Articles on medical emergencies

Primary Eye Care in 7 Emergency Situations

Dr. Manoj Rai Mehta, Ophthalmologist
Many People learn Basic Life Saving skills to save lives and render primary care to the sufferers in emergency situations.  Similarly, there can be "sight saving situations" where timely action can restrict damage and give sufficient time safely to reach a higher centre for further management.1. Sputtering of hot cooking oil into the eyes while frying.Rinse eyes immediately in running cold water or simply dip your head in a bucket full of water to bring down the temperature as soon as possible.  Apply cool patch/ice pack around the lids.  Instil only lubricating drops (if available), gently patch the eyes with a sterile eye pad or clean handkerchief and take the patient to an eye surgeon. 2. Squirting of glue in the eyes.This is not an infrequent occurring with people trying to squeeze tubes that have a blocked nozzle. Immediate action should be to rinse eyes in running water.  Luke warm water around 40 degrees is somewhat more effective.  Put an ointment (lubricant or antibiotic) in the eye, gently cover the eye and take the patient to an eye surgeon.3. Chemical Injury to the eyes (domestic).Diluted Hydrochloric Acid, phenols, diluted caustic soda are some of the common corrosive chemicals found in homes for cleaning purposes.  They are acidic or alkaline in nature. Accidental exposure is not uncommon.  Immediate action is again washing off of the chemical to dilute its damaging effect.  Wash should continue for several minutes before a patient is taken to a medical facility.  lubricating drops, gels, ointments or antibiotic ointment may be applied for relief.Carry the bottle or the container in which the chemical was stored, with a label, in case the exact nature of chemical is not known, it will help the treating doctor in carrying out specific treatment.4. Foreign Body (FB) in the eye (domestic)Foreign bodies of different kinds fall into eyes under various circumstances such as- dusting, blowing dust with a vacuum cleaner, using a screwdriver on rusted components, hammering a nail, splicing cables, cutting wires, gardening or simply going for a ride.  Do not rub the eyes or put pressure as the FB can go deeper into the cornea.  Rinse in running water for a while, cover the eye with a suitable patch and take the patient to a facility.  One can use lubricating drops or antibiotic drops on the way.  No ointment, please.   5.  Soap solution, shampoo, chlorine in water or face creams in the eyesThis is a common issue especially with young children and all it requires is thorough rinsing followed by a lubricating eye drop and some cool compresses.  Creams can be very irritating as they adhere to the cornea and take a while to get washed off.  Chlorine in the swimming pools can also cause a lot of irritation especially on the days when tipping is done.  Preservative free lubricating drops, cold compresses provide relief.    6. Blunt trauma around the eyesAccidental injuries from window panes, friendly boxing or grappling amongst children are also a frequent occurrence.  Apply gentle pressure on the bones to prevent swelling around the eyes and apply a cold patch with pressure.  Take the opinion of a doctor in due course.  At times a blue haematoma may occur after a few days.  Please take an opinion as some blunt traumas around the eyes can lead to retinal oedema (Berlin's Oedema) that needs to be tackled timely to prevent a loss of visual acuity. 7. Penetrating InjuriesPenetrating injuries are seen with pencil tips, pen tips, compass used in geometry, knives, scissors, sewing needles, screwdrivers etc. Do not try to examine the eye forcefully, prise the lids, put pressure on the eye or even touch it. All these actions can result in disastrous outcomes!  Prevent the child from pressing or touching the eye by firmly holding in lap. Patch the eye gently with a clean handkerchief or a sterile pad and reach a facility at the earliest.You may keep a special first aid kit ready with disposable sterile eye pads, clean bandages, one-inch plaster tape, scissors, preservative free lubricating gel drops and gel tubes, antibiotic eye ointment, antibiotic eye drops etc.  A plastic bottle with a bent tube at the opening may be useful for gentle irrigation of the eyes with water.  It is equally important to reduce the risk of injuries at home by keeping potentially harmful chemicals out of reach of children and supervise them when they are using sharp instruments.  Safety always Saves.   

