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Health Talk: Medical Care at Home
Tuesday, October 5, 1999 Home may be where the heart is, but it’s also a prime site for medical care. From burns and scrapes to headaches and sniffles, many health problems are treated at home. How should you be prepared? Barbara Caracci, master trainer for the National Safety Council's First Aid Institute, was our guest for this week's "Health Talk" with host Abigail Trafford. Please read the discussion below. Abigail Trafford:
Hello everybody and welcome to Health Talk. Ever worry what to do if you have an emergency at home? Barbara Caracci is here to advise us on keeping the family medicine cabinet up to date. Send us your questions.
Abigail Trafford: All of us have had a terrifying experience at home when someone gets hurt: a child swallows some pills, a grandmother trips on the rug and falls. We race to the phone. We race to the family medicine cabinet. Today in the Health section, we present what the averal household needs in the medicine cabine. Tell us, Barbara, what are the most common emergencies in the home, and what is essential to have at home in the way of first aid? Barbara Caracci:
Falls are the most common cause of injury in the home, followed by poisoning and burns. Last year, 28,000 people died and 6,800,000 were injured in home incidents. Family members should be prepared to handle these and other emergencies by having the number of the poison control center close to the phone and by having first aid training and a first aid kit available.
Abigail Trafford: The experts recommend having on hand some syrup of ipecac to induce vomiting. What if you don't have ipecac and need to make a person throw up? Is there an alternative. Barbara Caracci:
First, be sure the poison control center WANTS you to induce vomiting. If they do, vomiting must be induced within 30 minutes. Activated charcoal is the most effective for most swallowed poisons. It keeps the poison in the digestive system. So, if you can't induce with syrup of i, bind with activated charcoal.
Woodbridge, VA: I have a three year old at home who is still rather clumsy. What are the best things to keep around the house when she does get cut, bruised etc.? Also, how do you truly know if an ER trip is necessary? Trying to get an idea of how much it hurts or where is difficult at 3 or younger. Barbara Caracci:
Minor cuts should be washed with soap and water--not necessarily anti-bacterial soap! Generally, small abrasions (scrapes) and cuts should be washed and covered with a band-aid. Neosporin can be used for minor cuts and scrapes to keep the bacterial down to a level your body can manage. Even tho your caretaker probably did this for you, NEVER breath on or kiss a wound. You'll end up putting more bacteria on it.
Arlington, VA: I heard once that storing medicine and drugs in the bathroom is problematic because of the steam from the shower. Is that true? Barbara Caracci:
That's not just an old wives tale — it's true. Keep medicines out of steamy areas. When in doubt, ask the pharmacist about storage.
Washington, DC: Is medicine that has expired really bad for you? Will it hurt to take it? Abigail Trafford: And will the medicine not do any good?
Barbara Caracci:
Prescriptions that are given for an illness should be taken until they are gone or your doctor tells you to stop taking them. Throw away old RXs. Sometimes effects from an old RX could interfere with medications you currently are taking. Sometimes, a synergistic effect occurs--the effects of multiple drugs (cold remedies that are over-the-counter plus old RXs) are greater than the effects of either drug alone.
Abigail Trafford: What kinds of nonprescription drugs should you have on hand? What are they for? Barbara Caracci:
Ibuprofen is a good general over-the-counter remedy to keep on hand. Examples are ADVIL and NUPRIN. These not only reduce fever and pain but also reduce inflamation. For children, acetaminophen (Tylenol) relieves/reduces fever and pain--not inflamation. For minor cuts and burns, neosporin or bacitracin also is good to keep on hand.
Abigail Trafford: Let's say a couple has come to dinner and the woman, about 45, slips on the stairs and has a bad fall. What's the best first aid I can give? Is it true that you should never try to move someone out of fear of injuring the back and causing paralysis? Barbara Caracci:
Falls from one level to another result in many fractures and, sometimes, result in spine injury. The best first aid you can give is to establish responsiveness (Shout, "Are you O.K.?) and, depending on the response(e.g., "I can't feel my legs", either phone 911 or ask someone else to phone. If the person is not responsive, you MUST check to be sure they are breathing. Roll the body as a unit, protecting head and neck, then check for breathing. You can learn to do this in a standard first aid course. If the person IS responsive (they can speak--therefore they are breathing!), ask them for symptoms (does anything hurt) and look for deformity, tenderness and swelling. If any are presented, isolate the area and transport to the ER for testing and evaluation.
Abigail Trafford: What about vitamins and minerals. Are they potentially harmful if children get into the multi-vitamin bottle? Barbara Caracci:
It's the iron that is particularly dangerous to children. They are unable to metabolize the iron and, as a result, it builds up in the liver, causing damage. Again, the poison control center is your best bet for advice on how to handle this.
Rockville, MD: Hi Abigail: It's that time of year again. Kids in school and those little bugs (lice) that follow them home. What is the best stuff on the market to get rid of them and keep them away. Also, would you tell people that having lice doesn't necessarily mean your child is dirty or doesn't have good health habits? Just putting on someone else's hat or using a comb can bring on a nasty case, right? Abigail Trafford: My daughters had lice, so I know how you feel! Last month the Health section had a review of treatments for lice written by Dr. Jay Siwek, who writes a weekly column for us. Some of the leading treatments:
Barbara Caracci:
While this is often a parent's concern, it's really not FIRST AID. Your best to see your family physician.
Washington, DC: Should your emergency supply kit or medicine cabinet have anything special if you have kids around the house or are the supplies needed basically the same? Barbara Caracci:
Believe it or not, the supplies you need for children are basically the same as those you'll need to treat adults.
