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8 First Aid Tricks ER Doctors Wish You Knew

Discussion in 'Emergency Medicine' started by Dr.Scorpiowoman, Aug 2, 2018.

  1. Dr.Scorpiowoman

    Dr.Scorpiowoman Golden Member

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    From how to stem bleeding to the secret of saving a knocked-out tooth, these are the things you really need to know before an emergency even happens.

    How to use an EpiPen


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    An injection of epinephrine can reverse anaphylaxis, a severe allergic reaction often caused by a food or an insect sting. The problem? Many folks who need it aren’t using it, according to a 2018 study published in Annals of Allergy, Asthma, and Immunology. “Unfortunately, many people have the device and still remain hesitant to use it,” says Shari Platt, MD, chief of pediatric emergency medicine at New York-Presbyterian/Weill Cornell Medical Center. That’s a big problem because anaphylaxis can progress quickly and even be fatal.

    So make sure you fill the prescription and carry the two-pack everywhere. Ask your doctor’s office to walk you through exactly how to use this prescription device; it varies slightly depending on whether you’ve been prescribed an EpiPen, generic device, or an Auvi-Q (this one includes a neat feature—it has a voice feature that walks anyone through the proper steps).

    One basic to remember: You need to inject the epinephrine into the outer thigh—not the inner thigh, the butt, or anywhere else. And right after you use it, call 911 or get quickly to the emergency room.

    How to use an AED

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    When someone goes into cardiac arrest, blood stops pumping to the organs and they can quickly die. That’s why more and more public spaces (restaurants, schools) are now stocked with an Automated External Defibrillator (AED), a device that can restart the heart in the event that a child over 8 or adult is in sudden cardiac arrest. An AED device works by shocking the heart back into a normal rhythm. Picture those paddles that you see on medical dramas on TV where they yell, “Stand clear!”

    The benefits are indeed as dramatic as they look on TV. “Knowing how to properly use it could potentially help save another human being’s life,” says Shari Platt, MD, Chief of Pediatric Emergency Medicine at New York-Presbyterian/Weill Cornell Medical Center. You should take an emergency first aid course to get properly trained, but here is a cheat sheet to the steps involved in AED from the American Red Cross.

    How to stop the bleeding from a minor cut

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    First grab a clean towel, or sterile gauze pads if that’s all you have, and put direct pressure on the wound. Now comes the insider trick: “Use ice to help the blood clot a little faster,” advises Mary Jane Piroutek, MD, a pediatric emergency medicine specialist at CHOC Children’s. Once it’s no longer bleeding, wash the wound out, particularly if there’s a chance there’s dirt or gravel in it. You may wonder: Do I really need to go to the emergency room with a cut? “If it’s through all the layers of the skin, it will heal much better and leave a smaller scar if you come into the Emergency Department and have it cleaned really well and sutured shut,” she says.

    …And how to stem bleeding if you’ve cut a vein or artery

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    Even if you do have the alarming blood flow from a cut artery, your first step should be to apply pressure. If that won’t stem the blood loss, you may need to do a tourniquet: “It can be the difference between life and death—especially if you are far from a medical facility,” says Jesse Sandhu, MD, Physician/Owner at Steamboat Emergency Center in Steamboat Springs, CO.

    You don’t need special medical equipment—”tourniquets can be easily fashioned from rubber bands (for fingers) and straps or exercise bands for arms and legs,” he says. First, try applying direct pressure using a towel, he says. If the patient is bleeding significantly despite you applying a large amount of direct pressure on the wound and they’re pale, sweaty, dizzy, or short of breath, “that’s a sign of significant blood loss and I wouldn’t hesitate to do a tourniquet,” Dr. Sandhu says. To fabricate your tourniquet, take a clean towel and wrap a band or belt tightly around the limb. Then immediately dial 911.

    You can also use the tourniquet technique if you cut your finger with a kitchen knife. “Wrapping a rubber band around the finger, and holding it above the head will stop the bleeding almost immediately and allow you to put a tight dressing over it. Don’t strangulate the finger for more than 5-10 minutes,” he says. “That’s just enough time to apply a pressure dressing (gauze and tape tightly). Once a dressing is in place, open the rubber band and restore blood flow to the finger.”

    How to save a knocked-out tooth

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    Whether you wipe out while running or your child takes a baseball to the mouth, losing a tooth is scary. What now?! The key to saving that tooth is knowing what to do ahead of time, says Andrew Wittenberg, MD, Chairman of the Department of Emergency Medical at Long Beach Memorial Medical Center.

    Ideally, place it in a glass of milk, he says, but if you can’t do that quickly, then put the tooth back in your mouth and try not to swallow it on the way to the dentist or ER. “That’s your best bet for keeping the root viable so it can successfully reattach,” he says. “Yeah, it’s a little gross but well worth it.”



    How to avoid risky medication mistakes

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    When you’re facing a life-and-death scenario, there’s no time to Google the spellings of drugs you’re taking or try to remember what dose you are currently on. At the same time, the ER staff needs to know this crucial info, or else they could accidentally give you something that interacts with your usual meds. Here’s a stay-safe tip to do today: “Use your cell phone to take pictures of your pill bottles,” advises Carlton Buchanan, MD, president of the medical staff at Gwinnett Medical Center (GMC) and GMC-affiliated emergency physician.

    Having this must-know info stored in your phone will help you stay safe. (Make sure your loved ones know your password and where to find it on the phone.) Dr. Buchanan also recommends snapping shots of your physicians’ business cards while you are at it. That way, your emergency medical team will be able to confer with your usual doctors if they have questions, which can mean better care for you.



    How to get a stinger out

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    You may have been told to use your fingers or tweezers to remove a bee or wasp stinger, but that can send more of the venom straight into your wound. A better bet is to scrape out the stinger with a credit card, says Piroutek. Out in the woods without your wallet? No worries; use a clean fingernail to scrape, according to the American Academy of Dermatology (AAD). After you get the stinger out, wash the area with soap and water. An ice pack comes in handy to minimize swelling. Warning: If you develop swelling in other parts of your body, hives, or nausea, go straight to the emergency room because you may be having an allergic reaction, warns the AAD.

    How to safely remove a tick

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    First what NOT to do: Do not light a match right next to the attached tick to get it out. That old wives’ tale can lead to accidental injuries, says Katherine Williamson, MD, a pediatrician at CHOC Children’s. Instead, she advises, “Dip a cotton ball in liquid soap and soak the tick for one to two minutes. Then locate the head of the tick and use tweezers to pull it straight out.” Don’t twist or squeeze or you could break it, leaving the head inside you. Next, wash the area with soap and water, according to the AAD. A tick bite doesn’t guarantee contracting Lyme Disease or another tick illness but do stay alert for early signs, which may include flu-like symptoms, stiff neck, and a rash that often but not always looks like a bullseye.

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