The Unmet need for Contraception in India!

Dr. Neelam Nath Bhatia, General Physician
26th September Is World Contraceptive Day & India Needs More Awareness.We were 1 billion in 1999 and we are 1.3 billion now in 2016. Why is one billion figure is worth its might- to cause a scare or to remind us about our depleting resources like water, food, and polluted air?Also because Dev Anand made a movie around same time titled 100 Crore to remind us about our might to Fight Corruption!If a qualified doctor happens to work in a one amongst thousands of rural villages right within Delhi/ NCR ,the harsh reality of numbers stares at us. No family has less than 4- 5 children and women are married at less than 18,the official age ,they have kids one after another every year in a row,by the time they are 25 , they are anemic mothers along with malnourished kids hanging around them but not willing to go to school despite education being made free.Still, it is our duty to guide these people, being visited by Government Vans to give them advice for free.Nobody offers them a Cafeteria approach to choose.Every contraceptive does not suit all women. It cannot be robotic.Why I wrote women here? Do men share no responsibility about family planning matters? The harsh reality is Yes.There are Myths associated with Male sterilizations, though medically it is the Safest for man and his family as Abdomen is Not involved. It is No Cut Vasectomy and the man walks out of clinic as if no procedure has been done, ready to go to work the same very day ,including lifting weights etc.Compare this with keyhole surgery of tubal ligation (safest choice for a woman who has completed her family) It looks like 1 stitch operation , but without sounding scary about the surgery, local anesthesia is given and abdomen is bloated up with gas to see tubes through a machine and bands are tied on both tubes one after another. Like any abdominal surgery, there is pain afterward , the woman is advised Not to Lift heavy weights for about 2 weeks lest the bands come out and Operation is a Failure.For temporary contraception, Pills, Condoms ( protection against STDs also ) are suggested but side effects are - Condoms have 20% failure rate,pills have side effects associated with hormones ( more on that later in another article)IUCD-Intrauterine Contraceptive Device is fairly good provided it is inserted to women under hygienic conditions & she does not suffer from heavy periods.I-pill means Only Emergency pill, it is loaded with hormones and can make regular cycle as erratic.Some girls have become habitual of taking it as a routine.Similarly, OCs should Not be given for more than 6 months at a stretch.A recent introduction is an injection for 5 years. This injection is the one being given every 3 months to avoid pregnancy. It is for women who forget to take a pill every day.Injection has hormone Progesterone. The woman is loaded with a dose for 3 months instead of a low dose to be taken daily. These women tend to get an Early Menopause & other conditions related to high doses of hormones. Motivate as many women as possible for safer procedures like Laprascopic Ligation / IUCD after asking them the details about their complex problems.One Happy woman may Not Share her Experience but another unhappy woman with wrongly fitted IUCD in a Van by Inexperienced Nurse/Health Worker is going to badmouth to entire Mohalla about bad effects of IUCD/Ligations.

