Heatwave in London

Now I'm not sure what weather conditions are like around the world, but here in London, its so hot, we've got a heatwave! Yes, you read that right. A heatwave in London. Saturday was the hottest with the temperature hitting 30oC. I was working in Hyde Park that day at the Barclaycard British Summer Time Concert, and I had so many patients that had problem either as a direct result of the heat or the heat contributed.

Lots of heat related illness can be prevented by drinking water, as a rule try to drink around 1.5 litres a day. 

What are the problems caused by a heatwave?

There are three main problems that are caused by a heatwave;  Dehydratation , Heat exhuastion and Heatstroke.

Dehydratation

This occurs as result of a person not drinking enough water. If you think a person is suffering for dehydration, then let the person rest in a shaded/cool area and give them lots of water to drink. Try to avoid caffeinated or fizzy drinks.

Heat exhuastion

This occurs when a person's temperature is between 37oC ( your normal body temperature) and 40oC. People with heat exhaustion normally are very tired, have a rapid pulse, feel dizzy and feel sick (nausea). The treatment is the same as dehydration. Cool the person and rehydrate the person.  

The effect caused by changes in body temperature  

Heatstroke

Heatstroke is very serious. The symptoms of heatstroke are a rapid pulse, paid breathing and a temperature over 40oC.  In some cases person are also confused, anxious and may fall unconscious. If you suspect someone has heatstroke call 999 immediately. While you're waiting for the ambulance to arrive, give the person lots of water to drink , additionally you could also place damp sheet on them or spray them with water to cool them down.  

Who's at risk during a heatwave?

Pretty much everyone, but the people that are more susceptible are: 

• Older people (<70 years old)
• Babies and young children
• People with chronic heart or lungs problems
• People who are physically active
• People who misuse drugs and/or alcohol

In the hot weather, many people faint due to not staying hydrated (90% of my calls on Saturday were "Patient fainted and feeling unwell") . Should someone faint/feel faint near you here's what you do:

• Lie them down
• Raise their legs 
• Give them water
• Get rid of people (politely) that don't need to be there as this could make the person more anxious.  

Try to stay in the shade as often as you can and keep drinking cold drinks avoid  tea,coffee and alcohol. And try to enjoy the sun, you don't get it that often in England. 

There's one golden rule during a heatwave.....!!!STAY HYDRATED!!!

Fruther infomation

http://www.sja.org.uk/sja/about-us/latest-news/heatwave-advice.aspx

http://www.nhs.uk/Livewell/Summerhealth/Pages/Heatwave.aspx

Code STEMI

I have always found cardiology interesting and always wanted to study it at university and then work in a cardiology department. Working with SJA allowed me to gain more knowledge as the doctors and nurses often taught about how a cardiology department works and what are the common heart problems that are treated.
On the occasions I've worked alongside the LAS (e.g. Notting Hill, NYE), they've explained to me about how the Lifepak 12 (a machine that can do ECGs, act as defibrillator and monitor the patient e.g. O2 stats, BP, pulse) has helped them to diagnose and treat cardiac problems far more effectively.

While I reading Insomnia Medic's blog (http://www.insomniacmedic.com), I came across his post on Code STEMI, a documentary made in conjunction with the LAS. This documentary will show how cardiac arrest survival rates have increased dramatically. The LAS are the busiest emergency medical service (EMS) in the world with 250+ ambulances, 100-120 fast response units, and motorcycles,bikes and a helicopter standing by ready to deal with the 4,000 calls (on average) its receives each day. You hear the views from the cardiac arrest survivors, paramedics,cardiologist and a nurse giving you an in-depth insight into what happens from the moment a STEMI is identified to the moment when the patient returns to normal.

Hold up,what's a STEMI?

STEMI stands for ST-Elevation Myocardial Infarction. I'll break it down further and explain each part.

ST Elevation refers to elevation of the ST segment of a PQRST complex on an ECG. An ECG measures the electrical activity in the heart. The ST segment represents the electrical activity when blood is pumped out of your heart. An ST Elevation indicates that your heart is having to pump a lot harder than normal to pump blood out of the heart,which means that there is a blockage which is impeding normal blood flow.

