There are three videos which I think every first-aider, or those who are interested in first-aid should watch.Be warned though, there are autopsies being performed on all three videos.
I am a fan of Dr. Gunther's. He is a German anatomist. Using his plastination techniques, he was the creator of the world traveling exhibition "Body Worlds".
I find that he is a very misunderstood character in the eyes of the public. People think that he is perversely satisfying himself by dissecting cadavers and showing it to the public in the name of Science. Some even say that he is doing the Devil's work. I think that people have always hated the idea of death, so they can't accept it when it is shown to them how it is like.
In these videos, Dr. Gunther, joined by the British Red Cross, will show you how the human body works, how certain injuries can happen, what the injury does to the body, and how to execute emergency actions if it happens. If you cringe at the sight of gore, now is the time to move away from this post. If not, then do enjoy these educational videos.
Have you ever had your finger caught between the door or had your toe hit something really hard before? I did. And I will tell you a little story of mine at the closing stage of this post.
So what is subungual hematoma? It is a common traumatic injury that causes bruising under the finger or toe nail. The capillaries are severe by the traumatic force and sub-dermal bleeding occurs. Just like any other bruises, the injury site has a blackish-blue colouration to it. You will feel a constant sensation of pain as pressure is building up where blood is pooling in a particular area. Usually, mild forms of subungual hematoma will recover without any intervention. The discolouration of the nail bed will slowly, but surely return to normal with time. When it is a severe subungual hematoma, the old nail would most likely detach when the new nail is growing. The old nail then comes off harmlessly.
I am going to teach you, from my personal experience, what are the things you should and should not do when you sustain such an injury.
What you SHOULD NOT do:
Do not rub your injured finger/toe - Friction causes heat, and both friction and heat will cause more capillaries to rupture and severe, potentially aggravating the injury.
Do not place anything warm such as a towel soaked with warm water over the injury, the reason is the same as the above-mentioned.
Do not place further strain on the injured finger/toe. Stop activities such as soccer, heavy lifting, basketball ect. until the injury is healed
Do not perform self-remedies. I know some people do that by heating a sewing needle over fire. When the needle is hot enough, they place the sharp point on the nail, melting the nail and then slightly piercing the nail bed, causing blood to release thus relieving the pressure and pain. Please don't do that. You are not a doctor and you may pierce deeper than you intended to. There is a high possibility that infections may occur if you are a diabetic or you have some type of blood disease which causes your wounds to heal slower than normal.
Do not try to remove your old nail forcefully when the new one is growing. Just let it come off naturally.
What you SHOULD do:
Consult a General Practitioner quickly. There may be lacerations on the nail bed and stitching is required, but for that to happen, the doctor will have to remove the entire nail first. The preferable time-frame is within an hour of the incident. It is because your blood tends to coagulate at the injury site, and that makes things trickier. Speaking from personal experience, I will explain to you why that is a problem later when I do a recollection of my story.
Rest the injured area.
If the injury is at the finger, you may want to raise you arm above the heart level, so that you could sleep better at night. If the injury is at the toe, you may want to place a pillow or two to elevate your leg where the injured toe is, so that the toe doesn't hurt as much when you sleep at night.
Yep, I believe that's my finger. That's subungual hematoma at the index finger of my right hand. Luckily, I am a lefty.
Okay, here's how my story goes...
It was a misfortune that I got my finger caught between the door when I was at a party three months ago. At first, I just felt a sharp pain when the door slammed onto my finger, and the only thing that came to my mind at that moment was a scientific formula: Force = Mass x Acceleration
It didn't hurt much until the next day. My finger got pretty puffy and I was surprised at how quick the entire nail changed colour the next day. The pain was excruciating. On the pain index from 1 to 10, I was at 7, but I still refused to go to the doctor.
For the next 3 nights, I couldn't sleep well as the pain was very pronounced. It was throbbing pain. I could literally count my heartbeats through my injured finger every night. If you thought counting sheep was bad, try counting heartbeats.
The next night, I took it no more. I went to a hospital to get my finger checked as I feared that there may be a hairline fracture in my digit.
At the hospital, they did an x-ray for me. Luckily there was no fracture. I pleaded to the doctor to help me ease the pain by relieving the pressure through a process known as trephination.
Alas, the doctor said that it's too late, my blood has already coagulated. There was no point drilling a hole in it, not much blood would be let out, and so the pressure will still be there.
The doctor had also advised against my second option of pulling the entire nail out because I am a diabetic. Diabetes and wounds don't really rhyme well with each other.
In the end, I decided to go with what the doctor had suggested - let it heal naturally. All he did was give me antibiotics and painkillers. The x-ray, medication and consultation cost me $80. Healthcare in Singapore is very affordable unaffordable.