Alexandria, VA: Barbara, what safety items should you keep in your car? I have a blanket and flares, but is it a good idea to keep a small kit? Barbara Caracci:
Great question! Most injuries that you'll ever encounter will occur as a result of motor vehicle crashes. A blanket and flares are a good way to begin (triangles are better than flares), but a stocked first aid kit kept in the trunk will fill out your preparations. Be sure that your kit has a CPR shield or face mask, in case you need to help a non-breathing victim. Also, be sure to have latex or vinyl exam gloves to prevent yourself from bloodborne pathogens. Several gauze dressings of various sizes (4X4, 3X3) will help if there is bleeding.
Abigail Trafford: Are there any ready-made first aid kits that you would recommend? Do they supply all the basics that you need? Barbara Caracci:
A great all-around first aid kit is made by Allegiance Health Care. It's called the ER Kit. I like it because it contains envelopes for each type of first aid need which contain the items you need to treat the injury (breathing, bleeding, burns, etc.) and a handy picture/narrative description on how to handle the injury.
Abigail Trafford: And when you go on vacation, should you take a little medical kit, too? Barbara Caracci:
Absolutely! No one can plan when an injury will occur. Best to have it and not need it than to need it and not have it. Remember, first aid can mean the difference between a quick and a long recovery, between life and death.
Columbia, MD: I'm confused. Which injuries should you put heat on and which should be treated with ice or a cold pack? Barbara Caracci:
Think about what you want to happen. For sprains and strains, you want the swelling to go down, hence the use of cold for the first 24 to 48 (yes, you read that right) hours. Then afterwards, you want to increase blood flow to accelerate healing, hence the hot pack (for the next 12-24 hours). When in doubt, just remember what you are trying to accomplish.
Washington, DC: Once an injury is determined to be serious, under what circumstances would you recommend transporting someone to an ER yourself, and when is it time to call the ambulance? Barbara Caracci:
The ambulance always will get to the ER faster — and more safely — than you can. For true emergencies, always call 911 or the 7-digit number for your area. Be the last to hand up, as the dispatcher may need information only you can give.
Abigail Trafford: In most houses, the medicine cabinet is indeed in the bathroom, usually above the sink. If that's not good for supplies, where should the medicine cabinet go? Barbara Caracci:
Try to locate medicines in an area like the kitchen, preferable in a high cabinet so little ones can't reach. It's a good idea to keep a jar with a paper explaining what RXs you're taking as well as their location(s) in the refrigerator. Paramedics are trained to look in the refrig for just such an inventory.
Arlington, VA: Are there any simple guidelines for emergencies on when you shouldn't try to treat something yourself and should instead seek expert advice at the doctor or hospital? Barbara Caracci:
In these instances, calling the emergency medical system is definately the right thing to do: severe bleeding (1/2 cup in infants, 32 ounces in adults); drowning; electrocution; possible heart attack; breathing difficulty or no breathing at all; choking; altered mental status (shows the brain lacks oxygen); poisoning; attempted suicide; critical burns; paralysis; spine injury; imminent childbirth.
Bethesda, MD: What's the best way to stop a nosebleed? Barbara Caracci:
If it's your nose that is bleeding, pinch it between your thumb and index finger as you lean slightly forward. Hold this for about 10 minutes (most nose bleeds will stop well before this time.) If it's someone elses nose, either coach them through with this info or, if you have to do this for them, don your latex gloves and follow this procedure. NEVER put the head back — to do so invites choking.
Fairfax, VA: Is it a good idea to use antibacterial ointment on wounds routinely? I always use it when my daughter has a cut or scrape. Is one ointment better than the other. There are a lot of them on drug store shelves. Barbara Caracci:
Many choices, same result. Choose one that you feel confident about. They're all pretty much the same. Using them for MINOR cuts and scrapes is absolutely the right thing to do as it promotes healing by reducing bacteria at the site of the wound to an amount that the body can "fight."
Arlington, VA: I was told recently that many headaches are caused simply by dehydration, and that it's not the Advil that makes you feel better, but the glass of water you drink with the pills. I've tried just drinking a couple of glassses of water whenever I have a headache, and it does seem to work. Is this just an old wives' tale, or does it have some basis in fact? Abigail Trafford: Wow. . . Barbara?
Barbara Caracci:
Headaches have multiple causes and can't always be "cured" with a glass of water. Signs of dehydration include a feeling of thirstiness, infrequent urination and extremely yellow urine when you do go. We all should dring plenty of water (8 - 10 glasses/day) to keep well hydrated. Don't stop taking the ADVIL — it really may be what is helping the headache!
Abigail Trafford: Here's a typical story: a six-month old infant falls out of his parents bed and on to the floor. He screams and his face is bruised. Should babies who hurt their head ALWAYS be taken to the doctor to be checked out? Barbara Caracci:
A baby who has fallen has experienced trauma. It is best to give the doctor a call to see whether the child should be seen. This is a case where the MD — not the paramedics — should be called.
Alexandria, VA:
What is the best remedy for digestive disturbances e.g., vomiting-diarrhea. When the acute stage is over, what's the best way to rehabilitate the body quickly?
Barbara Caracci: When vomiting and diarrhea occur, dehydration becomes a real possibility. Electrolytes are lost. The best thing to do is rehydrate and replace those electrolytes, using some brand of sports drink such as Gatorade.
Abigail Trafford:
Thank you Barbara for your wonderful advice. I feel much better. Especially about the nose bleed! Thank you all for your questions. Our subject next week is LASIK surgery--the surgery with a laser on the eyes. People say they love the results. But one percent have complications, and there are a lot of questions about what happens after ten or fifteen years. Is this surgery for you? Join us next week, same time, same place.
© Copyright 1999 The Washington Post Company |
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