First aid is treatment on the occurrence of an injury or sudden illness, using whatever means that are available to you at the time; this may take place prior to a medical practitioner arriving. We advise all students before commencing in practice to attend a basic ‘first aid at work’ course. The purpose of first aid is:
• To preserve life
• To prevent the person’s condition worsening
• To promote recovery.
The following is just a guide for emergencies. If a patient becomes unwell or falls down on your premises it is your responsibility to ensure their safety.
• Remain calm – assess the situation and diagnose what is wrong.
• The principles of diagnosis – these are the same as we always use with patients.
• History – if the patient is conscious, ask what happened.
• Symptoms – ask the patient about any pain or sensations he or she may feel.
• Signs – look at the colour of the patient’s face; is the breathing shallow or are they sweating? Use your senses. Smell, look, listen and assess.
The main conditions you may come into contact with are listed below.
The following heart attack conditions are the result of reduction of the blood supply to the muscular wall of the heart causing lack of oxygen to the heart muscle.
This is often described by the sufferer as severe indigestion. It is a strangling, constrictive pain extending to the left shoulder and arm, and sometimes pain is felt in the throat. This pain is due to insufficient oxygenated blood reaching the heart muscle.
In this condition, again excruciating pain is felt in the chest, often following the same course as the above. In both conditions, the patient would complain of pain in the chest, anything from mild to severe. This pain can be such as to make them stop in their tracks or feel giddy, and lean against something for support or even fall to the ground. The breath is short and the pulse is weak. Nausea and dizziness and sweating are common. Their skin is often ashen and their lips are blue.
Emergency treatment. Do not move the patient unnecessarily. Loosen tight clothing and call for medical aid immediately. In the mean time, leave the person in a half-sitting position, with head and shoulders supported and knees bent, propped up against a wall if possible. If unconscious and breathing place the patient in the recovery position so the airway is unobstructed.
In this condition, the pumping action of the heart stops suddenly, with total loss of consciousness; there is no pulse, and no breathing. A person who is still breathing is not suffering from cardiac arrest.
Emergency treatment. If breathing fails, try to start the patient breathing as follows. Pinch the nose and tilt the head back while supporting under the neck. Make sure there is no obstruction in the mouth. Put your lips around the mouth and blow at least 10 times and then check to see whether the person is breathing. If not, repeat. Call an ambulance as soon as possible. Cardiac compression should not be done unless you are a qualified first aider and have a knowledge of the correct procedures.
Do not move or restrain the person unless there is any danger that they may hurt themselves more. Do not attempt to put anything in the person’s mouth or try to open the mouth in any way. When the attack is over, place the person in the recovery position. On recovery, encourage the person to rest for a while. It can take up to 15 minutes for the person to regain consciousness completely.
This follows a temporary reduction to the blood supply to the brain. This has been known to happen during a treatment of reflexology. It may be because the patient has remained in one position too long, or the room is overheated and there is insufficient ventilation, or the stimulation was too strong, or the patient is apprehensive and unsure. The person may also have been excessively fatigued on arrival, and they stood up too quickly after treatment. Finally, diabetics are sometimes prone to fainting (see below). Elderly people need to remain resting for a few minutes after treatment. Some drugs can also cause episodes of fainting. Always watch the patient for any signs of change of colour in the face. Sudden pallor often indicates a problem.
Emergency treatment. Sit the client down on the floor and put the head between the knees. Get the person to breathe deeply, loosening all tight clothing. If the patient becomes unconscious but is still breathing, elevate the legs above chest level. If the patient does not regain consciousness, check for any breathing, and if this is absent continue resuscitation as above (see Cardiac arrest). Then put the patient in the recovery position and send for aid.
This condition usually occurs in insulin-dependent diabetics, who may have a low level of glucose in the blood. This is a serious condition because the brain must receive sufficient glucose or it could lead to an impairment of certain functions. The problem may arise from too much insulin, too much exercise, or insufficient food intake. The person may appear drunk and incoherent, they may even be sweating profusely, and have a pallor to their skin. Their breathing is shallow and they have no odour on their breath.
Emergency treatment. If conscious, give the person something sweet to drink or eat (containing glucose or honey – or the person may be carrying glucose/dextrose tablets). If there is an improvement this is an indication that the insulin dose is possibly too high, so the medical practitioner should be contacted so that the insulin dosage can be reviewed. If the patient becomes unconscious put in the recovery position, put a glucose tablet in the mouth (or rub honey, if available, around the gums), and call for medical help immediately.
Note. Never apply too hard a pressure when treating diabetics with reflexology. If unconscious, check to see if the person has a bracelet indicating that he or she is diabetic.
This is excess glucose in the blood and insufficient insulin in the blood. This can simply be due to an inadequately controlled diet (e.g. excessive intake of carbohydrates and sugars). Usually the patient is aware that there is a problem.
Emergency treatment. If the person feels unwell, treat as for fainting. Suggest the patient sees the medical practitioner as soon as possible.
This can be an annoying problem; the patient may simply have blown their nose too hard, or possibly bent down and knocked their nose on some edge of furniture. If there is any profuse flow of blood from the nose, keep the head forward. Working SP-1 on the great toe helps to stem blood flow from the nose.
Note. Do not let the person raise their head as blood may be swallowed or inhaled, causing vomiting, or affecting the breathing.
Emergency treatment. Loosen all tight clothing, and pinch the soft part of the nose, do not encourage the person to speak. Let the blood trickle down, and mop it up as much as possible. Release the pressure after at least 10 minutes; if the bleeding has not stopped continue for another 10 minutes. If there is still a constant stream of blood after 30 minutes seek medical help immediately.
These are veins that are varicosed (swollen) and superficial; they are vulnerable to any slight knock on a chair leg or piece of furniture, and can bleed profusely. If blood flow is not controlled immediately the condition can be fatal.
Note. Before giving reflexology treatment always remove your watch and ensure your nails are well trimmed. Do not leave wires trailing or have loose rugs whereby a person can easily trip up.
Emergency treatment. Apply pressure to the area, and elevate the leg immediately. Treat as for shock, and call for medical help at once.
If the patient becomes unconscious but is still breathing, elevate the legs above chest level. If the person does not regain consciousness check for breathing. If this is absent, follow the resuscitation procedure above (see Cardiac arrest). Call an ambulance as soon as possible.
Apply the RICE routine: rest, ice, compression and elevation. This will help to alleviate any immediate discomfort such as pain and tenderness around a joint.
When cramp occurs in foot muscles, apply something cold to the plantar area of the foot and gently push the foot towards the body. For leg muscles, push the leg gently towards the body whilst elevating it slightly. For hand muscles, straighten all the fingers very firmly but gently. Gently massage all the affected muscles.