Normal ECG

ECG of a STEMI

Myocardial Infarction is a heart attack that results from an interruption in the blood supply causing some of the hear (cardiac) cells to die.
Myocardial - pertaining to the heart muscle
Infarction - tissue death caused by an obstruction in the blood supply causing a lack of oxygen

Code STEMI Documentary

Useful Links
http://www.insomniacmedic.com - Where this great Code STEMI documentary was discovered
http://firstrespondersnetwork.com/codestemi - The Code STEMI documentary website
https://twitter.com/Ldn_Ambulance - Twitter feed for the LAS, lots of relavent stuff on there
Twitter Hastag: #CodeSTEMI

Thank you

I would like use this post to thank you, the reader. The number of page views has exceeded 500 (it was a personal target of mine). I know my posting frequency is random, which is partially my fault but mainly it is because I have a lots of assignments and because I'm working a lot. And thanks to all of you, this blog is truly global.

And it wouldn't be fair to do a thank you post without mentioning +Brish M. She is the author of keytonutrition.blogspot.co.uk, my inspiration, my biggest supporter and the reason I started blogging.

I hope my blog, "The Life of a Volunteer Medic" has given you a slight insight into what I do and some basic first aid knowledge. Rest assured more topics are coming, and my posts will be more regular (education and work permitting).

Thank you again for reading guys and girls and remember if you have any questions,comment or just wish to express an opinion about the blog (good or bad - all comments are welcome), use the contact me page at the top of the blog.

Shock

Let me start with a question, which person below do think is suffering from shock?

                  

The answer is both of them. Our friend on the left is suffering from psychological shock (maybe she saw that this blog has a global audience), and our friend on the right is suffering from medical shock.

What is medical shock?

Shock is a life-threatening condition where important organs like the brain and heart are are deprived or have low oxygen levels.

How do I know if someone is suffering from shock?

If a person is bleeding quite severely or if there is a chance they may have sustained a spinal injury, there is a high chance that they may go into shock.
The symptoms of shock are:

• Pale face
• Fast, shallow breathing
• A fast weak pulse
• Cold, clammy skin
• Sighing or yawning

Sometimes a person suffering from shock can become unconsciousness.

How do I treat someone who is suffering from shock?

How To Treat Shock

Should I call an ambulance, and what do I tell them?

Call 999 and ask for an ambulance. Your response should be along the lines of  the following template.
"A  _(age and gender)_  is suffering from shock, she has sustained a _(the type of  injury e.g. head wound)_ and _(any other information which could be useful)_.
Don't worry the emergency medical dispatcher (the guy on the right), will prompt you and ask you questions to help you.

Here's an example. (I've put some of it in green to give a better idea of what is the most information they require).
A 21 year old female is suffering from shock, she has a head wound which is bleeding severely, she
also feels slightly dizzy. I'm opposite Wimbledon station, in front of the Starbucks.

Now you should know:

• the symptoms of shock
• how to treat shock
• and what to tell the emergency medical dispatcher

Thanks for reading.  If you have any questions, comments or just wish to express an opinion about the blog, use the contact me page at the top of the blog.

New Years Eve

Happy New Year Guys and Guys! 2013 is here! Hope everyone enjoyed NYE and had fun!

I was at a treatment centre at Waterloo station (well outside it, rather than in it but you get the picture), and I treated quite a few intoxicated patients. One things, that several other medics at various treatment centres and I came across was that lots of intoxicated patients had come with friends, but those friends had abandoned them when they became ill or unconscious. SERIOUSLY???

"Faithful in Adversity"- Royal Army Medical Corps motto

You should always remember that motto when going out drinking with the intention of getting drunk. As stated in my previous post "The Effect and Consequences of Mixing Drugs and Alcohol", the friend or person with the intoxicated patient is sometimes more useful to us (the medical personnel). As sometimes the patient might either not remember/refuse to tell what and how much they've drunk, in which case the friend can tell us what they've drunk allowing us to treat more effectively.

My journey home was interesting after NYE celebrations (think I got the train at about 0450), got onto the train and a group of drunk people started clapping and hugging me and saying thank you!

Anyways, 2013 is here! I hope you have a great year! I'm ready for 2013, SO LET'S DO THIS!

Winter and Hypothermia

Winter is here guys and girls, so......

Although winter is a great time because of the snow, you have to remember that the human body is easily affected by changes in temperatures.
Although all of us will wrap warm, you have to remember that children and older people are more likely to suffer the effects of the cold weather. Age UK estimates that up to 25,000 older people could die because of the cold weather.

What effect does a drop in temperature have on my body?

Your body temperature is around about 37^oC. The danger is that if your temperature drops by just one degree Celsius, it can have a detrimental effect on your body.
They say a picture is worth a thousand words, so instead of me explaining the effects see the picture below;

How do I know that someone is suffering from hypothermia?

