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First aid in the workplace

"Common things occur commonly" and so the designated first-aider or emergency-care provider in your workplace would expect emergencies related to common conditions in your community.

However, in a country such as America, common emergencies include:

  • Heart disease (heart attack)
  • Asthma
  • Diabetes
  • Epilepsy
  • Trauma (injury)

Communication
Every workplace should have a central point - an operations centre in a big factory or a switchboard in a small office, for example - through which emergency action can be co-ordinated. Someone should stay with the patient, while someone calls an ambulance, and another meets the ambulance, etc.

Internal response
Every office, factory, mall, shop etc. should have an emergency medical response team with training in first aid, including the use of automatic external defibrillation and basic first aid equipment with which to respond.

Communication from the "shop floor" with the control point is essential (radio or cellphone).

Heart attack
The symptoms of a heart attack include:

  • Severe central "crushing" chest pain
  • Pain radiating into the neck or arms
  • Sweating
  • Shortness of breath
  • Nausea and vomiting

The management is to rest the patient, i.e. don't let them walk anywhere; provide oxygen via mask if you have one, and offer them half an asprin tablet to drink voluntarily. Get the patient to the nearest hospital or hospital with a heart unit by ambulance (ambulances have all the right equipment to treat patients) as soon as possible.

If the patient collapses unconscious, their heart may have stopped and the emergency-care providers will have to do cardio-pulmonary resuscitation (CPR) and then provide defibrillation.

Asthma
Asthma is a very common respiratory disease that causes the lung air passages to narrow due to inflammation, swelling, mucous production and spasm of the muscle in the walls of the air passages.

The patient will be short of breath and may exhibit wheezing, a high-pitched sound on expiration. In the case of severe asthma, they may not be able to talk, will have a very fast pulse and may be confused. The asthma patient will want to sit up to facilitate breathing.

Provide oxygen if you can. If they have an asthma pump, they can attempt use but don"t delay getting them to hospital if the symptoms are severe. Transport the patient to the nearest emergency centre in a sitting position or call an ambulance.

Diabetes
Diabetics rely on injected insulin or tablets to keep their blood sugar at normal levels.

Occasionally they can inject too much insulin or, because they don't eat at the right time, the tablets or insulin they use lower their blood-sugar levels too much, causing loss of consciousness.

The patient may complain of sweating, anxiety and heart palpitations before lapsing into unconsciousness. If they're diabetic, they'll usually know they're going "hypo" and will take some food.

If they're unconscious, the first-aider can smear glucose gel onto the gums and must get them to an emergency centre as soon as possible. Low blood glucose is life threatening.

Epilepsy
Epilepsy is a very common condition (usually because the patient hasn't taken their medication) in which the patient may experience a loss of consciousness with initial whole body spasm followed by rhythmic contraction of all the body muscles. The patient will usually have a loss of bladder control.

Management of a patient having a seizure is to turn them on their side and protect the head from injury. Allowing the patient to seize on their back may cause a severe head injury.

Allow the seizure to pass and then monitor the patient on their side while you wait for an ambulance.

Trauma
The common consequence of trauma and injury is bleeding and fractures.

External bleeding is obvious and is best stopped by continuous external pressure with a wound dressing and or towel and elevation of the affected limb.

Blunt trauma to the chest or abdomen can cause internal bleeding which, for the first-aider, may be difficult to detect.

Uncontrolled bleeding may lead to "shock", insufficient blood and oxygen supply to the brain and major organs, and so the control of bleeding is very important.

Fractures are usually evident by the swelling over a bone at the site of injury, reluctance by the patient to move the bone, deformity, pain and grinding of the two ends of the bone on movement.

Fractures should be immobilised (splinted) in a position most comfortable for the patient, making sure that the circulation downstream from the injury is intact (pulse, good colour, capillary refill <2 seconds). The best splints are wire splints covered by padding. The joint above and below the injury should be immobilised.

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