First Aid/first Line Management in Important Medical Illnesses

Dr. Shashank Kumar Srivastav, General Practitioner
ELECTRIC SHOCK:--Turn off the source of electricity or move away the source using wood, card board or plastic board.-If burn injury is present, remove the clothing and rinse burnt area under cool running water for 10 minutes.-Make the affected person lie down and elevate his legs.-Do NOT throw water on the person or on the source of current.-Cover the person with a light blanket.-Call for ambulance immediately.CONVULSIONS:--Stay calm and composed.-Clear the surrounding area around the person.– Make a cushion below his/her head with something soft like blankets, jacket, sweater etc.-Note the time convulsion started.-Do NOT try to place anything in his/her mouth.-Do NOT try to restrict his/her movements or keep his/her jaws open.-Call for ambulance immediately or visit the doctor.NOSE BLEED/EPISTAXIS:--Sit upright and tilt your head FORWARD to allow drainage.-Pinch nose bridge firmly using thumb and index finger till bleeding stops.-Breath through your mouth.-Do NOT put anything inside the nose.-Loosen any tight clothing around the neck.-Place ice pack on forehead or around neck.-Check if bleeding has stopped after 10 minutes.-If bleeding persists, visit doctor immediately.EYE INJURY:--Do NOT rub the affected eye/eyes.-Wash hands thoroughly before touching the eyes.-If there is a suspected contact with chemical or foreign body, wash eyes with cold water for about 5-10 minutes.-If its a blow to the eye, apply ice pack and visit the doctor.-If eye looks red, there is pain, blurring of vision, visit a doctor.HIGH GRADE FEVER (above 102 degree F)--Monitor the temperature with thermometer.-Make the person rest in a comfortable cool temperature under a fan or an air conditioner.-If the person has chills, cover him/her with light clothing. -Give 500 mg paracetamol every 6 hourly round the clock.-Give the person sponge bath with lukewarm water.-Make him/her drink plenty of water or cool drinks.-If fever does not subside in 24 hours, visit a doctor.-If the temperature is over 106oF, call for an ambulance or rush the person to hospital.SUSPECTED STROKE/PARALYSIS:-Make the person sit/lie in a comfortable position.-Call for an ambulance or rush the person to hospital.If the person is unconscious-Make the person lie on his/her left side (recovery position) with head and shoulders supported.-Loosen any tight clothing around his/her neck and calm the patient.-Try to maintain breathing, if needed with open mouth.-Do NOT make the person eat or drink anything.-Call for an ambulance or rush the person to hospital immediately.ACUTE ATTACK OF ASTHMA:--Calm down the person and do not leave him/her alone.-Make the patient rest in a comfortable upright position.-Loosen any tight clothing around chest, neck area.-Get into well ventilated, open area.-If inhaler is handy, give 4 puffs of inhaler, at intervals of 1 minute.-If the person does not feel better, give another set of 4 puffs.-If the person is not relieved and feels dizzy, call ambulance immediately.

First Aid for Bleeding

Dr. Yogesh Kumar, Ayurveda
Looking at blood can often lead to squeamishness and nausea in most people who are not used to seeing blood but bleeding is one of the commonest medical emergencies. It is most frequent among children below 15 years and reduces thereafter. Almost 37.9 million visits to the emergency department are for injuries.           Bleeding or haemorrhage is oozing of blood from any body part. An injury to the skin, like a cut, wound or blunt trauma like being hit by a ball can lead to bleeding. In the case of a cut, the bleeding is visible externally as oozing and is termed as external bleeding. In cases of blunt trauma, there might be an injury to deeper tissues and organs leading to internal bleeding. This might be appreciable as a bluish black swelling at the site of injury and is called as a haematoma.  Humans have been blessed by a chemical mechanism wherein once there is an injury the enzymes automatically start making the blood thicker to stop bleeding. This is called as clotting. The thickened blood (clot) seals off the wound and prevents further blood loss. But this mechanism gets affected by various factors including the weather and thus is not completely reliable. Since too much blood loss can lead to shock and fainting, it is necessary that bleeding be stopped at the earliest by all possible measures. Thus, immediate action is a must; a wait and watch policy must not be adopted under any circumstance. Knowing the reasons behind the actions helps understand why it is being performed and helps in customisation in an emergency. Causes of bleeding:•Cuts with sharp or pointed instruments like knives, razors, sharp metal edges, nails, animal bites etc. •Bruises with blunt instruments like heavy objects, hitting a wall/vehicle, falls, etc. •Internal bleeding due to blunt blow causing the haematoma. How to arrest bleeding1. CleanWash your hands before handling the wound, as far as possible. If the wound looks dirty, wash it a little under cold, running water with soap and mild rubbing.2. PressurePress down a clean towel or any cloth directly on the oozing wound and apply firm pressure for 20 minutes to stop the bleed. If no cloth is available, then press the site of bleeding with the palm. Press till bleeding stops. Do not remove the cloth even if it gets soaked and blood oozes through. Add another cloth on top and continue applying pressure.   3. Avoid movementHold the limb/part still to reduce bleeding. Make the person lie down on flat ground. 4. ElevationRaise the injured limb/ part whenever possible. Elevate the lower half of the body slightly above the head to prevent fainting.5. TourniquetIn the case of an injured limb, tie tightly a cloth/wire/tube etc 2-3 inches above the wound, around the limb. This will act as a tourniquet and stop blood flow to the wound. Make sure you untie it within 30 minutes. If bleeding has stopped, remove it. Repeat this after a 5-minute interval if the wound continues to bleeds. Keeping the tourniquet on for too long will cause the limb to start swelling; thus, untying every few minutes is a must.  6. Ice packApply ice on the wound on and off throughout the next 24 to 48 hours. This will reduce the blood flow to the site of injury and slow down the bleed. It will reduce the swelling that forms later.  7. Pain medicationTake a painkiller like paracetamol (acetaminophen) if there is a pain. Do not take aspirin or ibuprofen. They will increase the bleeding.   8. Calling helpCall for help or rush to the nearest doctor or hospital if the bleeding is severe or accompanied by intense pain/swelling. If the victim takes blood-thinning medications, then see a doctor immediately. If the bleeding was due to an animal/human bite or from junked instrument, you might need to get a tetanus shot too.  9. Post-bleeding careOnce the bleeding stops and is followed by a haematoma or bruise the next day, apply hot water packs daily to promote wound healing. If there is a scab, apply the antibiotic treatment and fresh gauze dressing each day.  Recovery Pain, tenderness subsides in 2-3 days while the bruise will take about 2 weeks to clear out.

