow the blood to drain from the nostrils.

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2. Ask the casualty to breath using her mouth as this can also bring a calming effect. Have the casualty to pinch the soft part of the nose. Reassure and help him if necessary.

3. Tell the casualty to keep pinching her nose. Advise her not to speak, swallow, cough, spit, or sniff because these actions may disturb blood clots that have formed in the nose.

4. After 10 minutes, tell the casualty to release the pressure. If the bleeding still continues, tell her to reapply the pressure for another two periods of 10 minutes.

5. Once the bleeding has stopped, clean the casualty's nose with lukewarm water while the casualty is still leaning forward.

6. Advise the casualty to rest quietly for a few hours. Tell her to avoid any nose blowing because this action could disturb clots inside the nose.

Note:

-If the nosebleed is severe, or if it lasts longer than 30 minutes in total, send the casualty to hospital in the treatment position.

Heart Attack

A heart attack is most commonly caused by a sudden obstruction of the blood supply to part of the heart muscle. For example, because of a clot in a coronary artery (coronary thrombosis). Worst come to worst, the heart will stop beating.

Drugs such as aspirin, and medications that dissolve the clot, are used to limit the extent of damage to the heart muscle.


Ways to identify

• Persistent, vice-like central chest pain, often spreading to the jaw and down one or both arms.
• Breathlessness, and discomfort occurring high in the abdomen.
• Collapse.
• Sudden faintness and dizziness.
• A rapid, weak or irregular pulse.
• Profuse sweating.
• Extreme gasping for air

Treatment

1. Make the casualty as comfortable as possible to ease the strain on his heart. A half-sitting position, with the casualty's head and shoulders well supported and his knees bent, is often best.

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2. Call for ambulance. State that you suspect a heart attack. If the casualty asks you to do so, call his own doctor as well.

3. If the casualty is fully conscious, give him a full-dose (300mg) aspirin tablet and advise him to chew it slowly.

4. If the casualty has medicine for angina, such as tablets or a pump-action or aerosol spray, help him to take it. Encourage the casualty to rest.

5. Constantly monitor and record vital signs - level of response, pulse, and breathing - until help arrives.

6. If the casualty becomes unconscious, commence DR.ABC.

Hyperventilation

Hyperventilation (excessive breathing) is a manifestation of acute anxiety and may accompany a panic attack. It may occur in susceptible individuals who have recently experienced an emotional or psychological shock.

Hyperventilation will cause abnormal loss of carbon dioxide from the blood, leading the chemical changes within the blood.


What causes them?

• Casualty recently experienced an emotional or psychological shock.

Ways to identify

• Unnaturally fast, deep breathing.
• Attention-seeking behaviour
• Dizziness or faintness
• Trembling or marked tingling in the hands
• Cramps in the hand and feet

Treatment

1. When speaking to the casualty, be firm but kind and reassuring.

2. If possible, lead the casualty away to a quiet place where she may be able to regain control of her breathing more easily and quickly. If this is not possible, ask any bystanders to leave.

3. If the casualty failed to regain control of her breathing, ask her to rebreathe her own exhaled air from a paper bag. Tell her to breathe in and out slowly, using the bag, about 10 times and then breathe without the bag for 15 seconds. She should continue on with this cycle until the need to breathe rapidly has passed.

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4. Encourage the casualty to see her doctor about preventing and controlling panic attacks in the future.

**The End**

All the information above are from First Aid Manual 8th Edition.