The story doesn't end there...
The pain completely subsided in about 2 weeks, and I could see my nail has started to detach from the groove and eponychium. I don't know what came over me, I guess it was impatience that day, that I tried to remove the detached nail forcefully with a clipper. I accidentally tore some tissues from the skin bed and it started bleeding like hell. But strangely, I felt no pain from that. So I went back to the same hospital and got it checked, cleaned, and bandaged. I got a good scolding from the doctor as well. I deserved it, anyway. It took me about two months or a little more for my finger to heal and for the new nail to grow to a decent length.
So folks, don't make the same mistakes like I did. Keep safe and good luck. I shall do up Wound Management Part 2 soon, when my grandma gets back home from holiday next week. See you!
A new blood bank is opening soon at Dhoby Ghaut MRT Station. We are really low on all types of blood in Singapore. You can donate blood, blood plasma, and platelets there. :)
By popular demand,I shall do a blog entry about wounds. And since bruises are categorized under "wounds", I will include it in this segment. I know burns are as well, but I will leave that in a separate entry.
I am going to split this into two parts:
Part one covers the circulatory system and the different types of wounds, ranging from common to the not-so-common ones.
Part two covers the different types of dressings, bandages and anti-bacterial products and I will teach you how to use them to treat wounds.
Before we talk about damaged tissues, let's look at the human circulatory system.
Complex network of major arteries and veins connecting to the heart.
See how elegant that system is? It's our circulatory system. It's inside of you and inside of me. Of course that picture does not represent the entire system, it's just the thorax region that is depicted. Believe it or not, if you lay the entire system out and place them in a straight line, it's able to circle the Earth twice.
At the center of it all is the heart. A pump that never requests for a day off (if it does, you will be seriously short-handed). Every beat it makes drives the blood into all our tissues. Close your hand and make it into a fist, that's roughly the size of your heart.
Flanking from the left and the right of the heart, are the lungs. It's not in the illustration above, but they do play a vital role in our circulatory system. Our tissues and organs need oxygen for chemical reactions and regenerations, and that's where the blood draws oxygen from.
Take a good look at the picture above again. Do remember that the blue-coloured network represents the veins, while the red-coloured network represents the arteries. De-oxygenated blood flows through the veins, oxygenated blood flows through the arteries.
Here's how it works, it starts from you taking a mouthful of air. The air travels to your lungs through the Trachea (windpipe), and into microscopic air sacs in the lungs known as Alveolus. Wrapping around these air sacs are the pulmonary capillaries (little tiny blood vessels). That is where the stock-exchange begins. The de-oxygenated blood carries a waste product called carbon-dioxide through the pulmonary artery, then through the pulmonary capillaries, then finally to these air sacs, ready to be transferred and expelled by the lungs through exhalation. At the same time, the blood is also taking in fresh oxygen from the air sacs, making it oxygenated again. It then moves from the lungs and into the heart, ready to be pumped out into the tissues. Sounds confusing? I know...
Here's a video for you to have a better understanding of what I said.
You may also want to know that our blood has to two different shades of red. De-oxygenated blood is dark-red in colour, and oxygenated blood is bright-red in colour. If you happen to be a blood donor or if you have ever gone for a blood-test, you will notice the blood that they draw from you is always dark-red in colour, that's venous blood (blood from the veins). It is never taken from the arteries where oxygen-rich blood is, because your tissues need it to function normally.
Bright-red oxygenated blood on the left, and dark-red de-oxygenated blood on the right.
Before we venture deeper into the world of hurt, let us take a look at how a normal skin tissue looks like.
Every bit as complicated as the circulatory system.
Our skin is the largest organ of the human body (I know some men are going to disagree with that). It has two primary functions - 1) Regulate heat through perspiration. 2) Protect us from infections.
Nature is rarely unintentional. Nearly every part of the body has an intended purpose. Even the hairs on our skin are there to retain body heat when it gets cold, although they don't work as well as a sweater does.
When you mess around with your skin, on purpose or otherwise, the nerves' endings are there to send electrical impulses to your brains, then your brains warn you to stop doing what you are doing through the sensation of pain. At the same time, it releases a chemical called adrenaline to temporarily cope with the pain so that you have enough time to get out from a dangerous situation. See? Many things come with reason.
Now, let us see what are the types of damage that can possibly befall on your birthday suit.
Here is the list:
Contusions (bruises)
Abrasions (grazes)
Incised wound
Lacerations
Avulsions
Puncture/Penetrating wounds
Amputations
Severe contusion (bruising) of the left ankle.
A superficial wound most of the time. Blood vessels are ruptured and severed under the skin. A bruise is formed when blood pools underneath the skin tissue. The pressure exerted by the pooling blood onto the nerves causes the pain. However, the skin is not broken, therefore, this kind of injury has the least possibility of you suffering from an infection.