Dental Emergencies-by Dr Gaurav Malik (Shree Krishna Dental Care)

Dr. Gaurav Malik, Dentist
Dental emergencies and role of parents: There is nothing more traumatic for a child to loose his front teeth due to trauma and nothing more traumatic for parents to watch it helplessly.we are talking here of dental emergency in case child's permanent tooth or for that matter anyone's tooth gets knocked out.complete knocking of tooth out of socket is called avulsion and is a dental emergency.most of you are not aware that even if someone's tooth get knocked out and if it is brought to us in a suitable media I.e milk.we suggest milk coz it is readily available in shortest time say less than 60 mins.it has a very good prognosis.we have successfully done many cases of reimplantation.what is role of parents?dont let the child panic.control the bleeding by pressing the socket against cotton gauze.look out for lost tooth ,hold it by its crown ,dont touch the root .gently wash it and carry it in a container of milk or a ice bag .always remember in these kind of injuries you are fighting against time.Shorter the time spent by tooth outside of socket better is the prognosis.we hope you find this article written by dr.gaurav very informative and helpful.we are proud to tell you that dr.gaurav malik is helping patients get rid of their dental problem through online consultation and video conferencing depending upon his time and availability.so if u have any dental problem u can ask dr.gaurav malik and he will ans.it personally depending upon his time and availability.for more details you can always login to our website www.shreekrishnadentalcare.com.kindly note down our 24×7 dental helpline no.9814871823.copyright of this article written by dr.gaurav malik exclusively with shree krishna dental care amritsar.