The symptoms are:

• Shivering and cold skin
• Disorientation (confused as to where they are)
• Apathy or irrational behaviour, sometimes they can also be aggressive
• Impaired consciousness or being lethargic (sleepy or drowsy)
• Slow and shallow breathing
• Slow pulse which may gradually get weaker 

In some cases due to the slow pulse and slow breathing rate, the heart may stop.

So how do I treat them?

If they have been outside, replace their wet clothes with dry clothes.  If the person is able to get into a bath unaided, then run a bath at approximately 40^oC. Then put them into a bed and wrap them up. Give them hot drinks and high energy food such as chocolate (chocolate is good for you in moderation).

Should I call an ambulance?

There are some people who will call 999 for the randomest reasons, that's probably why the London Ambulance Service have this on their windows....

Call 999 if:

• They are in shock 
• They have serve difficulty in breathing (e.g are they wheezy?)
• They are unconscious
• They are not breathing and have no pulse

 So this winter, stay warm, drink lots of hot drinks, watch older people and children and have FUN!

The Effect and Consequences of Mixing Alcohol and Drugs

It's Halloween in 3 days! Although Halloween is a fun day with people going trick or treating, parties,raves and clubbing, things can and do go wrong often disastrously when there's alcohol or drugs involved.

Granted alcohol doesn't do much in moderation,but when you're drunk, you're unable to quickly or logically. However do have some element of control, albeit it minimal amounts, but everything changes if you've also taken drugs.

NEVER DRINK ALCOHOL AND TAKE DRUGS!
IT CAN BE FATAL!

Drugs affect you in different ways depending on what you've taken, how much of it, and it also depends on if the drug itself is impure (e.g. ecstasy is sometimes cut with anything from LSD to caffeine). When you mix it with alcohol,it does a lot of damage to your system.Some people incorrectly believe that because alcohol is a depressant if you take something that it designed to give you lots of energy (e.g. MDMA), it will make you normal and you will be fine....HELL NO!

It will affect your nervous system in such a way that you will be unable to speak coherently,control your body (you will have difficulty just walking or standing) or make competent decisions. And this is when the trouble starts.

What happens to the body and in effect me when I drink and take drugs?

First you may experience changes in body temperature (either an increase or a decrease), then you may fell nausea, disorientated or dizzy. At this stage, your body is severely struggling to cope with the toxins in your body (caused by the alcohol) and the drugs you've taken. at this point, you should leave the area you are in, and alert a friend and call 999.
Should you remain in that area and dismiss the symptoms, you may become unconscious. Now you are in severe danger. CALL 999 NOW!  If you're curled up or if you're head is tilted forward, your airway is constricted which makes it difficult for you to breathe. Now your oxygen levels start to decrease, oxygen begins to be diverted mainly to the vital organs. When the oxygen levels below a certain level in the brain, you become hypoxiated. Now there is an increased chance of you slipping into a coma. After this stage, your vital systems begin to shut down, you stop breathing and your heart stops beating. Once all your vital sign cease, you are dead.

What do I do when they become unconscious?

As soon as they become unconscious, first try to wake up by issuing commands such "Open your eyes". If they do not responds, then place them in the recovery position.  Watch the video below by Clive James ( an SJA member) to learn how to put someone into the recovery position.

How To Put Someone In The Recovery Position

Okay, I've put them in the recovery position, what do I do now?

Now dial 999 and request an ambulance, it is imperative that you stay calm and speak clearly. The main information that the ambulance service require are:

• Status - e.g. unconscious and breathing/ unconscious and not breathing
• Age and gender - e.g. 19 year old female
• What the has person taken - e.g. 3 pints of beer and MDMA
• Location (and any landmarks) - e.g. 15 recovery road, SW18 7TX, the house has a drive

If possible get someone to stand outside of the location, so that the ambulance knows where the incident is.

IMPORTANT - ALWAYS TELL THE PARAMEDICS,NURSES,DOCTORS EXACTLY WHAT YOU HAVE TAKEN OR DRUNK.
This means you can be treated more effectively, and they will be able to assist you more efficiently.

Also remember its not only you that is affected, your friends, family or however is beside you at that time can be affected. When I was working at Notting Hill carnival, I was helping the friend or family member who was with the patient by calming them down and explaining to them what was going on as it can be very worrying and scary for them.

If you put someone in the recovery position and give the information required to the ambulance crew, then the chances of the person surviving are greatly increased.

I think this post has got too much of a deathly tone so to cheer you up, follow the link for some great tasting halloween food!
http://keytonutrition.blogspot.co.uk/2012/10/halloween-kids.html

Stay safe on Halloween, don't drink and take drugs and most importantly HAVE FUN!