Abrasion (grazing) of the left elbow.
Another superficial wound, this type of injury is frequently a result from falling and fraction burns. The epidermis is grazed. Dirt and debris are often embedded on and the around the injury site. If those are not cleared away, infection may occur.
Incised wound.
A common clean-cut, linear-patterned injury from sharp objects such as knives, scissors, blades ect. Depending on the length, depth, and area of the cut, it ranges from superficial to severe. Infection will occur if wound is not cleaned properly.
Lacerations.
Tearing in the skin from sharp objects that are irregular in shape or edges such as a barbed wire. This type of injury often carries a real risk of infection.
Avulsion
Often caused by dangerous machinery or explosives, this wound has got skin and tissues torn off and left dangling. It may result in severe bleeding. High risk of infection.
Finger punctured by a nail.
Punctured wounds are often very deep wounds caused by a pointed tip object. These wounds have complications if the object is a rusty metal. Serious risk of infections are expected.
Amputation of the lower left arm.
A part that is totally torn off from the body. Massive bleeding will occur, and the amputee will go into shock due to the blood loss. Infections are to be expected. This is one injury that rushes for time.
We are done with looking at the circulatory system and the types of wounds. In the next part, I will go through the types of dressings, bandages, and anti-infection products, as well as teach you how to use them to treat wounds. Stay tune for part two!
I bought that for a Halloween party last year but did not manage to open and use it. I serendipitously found it lying deep in my cabinet, collecting dust. I have given it a name, it's Gory. Arise from your deep slumber, Gory, you are called into service again. Time for you to be of some use. You folks shall see a lot of Gory for most parts of the dressing and bandaging tutorials. Stay tune!
First-aid is usually performed by a non-expert but trained personnel to provide initial care for injury or illness, using facilities or materials available at the time while waiting for definitive medical personnel to arrive. Eg. Ambulance or Doctors.
Objectives of FIRST-AID
There are some important key points to first-aid.
Preserve life
- Aims to save lives.
- Maintain an open airway whereby air can travel in and out from the nose or the mouth, through the pharynx and to the lungs without any obstruction.(Conscious)
- Perform CPR when casualty is unable to maintain a patent airway.(Unconscious)
- Prepare the casualty to be transported to the nearest hospital.
Prevent further harm
- Prevent complications or prevent condition from worsening; such as moving the casualty unnecessarily as it may cause harm and danger either to the casualty and/or to yourself.
Promote recovery
- Assure the casualty by comforting him/her. Try to relieve pain by treating the injuries with the right techniques in order to maintain the condition of the casualty till definitive medical care arrives.
Please take note that FIRST-AID is NOT Advance Medical Treatment, your knowledge and skills have limitations and responsibilities begin when you start to help the casualty and continue to do so till medical personnel arrive.
Hello everybody. I am
Desmond. Being an avid reader of Medical Science and a first-aider myself, I
have been recently motivated to start a blog about first-aid. My aims are to:
Teach
basic first-aid
Teach you to recognize signs and symptoms
Debunk
popular myths
Review
first-aid products
Provide advice on first-aid
kit setups
Keep you in the loop of
first-aid happenings in Singapore and around the World.
I have
with me in my team, a wonderful lady by the name of Katrina. She is a medic
working for a private ambulance firm. I have invited her over to give us some
valuable advice on first-aid, and I believe her contributions will be most
vital to this blog. Also, not forgetting another important woman in my team and
in my life, she’s my grandma. She was very supportive and was awesome enough to
agree to become my model for First-Aid Kid. We are from Singapore and we hope
to impart our knowledge on the layperson, no matter which corner of the World you come from (because we are all made of the same stuff).
As first-aiders, our key role is to buy as much time as possible for the casualty through early assessment and treatment, until professional help arrives. We will never know when we might need those skills, but it is good to learn and retain these life-long, and life-saving assets.
If you have any doubts, please don't hesitate to ask us through the comments section. We will try our best to answer
your questions in this blog. However, being a first-aider has its limitations –
We are not doctors, not nurses, and not professional EMTs (Emergency Medical
Technician). But we will try to answer your queries to the best of our
knowledge. If need be, I shall do intensive research to satisfy your curiosity.
I welcome suggestions if you have any ideas on how to improve this blog, or if
you have other better first-aid methods about dealing with a particular situation. You
can share them to the public by e-mailing those suggestions to me at
h_m_tong@yahoo.com.sg
Lastly, speaking at a human capacity, I do make mistakes from time to time
(yeah, nobody is perfect). So you are also welcomed to correct me when I make a
mistake. That being said, let’s start learning from each other!