Your Emergency Guide For Toothache

Dr. Diksha Tahilramani Batra, Dentist
It’s 3 a.m. and you’ve had 3 Crocins but your heads still blasting and your cheek feels like it’s going to blow up! Nothing seems to control this severe throbbing, mind numbing pain. How many of us have found ourselves in this situation where we are stranded without help and wish we had not ignored that nagging toothache?If you don’t want to live with the looming fear of a tooth ache, the best prevention is a dental visit, but for the weak-hearted there is always hope.Dental pain or Toothaches can arise without reason and cripple you at any point whether in the middle of the night, in a different country, in transit or in a position where dental care is not accessible immediately.So here are a few quick tips to ensure that you keep that dental pain away!Take down your list of dental must haves for those bad Toothaches:Pain medication – The first thing that will strike you when your teeth are aching is to pop in a pain killer, although its important to use one which is more specific to teeth. While Paracetamol is the popular drug of choice we recommend you stock up on Diclofenac derivatives more targeted to toothache,ensuring that there’s no allergy for this medication is something that must be done.Clove oil –  An effective home remedy take a ear bud dipped in clove oil to ease off the pain on any open cavity where the nerve is exposed.It also works very well on those stubborn wisdom teeth.Ice pack-In case of trauma to the teeth, lips or face or if a swelling or bleed is seen placing an ice pack on your cheek is something that will not only ease off the pain but will also reduce the swelling.Salt rinses- If all else fails and all you have is a bit of salt then just put it in a glass of luke warm water and gargle with it to allay active gum infections.Gumex gum paint- A common astringent paint is a harmless alternative to reduce bleeding on gums after which a dental clean up can be instituted.Dental Floss- Tooth ache is often triggered by the lodging of food in open cavities between teeth. To stop this immediate trigger use a dental floss and remove the particle for instant relief.Sensitivity tooth pastes-  Acute sensitivity to extremes of temperature can be reduced temporarily by scrubbing in sensitive tooth paste and leaving it on the tooth for a few minutes rather than brushing and rinsing immediately.Needless to say a Dental check up every 6 months is the best method of preventing an emergency and to curb the problem in its nascent stages.My advise would be don’t ignore your teething troubles but if you do then we are still there for you, making sure you have what you need when you have those unexpected aches!

How to Diagnose Heart Attack ?

Dr. Nishith Chandra, Cardiologist
Heart Attack is  caused by blockage of the blood flow to the heart muscles.  Reduced blood flow leads to death of some portion of the heart muscle wall. While the word heart attack sounds almost fatal, it need not be the case. Knowing how to identify an attack and being aware of some simple measures can help save lives. SymptomsThe tell tale signs of a heart attack are as follows:- chest pain and discomfort usually described as a tightness or burning in the chest region- pain along the left side of the shoulder and neck, going up into the jaw, down to the arm- nausea and vomiting - profuse sweating - difficulty breathing - dizzy or fuzzy feeling - tired, extreme fatigue- anxious, apprehensive feeling However, be also aware that there are a lot of people who experience a silent heart attack. Women, obese, elderly, and diabetic patients can have silent attacks and depending on severity, either they go on with life as usual or can have a fatal attack.DiagnosisOnce you are doubtful of a heart attack, the next step is to reach the closest medical facility for a diagnosis. In addition to a detailed examination and history, the following two tests will be performed.1. Electrocardiogram (ecg): a 12-lead ecg will measure electrical activity of the heart and identify irregular electrical activity, which is indicative of a myocardial infarction.2. Blood tests: presence of certain enzymes in the blood, ck-mb and troponin are indicative of a heart attack. A complete electrolyte profile also will be done, and increase or decrease of some electrolytes is helpful in diagnosing a heart attack.3. In addition to these two, chest radiography, cardiac angiography, echocardiogram, stress test, and computed coronary tomography may also be required to confirm the diagnosis.ManagementOnce diagnosed, the first step would be to relieve the symptoms, negate the effects of reduced blood flow, and restore cardiac function. 1. Dissolve the clot - using blood thinners like aspirin & clopidogrel 2. Nitroglycerin - to dilate the blood vessels and improve blood flow, especially to the heart muscles3. Anticoagulant therapy - blood thinners are usually used to avoid blood clot formation; aspirin and heparin are the most commonly used agents.4. Drug therapy - blood pressure maintaining drugs like beta blockers and/or angiotensin-converting enzyme (ace) inhibitors are also used5. Use of statins - statins are used to reduce the amount of cholesterol in the blood and stabilize plaque deposits.In very severe cases, angioplasty and stenting or coronary bypass surgery may be required. Educating people on how to identify a heart attack and manage it is very useful and can help save lives.