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First Aid for the Festive Season

Dr Tony Laffan - GP

Nose Bleeds

What is the correct way to treat?

Sit with head tilted forward and squeeze the nose on the soft part just below the bony part, so you have to breathe through your mouth.

What are the common misconceptions?

Do not tilt head back, or lie down. Doing either allows blood to drip back into the throat and so causing you to cough, which increases the blood pressure in your head and neck and so make it more likely to re-bleed. Also, if you sit up the blood pressure in your nose will be lower than if you lie down.

When should you go to A & E with a nose bleed?

After about 15 minutes if the bleeding is not stopping. Or if you lose so much blood you become unwell...


What is the correct way to treat?

Call 999!
Always remember to bring the poison, or container, even if only suspected poisoning, to hospital with you - the reason is that different poisons are treated differently and having the exact ingredients means we can treat correctly and quickly.

If seen within 1hour we often can get the poison while still in the stomach and reduce the likely damage.
Do not make the person vomit, do not encourage drinking water.


What is the correct way to treat?

If the person is coughing, encourage them to keep coughing! If they can cough it means that air is getting into their lungs, so they are relatively safe, and coughing is the best way to clear out the bit of food (or whatever).

However if they are truly choking, they will not be able to talk or cough and will almost always put their hands up around thier neck in the universal 'i'm choking'

In this case the airway is blocked and you have to act fast. One should go straight for the heimlich manoeuvre (common misconception is to slap on the back as a first response - new evidence rejects this
option) - the manoeuvre can be repeated in cycles of 5 times as necessary till the piece of food comes out.

Minor Lacerations

How to deal with a carving knife cut?

Stop the bleeding apply a clean bandage to the area and press down on it for up to 10 minutes. Clean the wound under a tap for 10 to 15 mins. Do not scrub deep wounds, just wash them out. Antibiotic ointment and a sterile plaster/gauze will protect it till a scab forms.

When a cut needs medical attention?

Any laceration greater than 1/2-inch long that is through all layers of the skin exposing the underlying fat needs to be seen by a doctor. Or if you cannot stop the bleeding, If you think that there may be something in the wound such as glass or metal, if you cannot move your finger or toe in the area of the laceration, or you have lost sensation in the area beyond the laceration.

Check you have had a tetanus shot in the last 10 years.
In the following days, a little redness directly at the edges of the cut is normal and healthy as the body heals itself. However, any yellow pus draining from it, or any redness extending away from the cut are important signs of infection and you need to see a doctor.

What do we need in the first aid kit to show how to dress it?

Antibiotic ointment like a dettol cream, and a selection of plasters and some sterile gauze dressings. Also we'd need a box of disposable examination gloves (non-sterile are fine), size large.

Minor Burns and Scalds

Can some small burns can be dealt with at home?

Yes, like touching the element while taking the turkey out but large burns or burns involving the face or a joint should be seen by a doctor. To treat, rinse under a tap for 10 mins to cool the skin and remove any dead skin. Then spread on antibiotic ointment (this seals out infection) and cover with a gauze and bandage. Rinse and change ointment/dressing twice a day till it scabs over. Go see a doctor if pain gets worse, if it swells or it starts to release pus - it could be infected.

And scalds are more tricky?

They often cover a larger area, and the threshold for going to A & E should be much lower. In children this is obviously non-negotiable - go straight to A & E! Treatment is essentially the same as above for small scalds however.
In the hospital we use a great cream called flamazine. Gauze dressings as above. Roll of bandage and tape to secure it.

Sprained Ankle

What is the correct way to treat?

This one is straight out of the physio handbook, we use the acronym... we advise the person to manage their injury using PRICE

Protection - protect from further injury (e.g. by using a support or high-top, lace-up shoes).

Rest - avoid activity for the first 48-72 hours following injury and consider the use of crutches.

Ice - apply ice wrapped in a damp towel for 15-20 minutes every, 2-3 hours during the day for the first 48-72 hours following the injury. Do not leave ice on while asleep.

Compression - with a simple elastic bandage or elasticated tubular bandage, which should be snug, but not tight. Remove before going to sleep.

Elevation - advise the person to rest with their leg elevated and supported on a pillow until the swelling is controlled, and to avoid prolonged periods with the leg not elevated.

Advise the person to avoid HARM in the first 72 hours after the injury:

Heat (e.g. hot baths, saunas, heat packs).

Alcohol (increases bleeding and swelling and decreases healing).

Running (or any other form of exercise which may cause further damage).

Massage (may increase bleeding and swelling).

Use analgesia if necessary.